USMLE Step 1 and Step 2 Policy

  

Overview/Rationale

The United States Medical Licensing Examination (USMLE) is a three-step examination for medical licensure in the United States. The USMLE assesses an examinee’s ability to apply knowledge, concepts, and principles, and to demonstrate fundamental patient-centered skills. These skills constitute the basis of safe and effective patient care.   

VP&S requires students to pass USMLE Step 1 and Step 2 CK examinations to graduate.  

Accreditation Standards

LCME Accreditation Standard 9.9: Student Advancement and Appeal 

USMLE Step 1 Examination

All VP&S MD students must take USMLE Step 1 before March 1 following the completion of the Major Clinical Year and before beginning Differentiation and Integration (electives and scholarly project). Students in the Columbia Bassett program must take Step 1 before April 1.  Students must successfully complete all components of MCY clerkships, including passing shelf examinations, before taking the USMLE Step 1 examination.

  • Effective with the VP&S entering class of 2025 and thereafter, all MD-PhD students are required to complete the Fundamentals curriculum and a minimum of one core clerkship (at least 4 weeks in length, up to 12 weeks of Major Clinical Year experiences permitted) prior to initiating Step 1 preparation. MD-PhD students must take the USMLE Step 1 examination before beginning their PhD.  
  • Students in the PhD-to-MD program complete four Major Clinical Year clerkships before preparing for and taking Step 1.
  • Students who begin the MBA program at Columbia Business School immediately after Major Clinical Year can defer a clerkship to prepare for and take Step 1 before beginning business school in early January after Major Clinical Year. They will take this deferred clerkship upon their return to VP&S and before beginning Differentiation and Integration. This will require the approval of the Associate Dean for Student Affairs, Support and Services.
  • Students in the Oral Maxillofacial Surgery (OMFS) or Oral Pathology program must take Step 1 by late January following the completion of the Fundamentals curriculum, and before beginning clerkships with the second block of Major Clinical Year.
  • Passing Step 1 is a requirement to continue in the clinical curriculum and a requirement for graduation. Students who fail Step 1 will be removed from their academic work for one month to allow for study time to retake the exam. Step 1 must be retaken by 90 days after the first attempt. Students who fail Step 1 a second time will be removed from the curriculum for 6 months to prepare to retake it a third and final time. Students who do not pass Step 1 after three attempts are subject to dismissal from the School.

Any exceptions to the above USMLE Step 1 examination timelines require approval by the Associate Dean for Student Affairs, Support and Services, using this form. Students who request extensions to these deadlines will also be expected to meet with a CERE Medical Education and Learning Specialist.

 

USMLE Step 2 Clinical Knowledge (CK) Examination 

Students must pass USMLE Step 1 exam prior to taking USMLE Step 2 exam.

  • All VP&S MD students must take USMLE Step 2 CK by July 31 following the Major Clinical Year. Students must pass the USMLE Step 1 exam prior to taking Step 2.
  • Students beginning the dual degree MD/MBA program immediately after Major Clinical Year must take CK by July 31 after returning in January to medical school from business school.
  • Students in the MD-PhD and PhD to MD programs must take  Step 2 CK by July 31 of their final year.
  • Students who take a year off during Differentiation and Integration for research or other reasons are encouraged to take CK before beginning the research year, and must take CK by July 31 following the year off.
  • Students in the OMFS or Oral Pathology program must take CK by Jan. 31 of their graduation year.
  • Passing Step 2 CK is a requirement for graduation from VP&S. Students who fail CK must retake the exam by Jan. 31 of the same academic year. Students who fail CK and are in the MD-PhD, or OMFS program must retake CK by April 1 of the graduation year. Students can take Step 2 CK a maximum of three times but may not retake a Step exam that they have passed in an attempt to get a higher score. Students who do not pass Step 2 after three attempts are subject to dismissal from the school.

Any exceptions to the above USMLE Step 2 examination timelines require approval by the Associate Dean for Student Affairs, Support and Services using this form. Students who request extensions to these deadlines will also be expected to meet with a CERE Medical Education and Learning Specialist.

 

Policy History/Approval Date: 

The policy on scheduling and sitting for the USMLE Step 1 and Step 2 was taken from print-version student handbooks and online formats.  These documents were reformatted and codified into policy where specific procedures and edits were added.  The policy was reviewed and approved by the Committee on Educational Policy and Curriculum on April 19, 2024.

The policy was updated and approved by the Committee on Educational Policy and Curriculum on July 18, 2025.