Body
Unit Policy
Title
School of Medicine: Policy on Completion of United States Medical Licensing Examination (USMLE) Step Examinations
Introduction
Purpose
This Policy establishes requirements regarding the USMLE Step examinations that University of North Carolina at Chapel Hill (“University”) School of Medicine (SOM) students must complete to progress in the SOM’s Medical Doctorate (MD) curriculum (“Curriculum”) and qualify for entry into the National Residency Match Program (NRMP).
Scope
This Policy applies to all SOM MD degree and Dual MD degree program students (“Students”).
Policy
Policy Statement
Students must demonstrate a level of mastery of basic science that is adequate for clinical training and of clinical science that is adequate to support successful performance in internship and participation in the NRMP or other residency matching programs. In order to demonstrate such mastery and progress in the Curriculum, Students must pass the following USMLE examinations:
- Step 1 Examination (“Step 1”).
- Step 2 Examination Clinical Knowledge Examination (“Step 2-CK”).
Step 1
Students must take Step 1 following the completion of the Foundation Phase and prior to starting their first rotation of the Application Phase. Students must have a passing score posted for Step 1 before June 30 in the designated year of their cohort, unless a Leave of Absence (LOA) has been approved. Students who do not have a passing Step 1 score posted on or before June 30 will be placed on an Administrative LOA until they achieve a passing score for Step 1. UNC School of Dentistry Oral and Maxillofacial Surgery Residency Program Transfer Students whose program dictates that they can take Step 1 after completion of their Application Phase coursework are exempt from the Step 1 requirements in this section.
Students who receive a failing Step 1 score after starting the Application Phase:
- Will be permitted to finish the course or regional campus equivalent in which they are enrolled at the time of their failure but are not permitted to enroll in any additional courses or regional campus equivalents before passing Step 1.
- Will be required to discontinue their enrollment in any other additional courses or regional campus equivalents.
- Will be required to (i) discontinue their enrollment in any Longitudinal Application Phase Curriculum and start the curriculum over in a year after passing Step 1 or (ii) agree to be transferred to another campus with a non-Longitudinal Application Phase Curriculum (pending capacity) for entrance after a passing Step 1.
- Will have scheduled clinical courses dropped from their schedule, which may delay their graduation.
Step 2-CK
Students must have a passing score posted for Step 2-CK on or before November 1 of Individualization Phase. . Students who do not have a passing Step 2-CK score posted by November 1 of Individualization Phase will be subject to withdrawal from NRMP.
Delays in taking Step Examinations
Students seeking to delay taking a Step examination must email their delay requests to Student Affairs Leadership at SALeadership@listserv.med.unc.edu. The Associate Dean for Student Affairs or his/her designee may allow Students to delay taking Step 1 or Step 2-CK due to extraordinary circumstances in their sole discretion. Students seeking a delay should plan to meet with their advisor, the Office of Academic Excellence, and the Office of Students Affairs to develop a study plan that could include assessment through practice tests of their preparedness to take an USMLE and could include participating in a commercial review course.
Failure of Step Examinations
In the event a Student fails a USMLE examination:
- The Student’s failure will be reviewed by the Student Progress Committee (SPC), which will make any recommendations it deems appropriate.
- The Student will be required to meet with the Office of Academic Excellence, Office of Student Affairs, and their college advisor to design an Individualized Review Plan.
- The Student’s graduation may be delayed.
- The Student may be placed on an Administrative LOA.
- The Student may be required to enroll in additional clinical electives.
- The Student may be required to participate in a specially designed clinical science review.
- The Student may be referred for evaluation of a possible mental, physical, or cognitive concern or condition.
- The Student may be Dismissed from the SOM.
Students with a history of Academic Difficulty who fail Step 1 or Step 2-CK are subject to Dismissal by the SPC.
Students who fail Step 1 or Step 2-CK three (3) times will be Dismissed by the SPC absent a finding of exigent circumstances by the SPC.
Definitions
Leave of Absence (LOA), Administrative LOA: see Policy on Leave of Absence for definitions.
Dual Degree program: A combined degree program, one in which a student applies to both programs with a single application process, or an additional degree program, one which requires two distinct application processes.
Academic Difficulty: The presence of any of the following:
- One or more failing grades in:
- courses (including electives and selectives) or portions of courses
- the USMLE Step 1 or 2
- NBME subject shelf examinations
- Application Phase Objective Structured Clinical Examination (OSCE)
- Patient Centered Care (PCC) final examination
- Other summative examinations
- Failure to meet the requirements of any extramural academic activity approved and authorized by the Associate Dean of Student Affairs (e.g., requirements of the School of Public Health for the MPH degree or for other approved dual degree programs).
- Documented difficulties in clinical performance in any course that leads to an ‘incomplete’ or failing grade.
This includes delay of more than one (1) summative examination in Foundation Phase (Clinical Reasoning Exam [CRE], National Board of Medical Examiners [NBME] exam, PCC final exam), Application Phase (NBME subject shelf examination, OSCE), or Individualization Phase (Formative OSCE)
Dismissal: Student is administratively and permanently withdrawn from SOM. A Student can voluntarily withdraw from SOM or be Dismissed by the SPC. Students may not continue any courses at SOM once a withdrawal or dismissal decision has been made. Students can appeal an SPC dismissal decision (see Appeal of Student Progress Committee Action Policy) but cannot attend class while their appeal is in process.
National Residency Match Program (NRMP): an independent, non-profit organization whose responsibility is to place the nation’s medical school talent into clinical training programs, ensuring a steady pipeline of highly qualified professionals are building the necessary skills to care for patients across the country; also known as The Match.
Individualized Review Plan: a tailored academic support plan created for a Student who has failed a USMLE Step examination.
Posted Step Examination Scores: Step examination scores are considered “posted” once released by the NBME.
Longitudinal Curriculum: Refers to a clinical training model in which Students care for patients over time across multiple specialties simultaneously, integrating learning across disciplines.
Related Requirements
External Regulations
Unit Policies, Standards, and Procedures
Contact Information
Primary Contact
Name: Anthony Passannante, Senior Associate Dean for Medical Student Education
Email: Anthony_Passanante@med.unc.edu