USMLE Step Procedure
Rationale
Learners are required to pass Step 1 and Step 2 Clinical Knowledge (CK) of the United States Medical Licensing Exam (USMLE) prior to graduation. This policy ensures that each exam is taken in a timely manner and that learners are prepared for these exams.
Scope
This procedure covers timelines, remediation practices, and promotion requirements regarding USMLE Step 1 and Step 2 CK.
Definitions
Clinical Correlations Seminar (CCS): Remediation Course for USMLE Step 1 (8 weeks). The Course description can be found in the catalog on the Office of Medical Education website.
Clinical Application and Practice Seminar (CAPS): Remediation Course for USMLE Step 2 CK (2 weeks). The Course description can be found in the catalog on the Office of Medical Education website.
BSOM: Brody School of Medicine
Responsibilities
All Medical Learners
- Learners are recommended to utilize the resources available in the Office of Student Success and Wellness (OSSaW) to assist in their preparation for USMLE exams.
- Learners are required to pass both USMLE Step 1 (“Step 1”) and Step 2CK (“Step 2”) exams prior to graduation from BSOM. Progression to the M3 year is contingent on passing Step 1. Learners who receive passing scores after their scheduled May graduation date will be considered for the next available diploma date.
- Learners are allowed a maximum of three (3) attempts at each of the USMLE exams. Failure to pass a single USMLE exam after three (3) attempts will result in a recommendation for dismissal from the BSOM.
M2 Learners
- Learners must complete and submit all Step 1 registration paperwork to the BSOM Office of Student Affairs no later than the 1st Friday after returning from Winter Break.
- Prior to taking Step 1, all academic requirements of the M1 and M2 curriculum, including any necessary remediations, must be completed.
- Learners must take Step 1 no later than the date set by the Offices of Medical Education and Student Affairs at the start of the academic year. This date will generally fall in the first or second week of March.
USMLE Step 1 Study Time Extensions
- It is expected that all learners take Step 1 by the year-specific deadline. In very limited extenuating circumstances, a learner may petition the M1/2 Review and Promotion (R&P) Committee for an 8-week study extension. In those cases, the learner must meet with the Associate Dean for Student Affairs, Foundational Sciences no later than 3 days before the year-specific Step 1 deadline.
- A learner requesting an 8-week study extension must present evidence of extenuating circumstances to the M1/M2 R&P Committee. In addition to these extenuating circumstances, the M1/2 R&P will heavily consider a learner’s active, ongoing engagement with OSSaW. A learner must also present the following data as evidence of readiness to successfully prepare for and pass Step 1:
- An NBME Comprehensive Basic Science Self-Assessment (CBSSA) at an Equated Percent Correct (EPC) of 50 or above prior to the standard Step 1 deadline. All CBSSAs must be taken at standard time and not self-paced.
- If a learner does not achieve an EPC of 50 or above on a CBSSA prior to the standard Step 1 deadline, they will either re-enter Block 4 or be placed on an academic leave of absence until the start of the next academic year.
- If a learner is approved for an 8-week study extension, they will be allowed to take Step 1 only if they have a CBSSA with an EPC of 65 prior to the study extension testing deadline (determined on a year-to-year basis). If this CBSSA EPC goal of 65 is not met, the learner will not be allowed to take Step 1 and must either re-enter Block 4 or be placed on an academic leave of absence until the start of the next academic year. All CBSSAs must be taken at standard time and not self-paced.
- A learner must take AND pass Step 1 prior to end of the 8-week study extension. If a learner does not take Step 1 or is unsuccessful on their attempt, they will either re-enter Block 4 or be placed on an academic leave of absence until the start of the next academic year.
- Any learner who takes an 8-week study extension will sign an acknowledgment that this extension will limit 4th year non-clinical elective time and scheduling flexibility and harm subspecialty competitiveness in the residency match process.
Learners with USMLE Step 1 Failure(s)
- If a learner fails the first attempt of Step 1 and took Step 1 by the posted deadline for that academic year, they will be removed from their Cohort 1 clerkship and enrolled in the Clinical Correlations Seminar (CCS).
- The CCS Course description can be found in the catalog on the Office of Medical Education website. Failure to comply with CCS syllabus requirements and assignments may result in referral to the Professionalism and Community Standards Committee, the year-specific Review and Promotion committee, or further disciplinary action.
