USMLE STEP 1 Examination Policy

E-18 Requirements, Procedures and Guidelines

Timeline and requirements to take Step 1:

• Students will take the UWSOM proctored National Board of Medical Examiners (NBME) customized assessment at the end of term 2 and the NBME comprehensive basic science examination (CBSE) at the end of term 3.
• The deadline to take USMLE Step 1 is March 15.
• Remediation of any Foundations Phase required coursework must be successfully completed prior to taking USMLE Step 1.
• Students must take Step 1 prior to the Patient Care Phase start date for their entry year unless they have a mandated delay or an approved deferral (see below).
• Students who are unable to take Step 1 on the School of Medicine timeline must take Step 1 within one year of completing the Foundations Phase. Students who fail to take and pass USMLE Step 1 within one year of completing the Foundations Phase will be referred to the Student Progress Committee (SPC).

Mandated delay of Step 1 test date (Delayed start of Patient Care Phase)
The performance of all students in the Foundations Phase will be evaluated by the ad hoc Foundations Phase Mastery Committee^* during term 3. All factors (overall performance in the blocks, threads, and courses, trajectory during the foundations phase, the score on the NBME Comprehensive Basic Science Exam, and extenuating circumstances) will be weighed. Students identified by UWSOM as not demonstrating adequate mastery of the basic science curriculum will be required to delay sitting for Step 1. This will result in a delayed entry into the Patient Care Phase.

[Note: For E17 and E18 students, the delay will not be mandated but will be encouraged for appropriate students.] The requirement to delay the Patient Care Phase will be determined in the third term of the Foundations Phase (before clerkship schedules are completed).

Students identified by UWSOM as not demonstrating adequate mastery of the basic science curriculum will:

• Delay scheduling their Step 1 test date until spring quarter;
• Enroll in a UWSOM 8 credit Comprehensive Basic Science Review course to be administered during winter term;
• Complete self-administered Step 1 practice tests (CBSSA) to assess progress during the dedicated Step 1 study period;
• Complete a final CBSSA exam at the end of the delay period (by the end of spring quarter). Students whose final CBSSA score is predictive of a passing USMLE Step 1 score will be required to sit for the USMLE Step 1 exam in spring quarter.

Students whose final proctored CBSSA score at the end of the CBSR course (end of spring quarter) is not predictive of a passing USMLE Step 1 score will be placed on leave and will participate in required additional programming. Students will be required to meet with the Student Affairs Dean to formalize a leave of absence and will be dropped from summer quarter Patient Care Phase clerkships. A passing score on Step 1 will be required to re-enter the curriculum and enroll in the Patient Care Phase.

Students who have not taken Step 1 within one year of the completion of the Foundations Phase (end of term 3) will be referred to Student Progress Committee.

USMLE Step 1 Deferral Policy
USMLE Step 1 deferrals will be considered only for extenuating circumstances (personal and health reasons). Students must not plan travel, especially international travel until Step 1 is taken. Students requesting a deferral must meet with the Associate Dean for Student Affairs.

Students who fail to take USMLE Step 1 by the end of spring quarter after the Foundations Phase will be placed on leave of absence and will not receive a Patient Care Phase schedule until they obtain a passing score on the USMLE Step 1 examination. Delaying USMLE Step 1 past March 15 may result in medical school expansion. Students who fail to pass USMLE Step 1 within one year of the approved deferral will be referred to the Student Progress Committee.

*The ad hoc Foundations Phase Mastery Committee will be comprised of learning specialists, Foundations deans, and members from Student Affairs, Curriculum, and Registration.

E-19 Requirements, Procedures and Guidelines

Timeline and requirements to take Step 1

• Students must take the UWSOM proctored National Board of Medical Examiners (NBME) customized assessment near the end of Term 2 and the NBME Comprehensive Basic Science Examination (CBSE) during Term 3.
• The deadline to take USMLE Step 1 is March 15^th.
• An early action Step 1 delay or formal request for deferral is required to move the USMLE Step 1 deadline after March 15^th.
• Remediation of any Foundations Phase required coursework must be successfully completed prior to taking USMLE Step 1.
• Students must take Step 1 prior to the Patient Care Phase start date for their entry year unless they have an early action delay or approved deferral (see below).

Early action delay of Step 1 test date deadline (Delayed start of Patient Care Phase)
The performance of all students in the Foundations Phase will be evaluated by the ad hoc Foundations Phase Mastery Committee^* during Term 3.  Overall performance in the blocks, threads, and courses; trajectory during the foundations phase; and extenuating circumstances will be weighed.  Scores on the NBME Comprehensive Basic Science Exam will be used as confirmatory. Students not demonstrating adequate mastery of the basic science curriculum will be recommended to delay sitting for Step 1.  This will result in delayed entry into the Patient Care Phase.

Delayed students will:

• Enroll in a UWSOM 8 credit Comprehensive Basic Science Review course to be taken during winter term;
• Complete self-administered Step 1 practice tests (CBSSA) to assess progress during the dedicated Step 1 study period in spring quarter;
• Complete a final CBSSA exam at the end of the delay period (end of spring quarter).
• Sit for the USMLE Step 1 exam by the end of spring quarter (in June) if the final CBSSA exam results are predictive of a passing score.

