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M.D. Program

M.D. Program

USMLE Step 1 Policy

Revised July 2013

Guidelines

  1. Students must take and complete their USMLE Step 1 exam by the 15th calendar day prior to the start of Transition to Clerkships unless they receive approval to delay their take and complete date, due to:
    1. Emergency reasons1, in which case permission to delay must be sought from, and granted by, the Sr. Associate Dean of Medical Education (SADME) or the Associate Dean of Student Affairs (ADSA), or
    2. An OSLER recommendation that is approved by the SADME or ADSA and based on academic performance during Years 1 & 2 or identified learning strategy deficits.
  2. The deferral of clerkships to study for the USMLE Step 1 is approved using the same criteria and approval process as outlined above.
    1. Students will need to complete course deferral form2
    2. Students may defer only 2 clerkships (see 5 below).
  3. If an enrolled student receives a failing Step 1 score, the student will withdraw from his/her clerkship.
    1. Students will meet with Office of Student Learning and Educational Resources (OSLER) and the ADSA as well as with the SADME and Chair of CSP.  Students will be asked to submit a personal statement and a remediation plan to CSP3
    2. UCD School of Medicine Bylaws state that students must pass USMLE Step 1 prior to continuing clerkships unless the CSP gives them an exception.
      1. The exception terms are that students who receive a score of 178 and above may4 be allowed to take their exam prior to the start of the clerkship and receive their score after the clerkship has started.
    3. Students who fail Step 1 cannot receive partial credit for any 3rd year work5
  4. If a non-enrolled student fails their Step 1 exam, they will only be allowed to return to clerkships in accord with CSP policy/SOM bylaws (see 3(b)(i) above).
  5. Doctoring 3 is a required course intended to run concurrently with 3rd year clerkships.  Doctoring 3 policy is that students may not miss more than 2 clerkships.
    1. Students must either receive a passing Step 1 score prior to the start of Clerkship 3, or
    2. Have permission from the CSP to start Clerkship 3 prior to receiving their score (see 3(b)(i) above).
    3. Students unable to attain a passing score or permission from CSP to start Clerkship 3 must restart their 3rd year with the next class.
  6. Clerkship Lottery6:
    1. Students returning from a leave of absence must pass Step 1 prior to the 3rd Year Clerkship Lottery in order to participate in the lottery.
    2. Students on leave for Step 1 will need to receive a passing Step 1 score prior to the 3rd Year Clerkship Lottery in order to participate in the lottery.

See the Flow Chart for an overview of this policy.


  1. Emergencies should be supported by documentation and will most likely fall into the category of medical or family emergency or other significant extenuating circumstance.
  2. Course Deferral Form 
  3. CSP Procedures for Students with Academic Difficulties
  4. Student’s prior academic history will be reviewed and the CSP will grant this exception only when there is every indication that the student can achieve a passing score.  This policy based on review of historical USMLE Step 1 data.
  5. Successful completion of all Year 1 & 2 coursework and passing USMLE Step 1 is a prerequisite to promotion to Year 3.