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Failed the USMLE Step 1: Next Steps

Instructor: Carrie Soucy
While it's disappointing to fail Step 1 of the USMLE, it's not the end of the road. Read on for instructions regarding how to proceed, and get tips for passing the test on your next attempt.

USMLE Step 1: What to Do If You Don't Pass

If you didn't pass the USMLE Step 1, the National Board of Medical Examiners (NBME) allows you to retake the test, and you have many resources to help you improve your performance.

Upon finding out that you did not pass the exam, however, you should first contact your medical school, as each program has different policies regarding retaking the exam. At many schools, you will need to meet with an administrator and create a plan of study to prepare for your next attempt. You might also be required to retake and pass the exam by a certain date. Moreover, if you fail to pass the USMLE Step 1 on several attempts, you could face dismissal, so it is critical that you thoroughly ready yourself to retake the exam.

How to Prep

As you ready yourself to retake the USMLE Step 1, you should remember that you are not alone. In 2015, for example, more than 4,000 USMLE Step 1 test takers did not pass the exam on their first attempt; so do not be discouraged! It's also a good idea to look back at the study aids and strategies you used on your first attempt to decide what worked and, more importantly, what did not. Here are a few additional ideas and considerations you should keep in mind when creating your study plan:

  • Many students who failed on their initial exam (and then passed on a subsequent retake) identify not doing enough practice questions as their downfall. Several question banks are available for USMLE Step 1 test takers. UWorld, for example, offers more than 2,000 sample USMLE Step 1 practice questions.
  • Before you take the official exam, use practice tests to make sure you're fully prepared. If you fail a practice test, take more time to study before you retake the official exam.
  • If your school offers a program to help you get ready for the USMLE Step 1, utilize it! Such programs can boost your self confidence, teach you how to study effectively, and help you prepare an appropriate plan of study to present to your dean or advisors, if required.
  • USMLE Step 1 test takers may benefit from forming or joining a study group. Study partners can help you identify your weak areas and keep you accountable when it comes to your study schedule.
  • Study materials, such as review and reference books or online courses, can help you address areas of weakness. Study.com, for example, offers a variety of online review courses to help you master USMLE Step 1 content areas, such as Anatomy and Physiology, Biochemistry, Microbiology, Molecular Pharmacology, Genetics, Gerontology, Immunology, Nutrition, and Molecular Biology.

Retake Procedures

The NBME permits students to retake the USMLE Step 1 a maximum of six times. After your first failed attempt, you may retake the exam twice within one year. If you don't pass on your third attempt, you will have to wait six months to retake the exam. That fourth attempt must also be more than a year after the date you first took the exam.

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