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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.


USMLE Physician Tasks/Competencies

Posted: July 10, 2014

USMLE Physician Tasks/Competencies, a publication that provides a common organization of competencies and tasks assessed in USMLE examinations, is now available.

The outline comprises seven major sections:

  • Medical Knowledge/Scientific Concepts
  • Patient Care: Diagnosis
  • Patient Care: Management
  • Communication and Interpersonal Skills
  • Professionalism, including Legal and Ethical Issues
  • Systems-based Practice, including Patient Safety
  • Practice-based Learning

While this outline is common to all USMLE examinations, each Step will continue to have test specifications specific to that Step and will emphasize certain parts of the outline.

The USMLE Step 3 Content Description and General Information booklet contains a description of physician tasks/competencies covered in the restructured Step 3 examination for examinees taking the Step 3 examination on or after November 3, 2014. An updated USMLE Step 2 CK Content Description and General Information booklet containing a description of physician tasks/competencies covered in that examination will be available in July 2014.

USMLE Physician Tasks/Competencies is useful for understanding competencies assessed by multiple-choice question (MCQ) formats such as Step 1, Step 2 Clinical Knowledge, and the MCQ portion of Step 3. The outline will be updated as work to identify competencies covered by non-MCQ exam formats progresses.


Practice materials and other information for examinees taking the restructured Step 3 examination on or after November 3, 2014

Posted: July 10, 2014

Practice and informational materials for the restructured Step 3 examination have been posted to the USMLE website. Examinees who plan to take a Step 3 examination on or after November 3, 2014 should read the materials and practice with the sample items and cases. The materials include:

A summary of changes resulting from the restructuring of the Step 3 examination is also available.
Practice and informational materials for examinees taking the current Step 3 examination, which will be administered through September 30, 2014, will remain available on the USMLE website until early October, 2014.


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