Two successful Step examinations are the ticket to residency, and completing all three Step exams will allow you to practice as a licensed physician. These exams are unavoidable and critical to your future in medicine, so it is important that your medical school or residency program acts in good faith with respect to your Step exams.
If you face any kind of issue related to your Step 1, 2, or 3 exams, an attorney-advisor can file a grievance or appeal on your behalf. While the United States Medical Licensing Examination (USMLE) administers this globally-used set of tests, your school or program may have specific policies and procedures related to Step exams. Attorney Joseph D. Lento will navigate those procedures as he seeks a resolution to your Step exam timing issue.
A Brief Overview of Step Exams
USMLE Step examinations are required for every medical student. Regardless of which medical school one attends, the Step exams provide a universal baseline for a medical student or resident's fitness to move further in their medical career, whether it is to the next phase of medical school, to residency, or into medical practice.
USMLE explains that each of its Step exams “assesses an examinee's ability to apply knowledge, concepts, and principles, and to demonstrate fundamental patient-centered skills.” Each exam tests you on different medical concepts and elements of care.
What Is the Grading System for Step Exams?
Step exams have traditionally resulted in numeric grades. The scale ran from 1 to 300 for each of the Step exams, providing a clear pecking order for those who completed exams. However, Step exams are now graded on a pass-fail basis, with a score of 196 or higher constituting a passing score.
It is critical that medical students achieve this passing score. Failing to do so could have significant short- and long-term consequences.
Ramifications of Failing a Step Exam
Failing a Step exam can spark a domino effect of unwanted consequences. If you take and fail Step exams 1,2, or 3, you may:
- Immediately become a less attractive candidate for residency positions
- Have to delay progression to the next phase of medical school
- Have to delay clerkships
- Need to restart the Step exam practice regimen
- Question your ability to get through medical school successfully
- Put immense pressure on yourself to perform well on subsequent Step exams
- Have fewer job prospects in the future due to the cascading negative effects of a failed Step exam
- Face dismissal, which may result from subsequent academic issues after a failed Step exam
If you fail one Step exam, you are one step (no pun intended) closer to failing two Step exams. Multiple failures can be a death knell for your chances of obtaining a residency position.
While all is not lost after a failed Step exam, there is substantial reason not to fail if you can avoid it. If your medical program is pressuring you into taking an exam without deferring the testing date, is failing to provide study conditions that you are entitled to, or is causing another timing-related Step exam problem, an attorney-advisor may be able to negotiate a resolution for you.
When Do Medical Students Take Step Exams?
Medical students generally take their Step 1 exam at the end of their second year in medical school, though a deferral will change this timeline. This Step exam takes one day to complete.
You will generally take your Step 2 exam in your fourth year of medical school, as The Princeton Review explains, and complete this test over the course of two days.
Residents take their Step 3 exam after their first year in a residency program. The Step 3 exam may be the most comprehensive test of your knowledge and ability to care for patients, but you will ideally be best prepared for this Step exam thanks to multiple years of medical training.
You can consult your medical school or residency program's most current literature to learn of specific testing dates, as Step exam schedules may vary from year to year and institution to institution.
Deferring a Step Exam: What You Need to Know
Medical students generally complete their USMLE Step 1 examination following their second year of medical school. However, most medical programs allow students to defer the Step 1 exam so that they may be better prepared to succeed on the test. Schools may technically categorize this deferral as an extension of the “study period,” but you are essentially pushing back the date on which you will take the Step 1 examination.
At the University of California, Davis (UC-Davis), for example, medical students generally complete the USMLE Step 1 exam “on or before the Sunday prior to the start of the Clerkship Intersessions course.” If a student is not prepared at this time, they can request a deferral of the Step 1 exam.
A UC-Davis medical student who chooses to defer their USMLE Step 1 exam must:
- Complete a USMLE Step 1 deferral form
- Indicate on the form why they are requesting a deferral
- Submit the deferral form by the stated deadline, which at UC-Davis is the Wednesday of this sixth week of the dedicated Step 1 exam study period
The UC-Davis Committee on Student Promotions (CSP) will either grant or deny the deferral request, though deferring the Step 1 exam is common practice at medical schools across the country. If UC-Davis' CSP approves the request, it will give the student a new deadline for completing the Step 1 exam.
How Students Determine Whether to Defer Their Step 1 Exam
Practice tests are the primary way that students and schools determine your fitness to take Step exams, especially the Step 1 exam. At the University Illinois College of Medicine, for example, the school advises students about whether they're prepared for Step exams based on their CBSSA (practice) examination scores.
Your personal life may also be a factor in whether you take or defer a Step exam. If you recently had a death in the family, have been sick and unable to study as you normally would, are struggling with mental health, or face other circumstances that could affect your exam performance, it may be wise to seek a deferral.
