The test specifications used to construct USMLE Step 1 examinations did not change when the exam transitioned to pass/fail reporting.Ĭonsistent Style and Difficulty for Step 1 Exam Questions While not all topics listed in the content outline are included in each Step exam, overall content coverage is comparable among the various examination forms that different examinees of each Step will take. No Change to Exam Specifications for Step 1 in 2022Īll USMLE examinations are constructed from an integrated content outline, which organizes content according to general principles and individual organ systems. This process ensures examinees who take different forms are held to the same passing standard. Scores on individual examination forms are made comparable through equating, a psychometric process that adjusts scores based on the difficulty of the questions. Each USMLE Step examination includes multiple forms that are similar in difficulty and content for the respective Step. Within each Step examination, USMLE creates various forms that are similar in difficulty and content. These potential differences complicate comparisons to past performance data. These changes in test timing patterns suggest that those who tested during this period may not be representative of the typical group that tested during these times in the past.
We have observed shifts in the timing of when examinees tested, particularly around the pass/fail transition date. The increase in passing standard accounts for some increases observed in the fail rates. The Step 1 pass/fail transition beginning on January 26, 2022, coincided with an increase in the exam’s minimum passing standard from 194 to 196. These differences should be considered when interpreting report data. It is important to note that factors not present in previous years introduce complexities when comparing the 2022 examinee group to previous years. Results indicate a higher fail rate on the Step 1 exam for the 2022 examinees relative to recent years.
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