Students with final CBSSA scores not predictive of a passing USMLE Step 1 score will be placed on leave for summer quarter, and/or will participate in additional programming during summer quarter such as enrolling in an independent study course for additional dedicated study time. Students will be required to meet with the Student Affairs Dean to formalize a leave of absence or approval for additional programming, undergo expansion of their medical curriculum, and be dropped from their entire Patient Care Phase clerkships schedule. Taking Step 1 will be required to re-enter the curriculum and enroll in the Patient Care Phase.

Students who do not take Step 1 by the last day of autumn quarter (mid-December each year) will be referred to Student Progress Committee for review.

USMLE Step 1 Deferral
Student deferrals to take Step 1 beyond the March 15 deadline will be considered only for extenuating circumstances.  Students requesting a deferral must meet with the Associate Dean for Student Affairs.  Students who are granted a deferral and fail to take USMLE Step 1 by the approved deadline will have their entire Patient Care Phase schedule dropped until they have taken the USMLE Step 1 exam. Delaying Step 1 will likely result in medical school expansion. Students who fail to pass USMLE Step 1 by the last day of autumn quarter following their Step 1 deadline (mid-December) will be referred to Student Progress Committee for review.

^*The ad hoc Foundations Phase Mastery Committee will be comprised of learning specialists, Foundations deans, and members from Student Affairs, Curriculum, and Registration.

Scope:

This policy applies to all medical students enrolled at University of Washington School of Medicine (UWSOM) and refers to the timing of sitting for the United States Medical Licensing Exam (USMLE) Step 1.

Step 1 Deadline Policy Statement:

Students who complete Foundations Phase at the end of Fall Quarter must sit for the USMLE Step 1 exam on or before March 1* of the following year. MSTP students must sit for the USMLE Step 1 exam on or before March 1 after completing Foundations and prior to entering graduate school.

Short-Term Step 1 Extension Policy Statement:

Students who are academically ready to sit for Step 1 may request an extension of one week (March 8 or earlier) under the following circumstances:

1. Personal Illness

2. Personal/Family Emergencies: Examples of emergencies may include, but are not limited to: accidents, hospitalizations, or death of a close family member.

Procedure:

1. The student must complete the Step 1 Short Extension Attestation Form before March 1st. The attestation form will be forwarded to the student’s Foundations Dean.

Long-Term Step 1 Extension Policy Statement:

Students who are not yet academically ready (as defined below) to sit for USMLE Step 1 by March 1 or have not taken USMLE Step 1 by March 8 for any reason will complete their scheduled Spring quarter Patient Care rotations and will have their Summer A and B rotations dropped to provide additional dedicated study time.

The term “academically ready” refers to those with either a documented NBME CBSSA (National Board of Medical Examiners Comprehensive Basic Science Self-Assessment) test score which suggests >90% probability of passing or those with a written statement from a Learning Specialist indicating they are considered ready to take Step 1.

Students enrolled in spring quarter clerkships with long-term Step 1 extensions are discouraged from taking Step 1 during this time, as it takes focus off of clinical learning and performance. Attendance and Absentee Policy — Clinical Phases Policy requirements apply during this time.

Procedure:

1. Students who did not take Step 1 for any reason by March 8 and sit for USMLE Step 1 after March 8 may contact the registrar (somreg@uw.edu) and the Assistant Dean for Student Development (adminsa@uw.edu) after they have taken their Step 1 exam to request the addition of next quarter clerkships.

2. Students who need to delay taking Step 1 beyond summer quarter will have the following impact on their Patient Care schedule: † ‡t

a. If not taken by September 1st, Autumn A will be dropped

b. If not taken by the end of Summer B, Autumn B will be dropped

c. If not taken by the end of Autumn A, Winter A will be dropped

d. If not taken by the end of Autumn B, Winter B will be dropped and the student will be referred to Student Progress Committee.

*Dates referred to in this document are inclusive: “by March 1” indicates on March 1 or earlier.

† Because the internal medicine (IM) rotation spans an entire quarter, if a student is scheduled for IM during the quarter which will be dropped, the entire rotation will be dropped.

‡ Students enrolled in longitudinal curricula (e.g., LIC or WRITE) in spring quarter who require a long-term extension for Step 1 may complete the longitudinal component of their clerkship and the following quarter will be dropped.

WRITE Step 1 Delay Procedure:

WRITE clerkships are very challenging to re-arrange to accommodate Step 1 delays. In order to protect the WRITE rotation, an alternative schedule for students enrolled in WRITE will be in effect. The goal of this alternative schedule is to preserve the WRITE time in the patient care phase while aligning with the Step 1 policy as closely as possible.

Olympia LIC students with Step 1 delays will be handled on a case by case basis, again aligning to the current Step 1 policy as closely as possible.

Alternate schedule for STEP 1 delays for students enrolled in WRITE longitudinal clerkships:

1. If not taken by September 1st, Autumn A will be dropped

2. If not taken by the end of Summer B, Autumn B will be dropped

3. If not taken by the end of Autumn A, Winter A will be dropped

4. If not taken by the end of Autumn B, Winter B will be dropped and the student will be referred to Student Progress Committee.

5. If student is WRITE with WRITE clerkship in Autumn A-Winter B, student must have taken step 1 by the start of Autumn A or their Spring A and B for following year will be dropped. Referral to student progress committee will occur at end of Spring A the year following end of consolidation and after completing WRITE clerkship.