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Changes to USMLE procedures for reporting scores

Posted: May 04, 2011


Starting July 1, 2011, USMLE transcripts reported through the ERAS reporting system will no longer include score results on the 2-digit score scale. USMLE results will continue to be reported on the 3-digit scale. This affects the Step 1, 2 CK, and 3 examinations only; Step 2 CS will continue to be reported as pass or fail. These changes do not alter the score required to pass or the difficulty of any of the USMLE Step examinations.

Since its beginning in the 1990s, the USMLE program has reported two numeric scores for the Step 1, Step 2 CK, and Step 3 examinations, one on a 3-digit scale and one on a 2-digit scale. The 3-digit score scale is considered the primary reporting scale; it is developed in a manner that allows reasonable comparisons across time. The 2-digit scale is intended to meet statutory requirements of some state medical boards that rely on a score scale that has 75 as the minimum passing score.  The process used to convert 3-digit scores to 2-digit scores is designed in such a way that the 3-digit minimum passing score in effect when the examinee tests is associated with a 2-digit score of 75.

The USMLE program requires its governing committees to reevaluate the minimum passing score every three to four years. This process has, at times, resulted in changes in the minimum passing score, expressed on the 3-digit scale, and an accompanying change in the score conversion process, to ensure that a 2-digit score of 75 is associated with the new minimum passing requirement. A by-product of the adjustment of the score conversion system over time has been a shift in the relationship between the two score scales. This shift has no impact for USMLE score users who use the 3-digit scoring scale or for those using the 2-digit scale with a primary interest in whether the examinee has a passing 2-digit score of at least 75. However, it may create challenges in interpretation for score users who are focusing on 2-digit scores, other than 75, and are doing so for purposes of comparing USMLE scores that span several years.

To simplify matters and make interpretation of USMLE information more convenient for score users, the USMLE Composite Committee has asked staff to report 2-digit scores only to those score users for whom the scale is intended, i.e., the state medical boards. The Committee also asked that examinees continue to receive scores on both scales so that they are fully informed about the information that will be reported when they ask that results be sent to a state medical board. When examinees request that their results be sent to other score users, only the 3-digit score will be reported. Current plans call for these changes to begin with the elimination of the 2-digit score from USMLE transcripts reported through the ERAS reporting system starting July 1, 2011. Other systems and procedures for reporting results will be similarly modified as soon as possible after the July 1, 2011 date.


Updated abbreviation list for Step 2 CS patient notes

Posted: November 03, 2014

Examinees complete a patient note after each patient encounter in the Step 2 Clinical Skills (CS) examination. A list of common abbreviations that may be used in the notes is included in the Step 2 Clinical Skills Content Description and General Information booklet, and is posted at each computer station at all Clinical Skills Evaluation Collaboration (CSEC) test centers.

The Step 2 Clinical Skills Content Description and General Information booklet now includes an updated version of the abbreviation list; this version will be posted at test centers beginning November 3, 2014.

Changes to the list are minor. Examinees should be aware that this is not a complete list of all acceptable abbreviations, but rather represents the types of common abbreviations that may be used on the patient note. Patient notes are rated by licensed, board-certified physicians with experience in medical education, who will understand common medical abbreviations. However, an examinee who is in doubt about the correct abbreviation to use should write out the word or phrase.


USMLE Score Interpretation Guidelines

Posted: October 30, 2014

USMLE Score Interpretation Guidelines (SIG) have been posted to the USMLE website. Topics include:

  • Description of Examinations
  • Understanding Your Score
  • Recent Means and Standard Deviations (SDs)
    • Norm Table
    • Passing Scores
  • Precision of Scores
  • Guidelines for Use of USMLE Step Scores for Selection Decisions

The means and SDs and the norm table will be updated annually. Because percentile ranks depend on the cohort of examinees, you should always use the most recent norm table available on the USMLE website to obtain percentile ranks.


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