- This course will be graded as pass/fail and will be recorded on the learner’s official transcript.
- This learner must take AND pass USMLE Step 1 prior to the end of CCS in order to start their M3 clerkships in Cohort 2.
- If this learner successfully passes their second attempt at USMLE Step 1, they will enter their Cohort 2 clerkship and complete their originally scheduled Cohort 1 clerkship after the completion of Cohort 6.
The 8 weeks of CCS will be deducted from their 8 weeks of non-clinical elective time in the M4 year.
- If this learner fails their second attempt of Step 1, they will be placed on an academic leave of absence and withdraw from their M3 year. They then must successfully pass Step 1 prior to the start of M3 Orientation.
- Any learner unsuccessful on their second attempt at USMLE Step 1 may be permitted a third attempt. This third attempt must be approved by the M1/2 Review and Promotion Committee. Learners are required to present their situation to the Review and Promotion Committee, with the assistance of the Associate Dean for Student Affairs, Foundational Sciences.
Learners who are unsuccessful after their third attempt at USMLE Step 1 will be recommended for dismissal from the Brody School of Medicine.
M3/M4 Learners
- Learners must complete the application for USMLE Step 2 CK by May 31st of their M4 year.
- Learners must complete their first attempt at Step 2 no later than September 1 of their M4 year.
- Learners must take AND pass Step 2 prior to starting any leave of absence between M3 and M4 years.
Learners with USMLE Step 2 CK Failure(s)
- Passing USMLE Step 2 is a requirement for BSOM graduation.
- Learners unsuccessful in their first attempt at USMLE Step 2CK will be required to enroll in the CAPS course, either as an independent elective or concurrently with another elective during the same period.
Learners must complete their second attempt at Step 2 no later than February 1 of their M4 year.
- Learners unsuccessful on their second attempt at USMLE Step 2 CK may be permitted a third attempt. This third attempt must be approved by the M3/4 Review and Promotion Committee. Learners are required to present their situation to the Review and Promotion Committee, with the assistance of the Associate Dean for Student Affairs, Clinical Sciences.
- Learners must complete their third attempt at Step 2 no later than the Friday after Match Day of their M4 year.
- Learners who are unsuccessful after their third attempt at USMLE Step 2 will be recommended for dismissal from the Brody School of Medicine.
- If a learner is unable to meet any of the deadlines associated with USMLE Step 2, they must meet with the M3/4 Review and Promotion Committee to discuss potential barriers and solutions. Failure to meet these deadlines may be considered a professionalism concern and may result in a report to the Professionalism and Community Standards Committee.
Clinical Application and Practice Seminar (CAPS)
- The CAPS Course description can be found in the catalog on the Office of Medical Education website.
- This course will be graded as pass/fail and will be recorded on the learner’s official transcript.
- Failure to comply with CAPS syllabus requirements and assignments may result in referral to the Professionalism and Community Standards Committee, the year-specific Review and Promotion committee, or further disciplinary action.
Review and Promotion Committee
The M1/2 Review and Promotion Committee is responsible for notification of learners at risk for failing USMLE Step 1. The M3/4 Review and Promotion Committee is responsible for notification of learners at risk for failing USMLE Step 2.
Both Committees are responsible for: tracking deadlines associated with this policy, communicating with learners, and working with the Associate Dean for Medical Education and the Office of Student Success and Wellness to understand which learners are at risk.
Associate Dean for Medical Education
The Associate Dean for Medical Education is responsible for working with the Promotion and Review Committee to identify learners who are at risk for failing USMLE Step 1. They will provide guidance to the learner body and work with the Office of Student Success and Wellness to determine and communicate readiness and optimal exam timing.
Associate Deans for Student Affairs
The Associate Deans for Student Affairs will meet with each learner who fails any USMLE exam to explain the BSOM procedures and assist them with their clerkship schedule and meetings with the year-specific Promotion and Review Committee.
Procedures for Implementation and Review
This procedure is to be reviewed by the M1-M4 Curriculum Committees before approval by the Executive Curriculum Committee every three years.
This procedure will be disseminated by the Office of Student Affairs to students and teaching faculty/administration.
Related Policies
11.1
Applicable Laws, Regulations & Standards
LCME Standard 9, Element 9