Updates in the USMLE®

Dr Ripudaman Singh Bajwa

PGY-1, Internal Medicine

St. Peter’s University Hospital, New Brunswick, USA

7,699 foreign-trained medical graduates matched into a postgraduate year-one (PGY-1) training position in the United States of America in 2022 (1). This number shows an upward trend as international medical graduates (IMGs) are vital to the American healthcare system.

Recent Updates


The USMLE Step 1 examination is a stepping stone for pursuing a residency in the US. (2). The score reporting for this exam transitioned from a numeric score to a pass/fail outcome for exams taken on or after January 26, 2022 with a shy increase in the passing standard from 194 to 196. However, the preparation resources remain the same, indicating that the students must prepare as though it is a numerically scored exam. (3) The exam tests basic medical knowledge making appearing for consequent tests easier.

Step 2, Clinical knowledge also has an updated passing standard from 209 to 214 for those appearing on or after July 1, 2022. Here the examinee receives a 3-digit score which is especially important for an IMGs it may affect your probability of matching into the residency program of your choice.

Step 2 clinical skills are now discontinued (4). The Occupation English test (OET), requiring a minimum score of 350 on the Listening, Reading, and Speaking sub-tests, and a minimum score of 300 on the Writing sub-test to pass, has now taken its place, which is an ECFMG certification requirement. (5)

From July 1, 2021,  four attempts per Step exam are permitted rather than the six allowed previously.

Certification pathways

ECFMG offers 1-6 pathways for its certification, a mandatory requirement for every IMG. Most Indians get licensed with their medical council for the unsupervised practice of medicine after internship. Thus, most qualify under pathway 1 of ECFMG certification (6).

Starting in 2024, individuals applying for the ECFMG certification must be a student or graduates of a medical school accredited by a regulatory agency duly recognized by the WMFE (World Federation for Medical Education). This year NMC (National medical council) of India has extended its application, requiring Indians to be eligible for USMLE starting in 2024 (7).However, those who initiate their ECFMG processing before 2024 will remain unaffected.

(News 18 creative)

For everyone who is an aspiring resident, social media is your trump card. Use it to stay informed and proactive. Everyone has a purpose in life/medicine, and you need to see which serves you the best.

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