What if the United States Medical Licensing Examination (USMLE) Step 1, the test developed by the National Board of Medical Examiners (NBME), for which every medical student has studied diligently since the 1990s, was no longer released with a numeric score, but rather taken as pass/fail?
Explore this issue:April 2019
The journal Academic Medicine recently published an invited commentary in which six medical students from across the country suggested just that (Acad Med. 2019;94:302–304). Their article was published along with a response from Peter Katsufrakis, MD, MBA, president and CEO of the NBME, and Humayun Chaudhry, DO, MS, president and CEO of the Federation of State Medical Boards (FSMB) (Acad Med. 2019;94:305–308).
The student commentary described a negative academic climate to which they said the exam was contributing, a climate increasingly addled with competition and anxiety over matching into competitive subspecialties, as well as a stigma for those choosing to specialize in less competitive areas, such as primary care (the assumption being that they didn’t score high enough on Step 1 to have better choices).