USMLE Step 1 Policy

PURPOSE
To outline the deadline by which medical students must complete the United States Medical Licensing Examination (USMLE) Step 1 exam, and the process for remediating a Step 1 exam failure.

SETTING/AUDIENCE
All medical students completing the pre-clerkship curriculum before or during AY24-25

LCME STANDARD
8.4 Evaluation of Educational Program Outcomes

POLICY

  1. All students must pass the USMLE Step 1 exam as a graduation requirement from the School of Medicine.
  2. Students are allowed 4 attempts at the USMLE Step 1 as specified in the School's Bylaws and Regulations.
  3. All students are required to complete USMLE Step 1 before or on the Sunday prior to the start of the Clerkship Orientation/Clerkship Intersession Course. The specific date will be published at the beginning of the academic year. 
    1. Students who do not meet this deadline and do not have prior written approval to defer their clerkship and extend their study period may be dismissal eligible.
    2. Students will be required to meet with the Committee on Student Promotions (CSP) to create a plan for taking Step 1. 
    3. Students planning to take a year off for research, an advanced degree, or other activity, must complete the USMLE Step 1 exam before beginning their year off.
  4. Step 1 Exam Attempts
    1. First Attempt
      1. After completing the first attempt on Step 1, students are allowed to begin their first clerkship while awaiting their score. 
      2. Students who are unsuccessful on their first attempt may complete the clerkship in which they are enrolled; they will then be removed from the next clerkship to prepare for and retake the exam.
      3. Students who are unsuccessful will be placed on Academic Warning.
    2.  Second Attempt (if needed)
      1. Students will be allowed to return to the clerkship phase after completing their second attempt before their score is posted.
      2. Students who do not pass on the second attempt may complete the clerkship in which they are enrolled when the score is posted; they will then be removed from the next clerkship to prepare for and retake the exam.
      3. Students who are unsuccessful will be placed on Academic Probation.
    3. Third Attempt (if needed)
      1. Students requiring a third attempt must post a passing score before they will be allowed to return to clerkships. (Regulation 60, A, 2).
      2. If a student does not pass on their third attempt, the USMLE will impose a 6-month waiting period before a student can attempt the exam a fourth time.
    4.  Fourth Attempt (if needed): If a student does not pass, the School will not be able to support additional progress through the curriculum.
  5. Failure to pass the exam after the maximum allowable attempts and within 2 years of completing the pre-clerkship curriculum phase is grounds for a dismissal recommendation. (See the School of Medicine Bylaws and Regulations, Regulation 80, D, 1, a, v). 

PROCEDURE

  1. To request a deferral to extend the study period for the first attempt see the USMLE Step 1 Deferral Policy.
  2. Remediation - Second Attempt
    1. Students who do not pass Step 1 on the first attempt must meet with the Associate Dean for Students and the Director of the Office of Student Learning and Educational Resources to develop a plan to prepare for the second attempt; it must include a take and complete date. The plan must be submitted to CSP for review and approval.
    2. Students may remain in and complete the clerkship in which they are enrolled. If a student does not wish to remain in the clerkship, they must notify the Associate Dean for Students and the Curriculum Manager of this decision within 48 hours of their Step 1 score being posted.
  3. Remediation - Third Attempt:
    1. Students who do not pass their third attempt must meet with the Associate Dean for Students and the Director of the Office of Student Learning and Educational Resources to develop a plan to prepare for the fourth attempt; it must include a take and complete date. The plan must be submitted to CSP for review and approval.
    2. See Policy D-3 for additional details (above).
  4. Fourth Attempt – there is no remediation of the fourth attempt. See Policy items D-4 and E (above).

RESPONSIBILITY
Associate Dean of Students
Committee on Student Promotions
Curriculum Managers
Office of Student Learning and Educational Resources

REFERENCES
UC Davis School of Medicine Bylaws and Regulations, Regulation 60 and 80

RELATED POLICIES
Satisfactory Academic Progress Policy
Extending the MD Program Policy
Step 1 Deferral Policy

POLICY OWNER
Committee on Student Promotions

REVIEWED BY
Associate Dean for Students
Committee on Student Promotions*

REVIEWED DATE and REVIEW CYCLE
April 2025 - final review, being replaced

* indicates the Policy Owner