United States Medical Licensing Examination (USMLE) Timing and Failure Policy

Timing of United States Medical Licensing Examination (USMLE) Step 1

It is the policy of the University of Arizona College of Medicine – Phoenix that a student must take the USMLE Step 1 (Step 1) exam for the first time before the start of the Transitions to Clerkship block, including students in a dual degree program, unless a delay is granted by the dean, student affairs, or respective designee. Failure to sit for the exam prior to the start of the Transitions to Clerkship block halts academic progress and may delay financial aid disbursement and/or graduation. Students who post a failing score for Step 1 may complete the Transitions to Clerkship block to complete Year 2; however, their Year 3 clerkship schedule will be impacted, and they may not participate in clerkships until they have passed the exam.

Testing site closures

In the event of testing site closures on a state-wide or national level, Year 2 students still needing to take Step 1 will have the option to start the third year. Once sites re-open, students will consult with the dean, student affairs, or respective designee to determine the appropriate timing for testing and Year 3 progression.

Step 1 Readiness and clerkship scheduling/placement

Due to the strict requirements for schedule changes by clerkship affiliates, overall academic performance is used to optimize clerkship schedules for any student not on track to take Step 1 before the start of the Transitions to Clerkship block. Toward the end of the fall semester of Year 2, the dean, student affairs, or respective designee, will be notified of any student that may need additional readiness time based on a student’s question bank data, diagnostic exam score(s), life events, and other indicators related to readiness to sit for Step 1. When possible, students will be scheduled into clerkships which provide the greatest flexibility for scheduling changes, should a Step 1 delay occur.

Step 1 delay

Students whose objective Step 1 readiness data are non-reassuring in the week prior to the start of the Transitions to Clerkship block, and those who are unable to sit for Step 1 before the Transitions to Clerkship block due to extenuating circumstances, may request a Step 1 study extension or a leave of absence (LOA). Students may not take Step 1 during the Transitions to Clerkship block; this block provides critical information to prepare students for clerkships and cannot be made up elsewhere. Students who have not sat for Step 1 prior to the first day of the Transitions to Clerkship block will be placed on a Step 1 study extension automatically. The Step 1 study extension is approved by the dean, student affairs, or respective designee and may not exceed more than 12 weeks past the end of the Transitions to Clerkship block. The Student Progress Committee (SPC) will be notified of any Step 1 study extensions approved by the dean, student affairs, or respective designee and the student will be dropped from the first 8-16 weeks of clinical rotations and the first week of PPD 3. A delay in the start of clerkships may impact a student’s remaining Year 3 clerkship schedule, clinical site placement, Year 4 schedule, graduation date and financial aid eligibility.

Students on an approved Step 1 study extension will be enrolled in the Basic Medical Science Independent Study elective for up to eight credits. Credits earned for this elective will count toward the student’s graduation requirements and the non-patient care elective credit limit.

Any student who is unable to take Step 1 within 12 weeks from the end of the Transitions to Clerkship block (or end of dedicated Step 1 study for MD/PhD students), due to extenuating circumstances, may request a personal leave of absence (LOA) through the SPC or a medical LOA through Campus Health Services. Such occurrences will result in a graduation delay and will be included in the student’s Medical Student Performance Evaluation (MSPE). These students will be dropped from all courses in the fall semester and, pursuant to credentialing requirements, will not be rescheduled until they have taken Step 1; this will impact financial aid eligibility. Once the student takes Step 1, the MD student can be enrolled in the first available clinical rotation and the MD/PhD student can begin their graduate courses. Students should plan to start their first clinical rotation approximately 4-6 weeks after taking Step 1.

Students with a Step 1 delay who are enrolled in the Longitudinal Integrated Clerkship (LIC) or rural clerkships may need to be placed at a different site at the time of the student’s return. If a suitable alternative site is not available, the student may be required to complete some or all of their clerkships through the traditional Year 3 curriculum. Changes which alter a student’s site placement and timing will impact related housing arrangements.

