A passing score on the USMLE Step 1, Step 2 Clinical Knowledge (CK), and Step 2 Clinical Skills (CS) examinations are required for graduation from medical school. Students must have the approval of the Academic Status Committee to be sponsored for each of the three USMLE examinations.
USMLE STEP 1
All students must take USMLE Step 1 following the successful completion of Phase 1 (Principles of Medical Practice) and prior to beginning Phase 2 required clinical clerkships. All students must complete USMLE Step 1, on or before the Sunday immediately prior to the start of orientation to Phase 2 clerkships, unless there is an extraordinary circumstance that warrants delay. To support success on USMLE Step 1, all second year students will take the CBSE within 1 week of completion of Phase 1 courses.
Students who (1) have a cumulative average score for Phase 1 courses ≥ 1 standard deviation below the class mean and (2) score ≤ 56 (Step 1 equivalent = 165) on the CBSE will be required to:
- Meet with the learning specialist and develop a structured learning plan.
- Meet with an identified content expert.
- After 4 weeks of intentional study; students identified above must retake the CBSE* and score at 64 or above (Step 1 equivalent = 185) to be sponsored for USMLE Step 1.
- Students who do not make the benchmark will delay the first clerkship and have a monitored individual study plan approved by the Academic Status Committee.
*Of note: any student may take the CBSE again at the 4 week mark for self-assessment.
Not sitting for USMLE Step 1 prior to the beginning of Phase 2 required clinical clerkships in May results in an immediate one year leave of absence for the student. Deferrals may be granted by the Associate Deans for Student Affairs or Medical Education. Deferrals may be granted for medical reasons. Documentation from the student’s healthcare provider will be required. Deferrals may also be granted for significant personal reasons, such as life-threatening illness in a close relative.
If a student receives notification of USMLE Step 1 examination failure, the student may petition the ASC to request approval for a second administration of the USMLE Step 1 examination. If a second administration of the USMLE Step 1 examination is approved by the ASC, students who are otherwise in good academic standing will be allowed to finish their current clerkship. If they are on the Family Medicine Clerkship, they may finish the clerkship. They will then defer the next clerkship to study for the re-examination. They must prepare an individualized study plan and have this plan approved by the Associate Dean for Medical Education or the Associate Dean for Student Affairs. They must register for the re-examination prior to the onset of the next clerkship.
Students who are not in good academic standing (e.g., academic probation) at the time they receive notification of failure should follow the same course of action outlined above with one exception. If approved by the ASC for a second administration of the USMLE Step 1 exam; their study plan must also be approved by the ASC. Any student who does not pass USMLE Step 1 within one year of the end of the Phase 1 curriculum must appear before the ASC.
Students who subsequently fail a second administration of USMLE Step 1 examination and have previously failed a course or received an unsatisfactory grade will be on academic probation. These students may petition the ASC to request approval for a third administration of the examination. If approved by the ASC the student will be placed on a leave of absence for the remainder of the school year in order to prepare for the examination. Students must schedule the re-examination by March 15 so that the examination score is available before the start of the new Phase 2 academic year. Failure of USMLE Step 1 examination on the third attempt will result in dismissal of the student from medical school. The student may appeal this action to the ASC. If the ASC denies the appeal, the student may then appeal to the Deans’ Advisory Committee. The decision of the Deans’ Advisory Committee is final and will constitute final agency action.
USMLE STEP 2
All students are required take both USMLE Step 2 examinations, Cognitive Knowledge and Clinical Skills, after successful completion of Phase 2 and prior to October 31 of their fourth year. Exceptions due to extenuating circumstances may be approved by the Associate Dean for Student Affairs. Students are not eligible for graduation unless they achieve a passing score on both USMLE Step 2 CK and CS examinations. Students who receive a failing score on either USMLE Step 2 CK or Step 2 CS will be referred to the ASC for review.
If, due to extraordinary circumstances (e.g. pandemic), a student does not achieve a passing score on Step 2 CS in time for graduation, after consultation with the course director of the Clinical Skills Refresher Course and review of their academic record the student may petition the Academic Status Committee to allow successful completion of the Clinical Skills Refresher Course to substitute for the USMLE Step 2 CS graduation requirement.
CLINICAL SKILLS EXAMS (CSEs)
Seven Clinical Skills Exams (CSEs) are required within the UF COM educational program as outlined below:
- Year 1 – Two CSEs are conducted within the ICM courses.
- Year 2 – One CSE is assessed during the ICM course. A second CSE (CSE 2B) is part of the USMLE Step 1 Preparation course and is a high stakes examination. If a student fails the second examination he/she must develop an individualized learning plan and review best practices videos. The student will also meet with the Medical Director of the Anaclerio Learning and Assessment Center or the Associate Dean for Medical Education to review performance and the ILP. The student may then progress to the third year clerkships. After 3-6 weeks, the students will revisit their ILP and reflect on performance and progress. This is shared with the Associate Dean for Medical Education.
- Year 3 – Two CSEs are required independent of the clerkships. The first CSE occurs near the end of the first semester. This examination is “formative” for most students. For students who failed the CSE 2B, this examination is, in essence, the remediation examination. They must pass this examination in order to continue in the clerkships. Another CSE is presented near the end of the third year. Students who fail this examination must meet with the director of the 4th year and the Associate Dean for Student Affairs to discuss modification of their senior schedule. They also will be required to take an elective designed to improve interviewing and physical examination skills. This course is also required for any senior student who fails USMLE Step 2 CS.
- Year 4 – One CSE is required within the sub-internship rotation and is formative.