As a new or future medical student, you may have heard some talk in recent years about changes that were made to the United States Medical Licensing Examination (USMLE) Step 1. The exam was created to evaluate your mastery of the basic science concepts that are required of those who practice medicine. It is considered a critically important step in your journey toward becoming a physician.

With so much on the line when it comes to achieving a USMLE Step 1 passing score, it’s important to stay up to date on what’s happening with the exam. Check out the summary of these USMLE Step 1 changes below.

Changes to the USMLE Step 1

The recent shifts to the USMLE Step 1 were the product of a regular review of the licensing exam. A comprehensive analysis of each Step exam typically occurs every three to four years. This ensures that passing standards and other elements remain consistent with the expectations of the level of content mastery needed to support effective medical licensure and practice.

There have been two prominent changes to USMLE Step 1 processes in recent years:

Changes regarding USMLE Step 1 retakes

The first change that went into effect had to do with the number of Step 1 exam retakes each student is allotted. The USMLE Management Committee determined that medical students should only be able to sit for the Step 1 exam four times; the previous limit was six.

This shift was implemented in 2021, and it was put into place with the goal of protecting the integrity of the exam and to more closely resemble the attempt limits put in place by state medical boards.

Changes regarding USMLE Step 1 scoring

The USMLE Management Committee also elected to shift the Step 1 exam to a pass/fail scoring system — a distinct change from the numerical scoring system used previously. In addition, the passing standard was increased by two points, shifting from 194 to 196.

This change went into effect in 2022, and it was made in part to lessen the emphasis on USMLE Step 1 scores in residency selection. The aim was to help ensure that students have the opportunity to be considered more holistically for residency placements.

Although there hasn’t been evidence to support the effectiveness of the USMLE Step 1 exam in predicting residency success, a high Step 1 score has long been a critical factor in landing competitive residency interviews. It was found, however, that medical students’ stress levels and overall well-being were negatively impacted by the historical importance placed on their Step 1 results.

It’s important to note that the exam content has remained unchanged. The USMLE Step 1 is still designed to identify physicians who can be safely licensed to practice medicine, and it remains an eligible indicator for medical competency at this stage of a medical student’s training.

Prepare for the USMLE Step 1 with confidence

These recent USMLE Step 1 changes don’t alter the fact that medical students must prepare extensively if they hope to perform well on the exam. It’s important to lay the groundwork for a passing score by beginning your USMLE studies early.

For more information on how you can be effective in your preparation, check out our article “How to Study for Step 1: Tips for USMLE Success.”