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 (COM – P) that a student must take the USMLE Step 1 for the first time before the start of the Transition to Clerkships Block, including students in a combined degree program, unless a delay is granted by the Associate Dean, Student Affairs. Failure to post a passing score prior to the end of the Transition to Clerkships Block halts academic progress and might potentially delay financial aid disbursement. Students who post a failing score for Step 1 still complete the Transition to Clerkships Block to complete Year 2; however, these students cannot progress to Year 3 clerkships until sitting for Step 1 again.

Score Reporting Delays by National Board of Medical Examiners (NBME) or Testing Site Closures

In the event of delayed reporting of scores by the NBME during the Transition to Clerkships Block, students can start the third year pending the score. 

In the event of testing site closures on a state-wide or national level, MS2 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 Associate Dean of Student Affairs to determine the appropriate timing for testing and year three 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 Transition to Clerkships block. Toward the end of the fall semester of Year 2, Office of Student Development staff will notify the Associate Dean, Student Affairs, or designee, of any student not on track to pass Step 1 based on a student’s Kaplan Step 1 diagnostic exam score and other at-risk indicators such as block examination retakes or failures. The student will also be notified. The student will not be scheduled for any clerkships requiring a more than 45-day notice for schedule changes during the first six months of Year 3 and, when feasible, will not be enrolled in any clerkship longer than six weeks for the first rotation.

In addition, all Year 2 students must take a college-sponsored NBME practice (diagnostic) USMLE Step 1 exam by January 31 of Year 2. Any student receiving a score lower than the predetermined standard prior to March 1 may be dropped from their first 4-8 weeks of clerkships/ambulatory selective depending on the type and location of rotation and where those initial rotations are scheduled. However, any student that does not have a score in the passing range by March 1 will be dropped from their first 4-8 weeks of clerkships/ambulatory selective and the student must meet with the Associate Dean, Student Affairs, to discuss a Step 1 delay.

Step 1 Delay Approval by Associate Dean, Student Affairs

Step 1 delays are granted by the Associate Dean, Student Affairs, who notifies the Student Progress Committee. If a delay is granted, the initial first attempt to take Step 1 must occur no later than 12 weeks from the end of the Transition to Clerkships Block. If this does not occur, disciplinary action is determined by the Student Progress Committee, up to and including dismissal. The Associate Dean, Student Affairs, may approve up to eight weeks of the delay time to be used for elective credit counting toward Year 4 (the elective request also needs to go through the fourth-year elective approval process). Any non-patient care credit received for Step 1 courses in the third year will decrease the amount of non-patient care credit remaining in the fourth year by the same amount of credits received. When the Student Progress Committee assigns a specific date for Step 1 to be taken with the expectation that the results will be back in time to allow the student to begin the next clerkship and the NBME is delayed in returning the results, the student will start the next clerkship unless a student request to delay the next clerkship is granted by the Associate Dean, Student Affairs. 

Any student with a Step 1 delay will be dropped from their first 4-8 weeks of clerkships depending on the type and location of the clerkships/ambulatory selective. Once the student sits for Step 1, the student can be added to the first available clerkship/ambulatory selective or MD/PhD students can begin their graduate courses. Any delay in the start of clerkships may impact a student’s Year 3 clerkship schedule, clinical site placement and Year 4 schedule. A delay may also require that a student miss a rotation due to lack of capacity and will likely delay their graduation date. 

All Step 1 delays, and reason for the delay, are noted on the Medical Student Performance Evaluation.

Course Remediation and Step 1 Timing

A student who is remediating a failed block or course in Year 1 or 2 must successfully complete the remediation before taking Step 1. The initial first attempt to take Step 1 must occur no later than 12 weeks following completion of the block or course remediation. A student may request a Step 1 delay after the 12 weeks from the Associate Dean, Student Affairs, for extenuating circumstances when a student remediated a course during dedicated Step 1 study time. The Student Progress Committee will be notified of any delays approved by the Associate Dean, Student Affairs.

Failure of First Attempt of USMLE 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.  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 sits for Step 1 again. 

The student must meet with the Office of 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. When the Student Progress Committee establishes a date for the retake, the student must abide by that date, unless subsequent approval is received from the Student Progress Committee otherwise.

Students will not be eligible to continue Student Government positions after a failure of Step 1. Any exception to this must be approved by the Student Progress Committee.

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 availability during the clerkship to this student and, when feasible, request ensured placement at a site that will not require excessive driving to maximize NBME shelf study time.

Multiple Failures of USMLE Step 1

A student that does not pass the second attempt at Step 1 will finish their current clerkship/ambulatory selective, but then must cease academic progression (other than Scholarly Project and Longitudinal Patient Care, if currently enrolled). A student must obtain approval from the Student Progress Committee before scheduling a third attempt at taking Step 1. The Student Progress Committee establishes a date for the retake, considering such things as the student’s previous scores, progressive improvement of scores on each attempt and the plan undertaken by the student to prepare, as well as recommendations from Student Development personnel. A student retaking Step 1 for the third time must post a passing score prior to enrolling in any further clerkships/ambulatory selective.  

Deadline to Pass Step 1

Every student must pass Step 1 within one calendar year (12 months) from the first day of Transition to Clerkships Block of the same academic year they begin Year 2 curriculum. A student who has not passed within that time frame is automatically dismissed from the MD program as per the Dismissal and Removal from Academic Environment Policy. The deadline of a calendar year may be postponed if the score is pending 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 leave of absence; however, the one-year period resumes once the leave of absence is concluded.

Dual degree students such as MD/PhD or MD/MBA students must pass Step 1 prior to the approval of a non-medical leave of absence for completion of graduate coursework.

Exceptions to the one-year timer when due to testing site closures, or curricular adaptations related to state or national emergencies, must be approved by the Student Progress Committee.  

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

A student must take Step 2 Clinical Knowledge (CK) for the first time by September 1 of Year 4, unless a delay is granted by the Associate Dean, Student Affairs.

Step 2 Delay Approval by Associate Dean, Student Affairs

Step 2 delays are granted by the Associate Dean, Student Affairs, who notifies the Student Progress Committee. If a delay is granted, the initial first attempt must be no later than October 15 (six-week delay). If this does not occur, disciplinary action is determined by the Student Progress Committee, up to and including dismissal as per the Dismissal and Removal from Academic Environment Policy. A request for a longer delay may be considered by the Student Progress Committee.

Deadline to Pass Step 2 CK 

A student must pass Step 2 CK, 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 is automatically dismissed. The exact deadline for the calendar year is postponed only until a pending score is posted for an examination that was taken before the one-year deadline. Passage of Step 2 CK is a requirement for graduation. The one-year time frame is extended if the student is on an approved leave of absence; however, the one-year period resumes once the leave of absence is concluded.

All USMLE Exams: If one or more of the USMLE Step examinations is not offered during the relevant time, an alternate University sponsored assessment may be designated in its place.