Changes to the USMLE for 2014 and 2015

Changes aheadSince 1992, the USMLE has provided licensing authorities with a common evaluation system to assess an applicant’s ability to apply their current medical knowledge within the confines of a standardized test. Evolution in medicine and medical education bring about changes which affect the Step 1, Step2 and Step 3 examinations.

USMLE Step 1

USMLE Step 1 minimum passing score change

The Step 1 Committee is scheduled to review the minimum passing score for the USMLE Step 1 examination at its meeting on December 9-10, 2013.

If the Committee determines that a change to the minimum passing score is appropriate, the new recommended minimum passing score will become effective for all examinees who take a Step 1 examination on or after January 1, 2014. The decision of the Step 1 Committee will be posted on the USMLE website.

USMLE Step 1 content changes

In 2014 and 2015, students will see an increased focus on quality improvement principles and safety science as well as a broadened focus on competency. Additionally, Step 1 will continue to focus on traditional content areas in the basic sciences within a clinical context.

USMLE Step 2 Clinical Knowledge (CK)

In 2014 and 2015, students will see an increased focus on quality improvement principles; safety science; epidemiology, biostatistics, and population health; professionalism; and interpersonal and communications skills. Various format changes are under development and if there are changes, they will be described on the USMLE site.

Step 2 CK will continue to focus on patient care and diagnosis.  The format will not change as it will still be computer-based multiple-choice questions.

USMLE Step 2 Clinical Skills (CS)

 USMLE Step 2 CS communication skills assessment pilot

The USMLE is currently working on pilot programs that will enhance the assessment of communication skills.  If these pilot programs are successful, Step 2 CS will introduce these enhancements to the exam no earlier than 2015.

USMLE Step 2 CS patient information gathering

Step 2 CS will continue to focus on examinees’ ability to gather information from patients, perform physical examinations and be able to communicate findings to patients and colleagues.

USMLE Step 3

USMLE Step 3 scheduling changes

Starting November 2014 examinees will no longer need to apply for Step 3 under any state’s specific eligibility requirements.  Examinees will be able to schedule the two-day exam on non-consecutive days, each day consisting of a maximum of 8 hours of testing. Step 3 will include increased numbers of items that assess an expanded range of competency-based content, including foundational science essential for effective healthcare; biostatistics, epidemiology, and population health; literature interpretation; medical ethics; and patient safety.

The 2 days of exams will consist of Step 3 Foundations of Independent Practice (FIP) and Step 3 Advanced Clinical Medicine (ACM).

USMLE Step 3 Foundations of Independent Practice (FIP)

FIP - This test day will focus on assessment of knowledge of foundational medicine and science essential for effective health care. Content areas covered will include applying foundational sciences; biostatistics, epidemiology/population health, and interpretation of the medical literature; and social sciences, including communication and interpersonal skills, medical ethics, and systems-based practice/patient safety. The test day will also include some content assessing knowledge of diagnosis and management. This test day will consist solely of multiple-choice questions and will include some of the newer item formats, such as those based on scientific abstracts and pharmaceutical advertisements.

USMLE Step 3 Advanced Clinical Medicine (ACM)

ACM - This test day will focus on assessment of applying comprehensive knowledge of health and disease in the context of patient management. Content areas covered will include assessment of knowledge of history and physical examination, diagnosis and use of diagnostic studies, prognosis/outcome, health maintenance/screening, therapeutics, and medical decision-making. This test day will include both multiple-choice questions and computer-based case simulations.

Things to keep in mind:

  • Registration for the current Step 3 examination will end July 31, 2014.
  • Registration for the restructured Step 3 examination will start August 2014.
  • No Step exams will be administered during the month of October 2014.
  • The will be a substantial score delay following the introduction of the restructured Step 3 exam in November 2014.  The delay will be determined by the volume of students taking the exam.
  • USMLE is expecting the first set of scores to be released the first week of April 2015 for the students taking the exam on November 2014.


About DIT Advising Team

The Doctors In Training Student Advising Team offers many advisory services including the following: customizing individual study plans for USMLE Step 1/ COMLEX Level 1 or USMLE Step 2 CK/ COMLEX Level 2, advising students with respect to combating everyday stress and test anxiety and preparing students for the residency application process.
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