Course remediation and Step 1 timing

A student who is remediating a failed course* in Year 1 or 2 must successfully complete the remediation before taking Step 1. The first attempt to take Step 1 should occur no later than 12 weeks following completion of the course* remediation. A student who has completed a course remediation during dedicated Step 1 study time may request a Step 1 study extension after the 12 weeks from the dean, student affairs, or respective designee. The SPC will be notified of any delays approved by the dean, student affairs, or respective designee.

Failure of first attempt of Step 1

A student who does not achieve a passing score on the first attempt of Step 1 may complete Year 2 and finish any courses they are currently taking. Except for the basic medical science elective, students will not be allowed to enroll in any other medical school course* required for graduation or any course* within a combined degree program (other than Scholarly Project and Longitudinal Patient Care courses) until the student takes Step 1 again and receives a passing score. Students who have already completed the credentialing requirements and/or required PPD 3 elements for a clinical rotation beginning within four weeks after their result is posted by the NBME may request an exception from the dean, student affairs, or respective designee, to complete their first scheduled rotation before retaking the exam. If approved, the dean, student affairs, or respective designee will notify the SPC, and the student will instead pause their progression after completing their first rotation.

The student must meet with Student Development to establish a plan of action prior to retaking Step 1. This plan may include various courses or electives with the expectation that they will be taken solely for preparation for Step 1. The student may select their exam retake date independently but should confer with Student Development to ensure objective data are utilized to reduce the risk of a second failure. A student retaking Step 1 for the second time must receive a passing score prior to enrolling in any further clerkships or electives.

The SPC will be notified of any failures by the dean, student affairs, or respective designee. Students in a student government position will require approval from SPC to continue in their position after a failure of Step 1. The clerkship director of the student’s initial clerkship, upon a Step 1 delay will be notified that the student is off cycle to maximize student orientation and support during the clerkship to this student.

Failure of second attempt of Step 1

A student must obtain approval from the SPC before scheduling a third attempt at taking Step 1. The SPC establishes a recommended time frame for the retake, taking into consideration the student’s previous academic and diagnostic performance, the plan undertaken by the student to prepare, related policy and NBME requirements, as well as recommendations from Student Development. A student retaking Step 1 for the third time must receive a passing score prior to enrolling in any further clerkships or electives.

Deadline to Pass Step 1

Every student must pass Step 1 within one calendar year (12 months) from the first day of the Transitions to Clerkship block of the same academic year they began Year 2 curriculum. A student who has not passed within that time frame will be academically dismissed from the MD program as per the Dismissal and Removal from Academic Environment Policy. The deadline of one calendar year may be postponed if the score is pending and if the exam was taken within the one-year time frame. No further attempts after the one-year deadline are allowed. The one-year time frame is extended if the student is on an approved LOA; however, the one-year period resumes once the LOA is concluded.

Dual degree students, such as MD/PhD students, must pass Step 1 prior to approval of a non-medical LOA for completion of graduate coursework.

Exceptions to the one-year calendar timeframe include testing site closures, or curricular adaptations related to state or national emergencies.

Timing of United States Medical Licensing Examination (USMLE) Step 2

All students must pass Step 2 to graduate. Additionally, students must take USMLE Step 2 for the first time by September 1 of Year 4, unless a delay is granted by the dean, student affairs, or respective designee

Step 2 delay approval

Step 2 delays are granted by the dean, student affairs, or respective designee, who notifies the SPC. If a delay is granted, the first attempt must be no later than December 1 (12-week delay). If this does not occur, the student will be required to meet with the SPC to establish a plan of action which takes into consideration the student’s anticipated graduation date, their remaining graduation requirements, and the dates by which the College of Medicine – Phoenix must certify the students’ residency application.

Deadline to pass Step 2

A student must pass Step 2, within one calendar year (12 months) after the date of the first attempt and prior to graduation. A student who does not pass within that time frame will be academically dismissed. The exact deadline is postponed only if a pending score is posted for an examination that was taken before the one-year deadline. The one-year time frame is extended if the student is on an approved LOA; however, the one-year period resumes once the LOA is concluded.

All USMLE Exams: If one or more of the Step examinations is not offered during the relevant time (due to a nationwide suspension of testing), an alternate University sponsored assessment may be designated in its place.

Course* = Any component of the curriculum where a grade is earned.