Reporting a Pass/Fail Outcome for USMLE Step 1: Consequences and Challenges for International Medical Graduates

After extensive stakeholder discussion, the Federation of State Medical Boards and the National Board of Medical Examiners announced in February 2020 that United States Medical Licensing Examination Step 1 will transition to a pass/fail exam. Program directors have historically used Step 1 scores in deciding which residency applicants to interview. The lack of numerical scores will force changes to the residency selection process, which could have both positive and negative consequences for international medical graduates (IMGs). In this Invited Commentary, the authors discuss how some of the issues associated with the transition to Step 1 pass/fail are likely to impact IMGs. The authors also provide insights into how this and other policy changes could help spur the medical education community to improve the process by which medical school graduates transition to graduate medical education.