Am I Guaranteed a Deferral for My Step Exam?
Each medical program has protocols for requesting a deferral of your Step exam. Though deferral requests generally go through an approval process, a student who is not ready to take their exam (based on practice test performance or other criteria) should generally be granted a deferral.
So, while a deferral is not guaranteed, you may generally receive one if you have legitimate reason to delay your testing. Though deferring the Step 1 exam is more common than deferrals of Steps 2 or 3, there may be legitimate reasons (and means) for deferring these latter Step exams.
If you do not receive the deferral you request, it may be worth hiring an attorney-advisor to appeal on your behalf.
Potential Timing Issue: Your School Pressured You to Take Your Step Exam Before You Were Ready
There are potentially life-changing ramifications to failing a Step exam. This is one reason why most medical programs allow students to defer taking the Step exam. If you're not ready, and you have the option to defer the Step exam, it is generally in your interest to do so.
Your medical school advisors, or committees with the power to grant deferrals, may have a different opinion. You may face encouragement or even pressure to take a Step exam before you feel ready. A school may even deny your request for a deferral without providing a valid explanation.
If you feel that your medical school or residency program is forcing you to take a Step exam, it may be worth hiring an attorney-advisor to fight for the deferral you seek.
Potential Timing Issue: Your School Did Not Position You for Success on a Deferred Step Exam
Medical programs generally grant students a dedicated study period for their Step 1 exam. This period, which some medical students refer to simply as “dedicated”, is critical to your success on the Step exam. These periods generally shrink with each subsequent Step exam, as medical students are generally more equipped for Steps 2 and 3 than Step 1.
During a dedicated study period, a medical program has a widely-honored responsibility to:
- Allow students ample time to learn concepts that will be on their upcoming Step exam
- Provide practice materials and allow the student ample opportunity to take practice exams
- Make reasonable accommodations that improve the student's chances of success on their Step examination
Most schools, including the University of Washington School of Medicine (UWSOM) work to ensure the success of students who delay their Step 1 exam. These students' practice test scores indicate that they are not progressing at the pace of certain other students, so UWSOM works to promote their success by:
- Enrolling them in a Comprehensive Basic Science Review course to bolster the concepts included in the Step 1 exam
- Requiring them to complete certain Step 1 practice tests
- Requiring them to complete a final CBSSA practice exam before sitting for the Step 1 exam at the deferred date
As the aforementioned UC-Davis policies explain, a student with a deferred Step 1 exam may also delay rigorous clerkships so that they can continue studying for their Step exam.
If your school required you to take overly rigorous clerkships, did not provide sufficient study time for a deferred exam, or did anything else that undermined your chances of success, we can file a grievance to rectify these issues.
Potential Timing Issue: School, Residency Program, or USMLE Fails to Accommodate Your Learning Disability
The journal Plos One found that 52% of medical schools refused to make accommodations for learning-disabled students who were taking the USMLE Step 1 exam. Correlated results of these accommodation denials included high exam failure rates, delays in progressing to the next phase of medical school, and even withdrawals from medical school.
An attorney-advisor can fight to get specific accommodations for your Step 1 exam, which may include a longer test-taking period.
Why Students with Step Exam Timing Issues Hire an Attorney-Advisor
Few features of your medical education and training carry more weight than Step exams. If you have an issue that affects or could affect your performance on a Step exam, therefore, you owe it to yourself to resolve the issue as efficiently and completely as possible.
Hiring an attorney-advisor could help you resolve your Step exam timing issue. An attorney-advisor from the Lento Law Firm can:
- Work with you to identify possible solutions to your Step exam issue
- Review every relevant detail of your medical school or residency program's policies regarding Step examinations
- Determine precisely where the school or program has failed to abide by its policies
- Identify the paths to a possible resolution, including but not limited to grievances and appeals
- Seek a resolution with your medical school's Office of General Counsel (OGC), which may ultimately have authority (or at least great influence) to resolve specific student issues
Most medical students are overwhelmed at any given time with their school-related responsibilities. If you are engaged in medical extracurriculars, have significant personal responsibilities, or have other time constraints, then the value of hiring a lawyer may be even greater.
We will work on resolving your Step exam issue. You can continue to study, complete coursework, and tend to your existing responsibilities.
Hire the Lento Law Firm, a Team That Specializes in Medical Student Issues
The Lento Law Firm fights for students and residents who face challenges to their academic and professional success. If you are having a problem related to a Step exam, you are facing a potentially career-defining challenge. Do not try to overcome this substantial hurdle on your own, as our team's experience, legal knowledge, and ability to negotiate with your school's legal counsel could be a major asset to you.
Call the Lento Law Firm today at 888-535-3686 or contact us online about your Step exam timing issue. We are prepared to begin work on your case today, so do not wait to call.
