Key facts
- Step 1 has been reported pass/fail only since January 26, 2022.
- The attempt limit was reduced from six to four per Step for applications submitted on or after July 1, 2021.
- Since January 2026, IMGs register for USMLE through FSMB; ECFMG still decides eligibility for ECFMG certification.
- Step 2 CK moved to a 16-block, 30-minute-block format for exams on or after May 7, 2026, and Step 1 to 14 blocks on or after May 14, 2026.
The USMLE program has changed several rules in the last few years, and old videos and forum threads often describe a system that no longer exists. Below is a dated log of changes we could verify on official USMLE pages, who each one affects, and where to read the notice.
Log of verified changes #
| Date | Change | Who it affects | Official source |
|---|---|---|---|
| Jan 2021 (announced Jan 26, 2021) | USMLE sponsors discontinued Step 2 Clinical Skills (CS) and dropped plans to relaunch it. The exam was last given March 16, 2020. | Everyone; IMGs, who previously had to pass it for ECFMG certification | USMLE notice |
| Jul 2021 | Attempts per Step reduced from six to four, for applications submitted on or after July 1, 2021. Step 3 eligibility returned to pre-CS criteria, and transcripts gained a note about Step 2 CS. | All examinees, especially those with several prior attempts | USMLE policy updates |
| Jan 2022 | Step 1 reported as pass/fail only, effective January 26, 2022. | All Step 1 examinees | USMLE notice |
| Jul 2025 | Step 2 CK minimum passing standard changed to 218 for exams on or after July 1, 2025. | All Step 2 CK examinees | USMLE scoring page |
| Jan 2026 | Registration, scheduling permits and customer service for IMGs moved from ECFMG's MyIntealth to FSMB (portal returned around January 12, 2026). ECFMG still decides eligibility for certification. | IMGs | USMLE transition notice |
| Jan 2026 | Step 3 services for US graduates moved from FSMB to NBME's MyUSMLE Portal (around January 26, 2026). | US medical students and graduates | USMLE transition notice |
| Mar 2026 | New test delivery software in place for all Step 3 exams since March 10, 2026. | Step 3 examinees | USMLE software notice |
| May 2026 | Step 2 CK (from May 7) moved from 8 to 16 blocks of 30 minutes; Step 1 (from May 14) from 7 to 14 blocks of 30 minutes. Content and day length are unchanged according to USMLE. | Step 1 and Step 2 CK examinees | USMLE software notice |
What each change means in practice #
Step 2 CS discontinuation (2021) #
Clinical skills are no longer assessed by a USMLE exam. For IMGs, ECFMG now uses Pathways to meet its clinical and communication skills requirements, and details are in the ECFMG certification overview. Older Step 2 CS results still appear on transcripts, with an explanatory note.
Four attempts per Step (2021) #
The current limit is 4 attempts per Step. If you have already made several attempts, read attempt limits and retakes carefully before registering.
Pass/fail Step 1 (2022) #
The change moved competitive weight to Step 2 CK, where a numeric score is still reported. See the Step 1 guide and the Step 2 CK score guide.
Step 2 CK passing standard (2025) #
The standard is reviewed periodically. Confirm the figure that applies to your test date on the USMLE scoring page, because the standard that applies depends on when you test.
FSMB registration for IMGs (2026) #
If you are following an older walkthrough, switch to the IMG eligibility guide and the USMLE notice. Name and document details moved too, so see name and document issues.
New exam format (May 2026) #
Practice with the current tutorial and interactive test. Pacing drills built around the old 60-minute blocks no longer match the real exam.
How to monitor changes #
- Read the Bulletin for your test year. The USMLE Bulletin of Information is the rule book, updated annually.
- Check usmle.org news before you register and again a few weeks before your exam.
- Check ECFMG and FSMB pages for certification and registration rules, since each handles a different part of the process.
- Note effective dates. Many changes depend on the date of application or exam, not on the announcement date.
- Screenshot or save the notice you relied on when you made a plan, so you can compare if something changes.
- Treat prep company posts as secondhand. They are useful for alerts but verify them on the official page.
Rules also change in ways this log may miss. If you spot something not listed here, check usmle.org before acting on it.
Frequently asked questions
Where do official USMLE changes get announced?
On usmle.org, in its news and Bulletin of Information, and for IMGs also on ECFMG and FSMB pages. Treat social media and prep blogs as pointers, not sources.
Does a change apply to me if I already registered?
It depends on the change. Many apply by exam date or application date, so read the notice for the effective rule and confirm with your registration entity.
Why do old guides disagree with this page?
Rules changed, notably the 2026 registration move and the format updates. Check the date on any guide and compare it with the official source.
Sources
- USMLE: Step 1 Pass/Fail Score Reporting Implementation Date
- USMLE: Work to Relaunch Step 2 CS Discontinued
- USMLE: Policy Updates Following Step 2 CS Discontinuation
- USMLE: Examination Results and Scoring
- USMLE: Service Transition Launching January 2026
- USMLE: Test Delivery Software Updates for Step 2 CK and Step 1
Found something out of date? Tell us and we will check it against the source.