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September 2, 2020

USMLE Step 1 Scoring System Change to Pass/Fail—Implications for International Medical Graduates

Author Affiliations
  • 1Division of Vascular Surgery, Penn State Heart and Vascular Institute, Penn State Hershey College of Medicine, Hershey, Pennsylvania
  • 2Division of Vascular Surgery, Loyola University School of Medicine, Chicago, Illinois
JAMA Surg. 2020;155(12):1098-1099. doi:10.1001/jamasurg.2020.2850
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    1 Comment for this article
    Another Unintended Consequence of the Step 1 change to Pass/Fail
    Marcel BRUSRAMER, MD PhD | Elite Medical Prep LLC
    The authors highlight potentially important effects of chaning the Step 1 exam to Pass/Fail. The challenges that foreign medical graduates (FMG) face, particularly those that are not US citizens or greencard holders, to match into a residency in the US are significant. Objective, though imperfect, scoring systems such as the USMLE Step 1 have likely helped FMGs to attain their training positions in the US.
    Although the increasing emphasis on the USMLE Step 1 among US medical graduates (and FMGs) over the past 20 years has affected medical education, it is unclear that switching to
    a Pass/Fail grading system will really benefit even the US medical graduates. Earlier this year, I outlined a series of likely downstream effects from this change: https://elitemedicalprep.com/how-usmle-step-1-going-pass-fail-will-affect-medical-school-curricula/
    I believe that the change in scoring may have dramatic effects on medical school class and clinical schedules and potentially negative effects on medical student participation and engagement in clinical rotations. The underlying assumption is that the Step 2 CK exam and the associated clinical Shelf exams will rise in importance, so much so that they may overwhelm any expected benefits in reducing excessive emphasis on USMLE Step 1 material and reducing student stress.
    CONFLICT OF INTEREST: President of Elite Medical Prep LLC