The recent decision by the National Board of Medical Examiners to change the United States Medical Licensing Examination (USMLE) Step 1 examination from score-based results to pass/fail has mostly been hailed by medical experts and many prominent experts in the field of medical education. The points that have been raised in favor of these changes include creating a less stressful examination, cost savings by avoiding the need to attend costly private examination preparation courses, and the fact that multiple choice questions can only determine the depth of medical knowledge and is not able to evaluate the broader areas of medical education. It is vital to consider the long-term implications of this decision. Both of us are international medical graduates (IMGs) and program directors who feel that it is essential to hear a different perspective. We each have firsthand experience of coming from foreign countries with different education and examination systems and then taking examinations based on multiple choice questions to qualify for certification by the Educational Commission for Foreign Medical Graduates.
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Aziz F, Bechara CF. USMLE Step 1 Scoring System Change to Pass/Fail—Implications for International Medical Graduates. JAMA Surg. Published online September 02, 2020. doi:10.1001/jamasurg.2020.2850
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