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Strategies for Success: Assessing Student Perspectives on the Impact of Step 1 Pass/Fail
Michaela J Derby1, Callie Olson1, Pasquale Manzerra1
1USD Sanford School of Medicine, Vermillion, SD USA.
Medical Science Educator
|January 20, 2026
Summary
The United States Medical Licensing Examination Step 1 exam
Area of Science:
- Medical Education
- Student Well-being
- Licensing Examinations
Background:
- The United States Medical Licensing Examination (USMLE) Step 1 exam transitioned to a pass/fail format in January 2022.
- The objective was to alleviate student test-taking pressure.
- The impact of this change on medical student experiences and outcomes remains under investigation.
Purpose of the Study:
- To assess the impact of the USMLE Step 1 pass/fail policy on medical student experiences.
- To evaluate the influence of curriculum, mental health, and academic advising on student outcomes.
- To identify areas for improvement in medical education and student support.
Main Methods:
- Survey administration to medical school classes of 2024 and 2025.
- Utilized five Likert-scale questions to gauge student experiences.
- Included open-response questions for detailed feedback on individualized preparation.
Main Results:
- Students report significant mental health challenges.
- Frequent academic advisor meetings, enhanced mental health counseling access, and reduced isolation may mitigate adversity.
- Students desire more National Board of Medical Examiners (NBME) test preparation resources and structured peer mentoring.
Conclusions:
- Medical schools should consider increased academic advisor engagement and mental health support.
- Curriculum adjustments, including supplemental student-led preparation and peer mentoring, are recommended.
- Findings offer insights for institutions adapting to the USMLE Step 1 pass/fail system and 1.5-year pre-clerkship curricula.
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