What Do Medical Students Think About a Pass/Fail USMLE Step 1? A Survey of 18 Allopathic Schools

Purpose The United States Medical Licensing Examination (USMLE) Step 1 exam changed from a 3-digit score format to pass/fail in 2022. The current study aimed to examine how medical students perceive this change, factors associated with those perceptions, and determine their preferred exam scoring fo...

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Main Authors: Shankar S Thiru, Rachel E Cherelstein, Scott M Feeley, Scott J Halperin, Sarah Lucas, Christopher M Kuenze, Edward S Chang
Format: Article
Language:English
Published: SAGE Publishing 2025-05-01
Series:Journal of Medical Education and Curricular Development
Online Access:https://doi.org/10.1177/23821205251337125
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author Shankar S Thiru
Rachel E Cherelstein
Scott M Feeley
Scott J Halperin
Sarah Lucas
Christopher M Kuenze
Edward S Chang
author_facet Shankar S Thiru
Rachel E Cherelstein
Scott M Feeley
Scott J Halperin
Sarah Lucas
Christopher M Kuenze
Edward S Chang
author_sort Shankar S Thiru
collection DOAJ
description Purpose The United States Medical Licensing Examination (USMLE) Step 1 exam changed from a 3-digit score format to pass/fail in 2022. The current study aimed to examine how medical students perceive this change, factors associated with those perceptions, and determine their preferred exam scoring format. Design and Methods A cross-sectional survey of US medical students was distributed from March through June 2024. The survey gathered data including demographic and school information, desired specialty, research involvement, and Step 1 scoring preference. Results The survey was completed by 192 students from 18 different US allopathic schools. Of students surveyed, 65.5% preferred pass/fail scoring, while 34.5% preferred a 3-digit-score format. Older age increased likelihood of preferring a 3-digit score (β = 0.345, P  = .047, odds ratio [OR] 1.41). A later graduation year decreased the likelihood of preferring a 3-digit score (β = −0.576, P  = .020, OR 0.56). Gender (β = 0.293, P  = .320, OR 1.34), specialty competitiveness (β = −0.095, P  = .776, OR 1.10), and research productivity (β = 0.0047, P  = .990, OR 1.00) had no significant effect on Step 1 scoring preference. Conclusion Medical students seem to prefer a pass/fail Step 1 regardless of gender, desired specialty and research productivity. However, pass/fail preference differed by graduating class year and age, with younger class years and students preferring pass/fail. While prior literature largely surveyed preference among medical educators, student sentiment on Step 1 scoring supports recent changes to the USMLE Step score format.
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spelling doaj-art-ae427dac62ec4a618412dca524dec8b22025-08-20T02:57:47ZengSAGE PublishingJournal of Medical Education and Curricular Development2382-12052025-05-011210.1177/23821205251337125What Do Medical Students Think About a Pass/Fail USMLE Step 1? A Survey of 18 Allopathic SchoolsShankar S Thiru0Rachel E Cherelstein1Scott M Feeley2Scott J Halperin3Sarah Lucas4Christopher M Kuenze5Edward S Chang6 , Washington, DC, USA Miller School of Medicine, University of Miami, Miami, FL, USA Department of Orthopaedics, , Bethesda, MD, USA Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT, USA Department of Orthopedics, , Washington, DC, USA Department of Kinesiology, University of Virginia, Charlottesville, VA, USA School of Medicine, University of Virginia, Inova Campus, Falls Church, VA, USAPurpose The United States Medical Licensing Examination (USMLE) Step 1 exam changed from a 3-digit score format to pass/fail in 2022. The current study aimed to examine how medical students perceive this change, factors associated with those perceptions, and determine their preferred exam scoring format. Design and Methods A cross-sectional survey of US medical students was distributed from March through June 2024. The survey gathered data including demographic and school information, desired specialty, research involvement, and Step 1 scoring preference. Results The survey was completed by 192 students from 18 different US allopathic schools. Of students surveyed, 65.5% preferred pass/fail scoring, while 34.5% preferred a 3-digit-score format. Older age increased likelihood of preferring a 3-digit score (β = 0.345, P  = .047, odds ratio [OR] 1.41). A later graduation year decreased the likelihood of preferring a 3-digit score (β = −0.576, P  = .020, OR 0.56). Gender (β = 0.293, P  = .320, OR 1.34), specialty competitiveness (β = −0.095, P  = .776, OR 1.10), and research productivity (β = 0.0047, P  = .990, OR 1.00) had no significant effect on Step 1 scoring preference. Conclusion Medical students seem to prefer a pass/fail Step 1 regardless of gender, desired specialty and research productivity. However, pass/fail preference differed by graduating class year and age, with younger class years and students preferring pass/fail. While prior literature largely surveyed preference among medical educators, student sentiment on Step 1 scoring supports recent changes to the USMLE Step score format.https://doi.org/10.1177/23821205251337125
spellingShingle Shankar S Thiru
Rachel E Cherelstein
Scott M Feeley
Scott J Halperin
Sarah Lucas
Christopher M Kuenze
Edward S Chang
What Do Medical Students Think About a Pass/Fail USMLE Step 1? A Survey of 18 Allopathic Schools
Journal of Medical Education and Curricular Development
title What Do Medical Students Think About a Pass/Fail USMLE Step 1? A Survey of 18 Allopathic Schools
title_full What Do Medical Students Think About a Pass/Fail USMLE Step 1? A Survey of 18 Allopathic Schools
title_fullStr What Do Medical Students Think About a Pass/Fail USMLE Step 1? A Survey of 18 Allopathic Schools
title_full_unstemmed What Do Medical Students Think About a Pass/Fail USMLE Step 1? A Survey of 18 Allopathic Schools
title_short What Do Medical Students Think About a Pass/Fail USMLE Step 1? A Survey of 18 Allopathic Schools
title_sort what do medical students think about a pass fail usmle step 1 a survey of 18 allopathic schools
url https://doi.org/10.1177/23821205251337125
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