On February 12, 2020, the Federation of State Medical Boards(FSMB) and the National Board of Medical Examiners (NBME)announced that Step 1 score reporting would be changed froma three-digit numeric score to a pass-fail system starting noearlier than January 1, 2022. Step 2 Clinical Knowledge (CK)and Step 3 will continue to be reported numerically, while apassing Step 1 score will become a prerequisite to taking Step 2Clinical Skills (CS). This announcement followed more than ayear of internal discussion by students and medical educatorsalike. Much emphasis was placed on the change’s purportedrole in reducing the “current overemphasis on USMLE performance”and medical student distress in preparing for medicallicensing examinations. While we endorse the prioritizationof mental health in medical education, we postulate that apass-fail Step 1 will fail to significantly shift the status quo oralleviate emotional burden. Furthermore, we are concernedthat this change reflects an ongoing trend in removing objectivemetrics from the evaluation of student performancefor residency selection. Nevertheless, this policy shift maycarry unforeseen and unintended benefits for students in thepreclinical years in realms apart from mental well-being.
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