Opinion: Make the Step 1 test for medical students pass/fail

“Are you OK?” a medical school classmate asked when I snuck back into the lecture hall. I had just learned that I bombed arguably the most important test of my life. I was not OK. I was employing every technique I could muster so I wouldn’t break down in public.

I had just checked my score on the United States Medical Licensing Examination (USMLE) Step 1 test. The first of three “Step” exams that physicians-in-training must pass to become licensed to practice independently, the computer-based test focuses on the basic sciences. It’s an eight-hour grind done in a single sitting.

This test, once completed in paper and pencil by students en masse and viewed mostly as a tedious hurdle towards licensure, has since become an obsessive focus among medical students due to its elevation in the residency application process, fueling anxieties, ambitions, and evaluations of self-worth.

I will never forget