Announcements 
Review of USMLE Step 3 minimum passing performance
Posted: July 12, 2011
The USMLE program recommends a minimum passing level for each Step. Medical licensing authorities may accept the recommended pass/fail result, or they may establish their own minimum passing requirements. The USMLE Step Committees are responsible for establishing and monitoring these standards. These committees are made up of physicians and scientists who bring educational, licensing, and practice perspectives to this process. Every three to four years the Step Committees are asked to complete an in-depth review of standards.
The Step 3 Committee is scheduled to review the minimum passing score for the USMLE Step 3 examination at its meeting on October 18-19, 2011.
In this review, information from multiple sources will be considered, including:
• Results of content-based standard setting exercises conducted with three independent groups of physicians in 2011;
• Results of surveys of various groups (e.g., state licensing representatives, medical school faculty, samples of examinees) concerning the appropriateness of current pass/fail standards for Step examinations;
• Trends in examinee performance;
• Score precision and its effect on the pass/fail outcome.
The decision of the Step 3 Committee will be posted at the USMLE website. If the Committee determines that a change to the minimum passing score is appropriate, the new recommended minimum passing score will become effective for all examinees who take a Step 3 examination on or after November 1, 2011.
End of year update: USMLE research; potential structural changes
Posted: December 23, 2011
The USMLE continues to evolve in the manner described previously. Step 2 CS changes anticipated for 2012 have been described. Additionally, new literature interpretation items have already been incorporated in Step 2 and will soon appear in Step 3. Other activities anticipated to occur in 2012 will continue in future years and have the potential to affect USMLE in significant and exciting ways.
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Changes to the Step 2 Clinical Skills (CS) examination
Posted: December 15, 2011
One of the recommendations emerging from the Comprehensive Review of USMLE (CRU) process is that USMLE consider ways to further enhance the testing methods used in the Step 2 Clinical Skills (CS) examination. As previously announced in the 2012 Bulletin of Information, these enhancements are scheduled for implementation in mid-2012. These changes will be introduced in Step 2 CS for examinations delivered beginning June 17, 2012.
The reporting schedule for examinees testing from June 17, 2012 through November 3, 2012 will be 2-3 weeks longer than for examinees testing during other periods.
More information about the Step 2 CS score reporting dates for examinations delivered in 2012 is provided in the Step 2 CS Score Reporting Schedule.
Changes to the assessment of Communication and Interpersonal Skills (CIS)
The CIS subcomponent of Step 2 CS has been redesigned to assess a fuller range of competencies. Background information about these changes is provided on pages 5-6 of the Fall 2010/Winter 2011 NBME Examiner. The new approach divides communication skills into a series of functions. These functions have been further divided into sub-functions. Beginning June 17, 2012, the Communication and Interpersonal Skills (CIS) scale will focus on five functions:
1. Fostering the relationship
2. Gathering information
3. Providing information
4. Making decisions: basic
5. Supporting emotions: basic
Several additional functions are still under development; these include making decisions: advanced; supporting emotions: advanced; and helping patients with behavior change. A list of the functions and sub-functions is available.
Changes to the patient note
Also beginning June17, 2012, a new patient note will be introduced. The patient note is completed by the Step 2 CS examinee after the encounter with the standardized patient. In the new note, examinees will continue to be asked to document relevant history and physical examination findings and to list initial diagnostic studies to be ordered. Examinees will also be asked to create a reasoned, focused differential (maximum of three diagnoses) listed in order of likelihood and to indicate the evidence obtained from the history and physical examination that supports (or refutes) each potential diagnosis. The new patient note provides examinees with an opportunity to document their analysis of a patient's possible diagnoses. A sample of the new patient note is available for review.
Practice Materials
Updated practice materials for Step 2 CS will be posted to the USMLE website in March 2012. These include the Step 2 CS Content Description and General Information Booklet, onsite orientation video, sample patient notes, and a simulation of the program for typing patient notes.
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