Additionally, there was a sharp increase in the number of students who obtained a ‘failing’ score on the UWSA 2 practice exam, despite the student having had above-passing performance on the NBME practice exams and the UWSA 1. His tracking of the students’ performance has shown that the gap is much larger between the scores on UWSA 1 and UWSA 2. At his institution, these have historically been taken as one long 8 block practice test, 7-10 days before sitting for the actual USMLE Step 1 exam. Smith also noted that at his school, medical students are reporting more extreme differences in their performance on the UWSA 1 and 2. Thus, students are reporting more anxiety because they are performing more poorly relative to those who had multiple attempts at the same set of questions.ĭr.

However, the most recent cohort of students are not using the UWorld Q-bank as intensively but their performance is being judged against those who went through the questions more than once. Prior to pass/fail scoring system of USMLE Step 1, a typical student would have completed the UWorld Q-bank more than one time, and often have completed the first pass well in advance of their exam. Instead of a 3-digit numerical score that can be referenced against the performance of students in prior years, students now only receive a percentile rank score that they obtain from their UWorld Q-bank. Smith suggests that the switch to pass/fail on USMLE Step 1 has created a significant problem in performance of self-assessment among medical students in the first cohorts to take the Step 1 exam without a numerical score. Whereas the last two cohorts scrambled to find later spots in Prometric centers all over their region, this year’s cohort often scheduled their Step 1 exam 2-3 weeks earlier.ĭr. Generally, students scheduled their tests sooner in the available time frame to take the test, than they have previously. On average, students are starting their dedicated study a week or so later and have done notably less USMLE Step 1 specific work in the months immediately preceding the dedicated study period since the exam has become pass/fail. Smith notes a shift to more passive learning styles which has included an increase in reading or video-based review activities compared to active/retrieval-based study approaches such as Qbanks or flashcards. Further, although students show the typical increase on successive NBME practice tests, their improvement is not quite at the rate previously seen. Compared to prior years, students are on average completing a lower overall percentage of their UWorld question bank and fewer cards in their Anki decks. In that cohort of students, there was less time spent on focused review for Step 1. Smith has noted some interesting observations so far with his students who most recently took USMLE Step 1 in February 2022, right after the switch to pass/fail. General Observations: USMLE Step 1 Switch to Pass/Failĭr. We have outlined them here for students and educators so that they can make more informed decisions in preparation for this exam. Thomas Smith, the executive director at the Center for Academic Excellence at MUSC, covered several important themes that should be strongly considered in preparation for Step 1. Are students incentivized to study with the same intensity? Has stress increased or decreased in response to this change? How are students utilizing the recommended resources? These questions have been piquing the interest of MELS and medical students alike as the new data will inform what institutions can expect of these changes moving forward.Ī recent conversation with Dr. One of the hottest topics among medical education learning specialists (MELS) is the behavior, motivation, and performance of medical students on USMLE Step 1 now that the exam has gone to pass/fail. In 2024, an additional subheading was added to reevaluate the advice given within the context of the 2024 USMLE Step 1 landscape.

2024 Update: This blog was originally posted on April 19, 2022.

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