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M.D. Program

M.D. Program

USMLE Step 1 Policy

Approved by CSP October 2014

Goals:

  1. Maximize student learning;
  2. Minimize student withdrawal from clerkship rotation sites as a result of the USMLE Step 1 exam;
  3. Create a consistent and transparent policy for students related to the take and complete date for the USMLE Step 1 exam; and
  4. Have a centralized body for students to approach for exception requests for delaying the USMLE Step 1 exam, and outline clear mechanisms for such requests, including the implications of such requests.

Policy

  1. All students must take and complete their USMLE Step 1 exam on or before the Friday immediately prior to the start of Transition to Clerkships (T2C) course.1
    1. If students do not take and complete the Step 1 exam by the above deadline, they will need to inform the Committee on Student Promotions (CSP) of their decision as soon as possible and, at the very latest, by 11.59 pm (Pacific Time) on the Friday before the start of the T2C course.
      1. Students delaying the exam will need to have a plan reviewed and approved by CSP (this will involve meeting the CSP Chair and the SADME2and/or coming to the CSP meeting in person).
      2. Students who do not inform CSP prior to the aforementioned deadline will be placed on Academic Warning and will appear at CSP.
      3. Students who do not take and complete their exam by the School’s deadline will be deferring their 1st clerkship3 and will need to take and complete their Step 1 exam prior to starting the 2nd clerkship.
      4. Students who do not take and complete their Step 1 exam by the School’s deadline still need to participate in T2C and Doctoring 3.4
      5. If they pass the USMLE Step 1 exam they will continue on with Clerkship #2 and their 3rd Year.
      6. If they fail the USMLE Step 1 exam they will be allowed to complete Clerkship #2 unless they elect to withdraw; all students who fail Step 1 will need to have their remediation plan reviewed and approved by CSP.  After the completion of Clerkship #2, they will defer Clerkship #3; study and retake the exam; and will be  subject to the following:

        1. On a case by case basis, CSP will determine whether it is optimal for a student to start Clerkship #4 prior to receiving their retake score back from the NBME.
          1. If they fail Step 1 on the reattempt,5they will need to withdraw from the Year 3 curriculum, show a passing score on Step 1 prior to the Clerkship Lottery for the next class (usually mid-January) and join the next 3rd year class.  (see footnote 4)
        2. Does not allow a student to start Clerkship #4 prior to receiving a passing score from NBME on the Step 1 retake, student will need to withdraw from the Year 3 curriculum, pass Step 1 prior to the Clerkship Lottery for the next class (usually mid-January) and join the next 3rd year class.  (see footnote 4)
    2. If students take and complete the USMLE Step 1 exam by the School’s deadline, they may start Clerkship #1.
      1. If they pass, they will continue their clerkships.
      2. If they fail, they will be allowed to complete Clerkship #16 unless they choose to withdraw from Clerkship #1.
        1. a) Students will defer Clerkship #2 to study and retake the exam.
        2. Students will need to continue with Doctoring 3.
        3. On a case by case basis, CSP will determine whether it is optimal for a student to start Clerkship #3 prior to receiving their retake score back from the NBME.
        4. If CSP does not allow a student to start Clerkship #3 prior to receiving a passing score from the NBME
          1.  A passing score will be required prior to restarting the clerkships. 
          2. A passing score must be received prior to the start of Clerkship #4.7
          3. Please remember that you may only miss 2 clerkships (see footnote 4).  Students who miss more than 2 clerkships should be prepared to go on a leave, pass their USMLE Step 1 prior to the Clerkship Lottery for the next class (usually mid-January) and join the next 3rd year class.

Additional Notes:

  • Students who defer 1 or more clerkships will be accommodated into the 3rd year clerkships in their 4th year in a sequence that is logistically feasible (to be determined by the OME and Curriculum Managers) and not necessarily in the same sequence as the students were originally enrolled.
  • Students who fail the Step 1 examination and choose to withdraw from the clerkship they are enrolled in, will not get partial credit for the clerkship.

Step 1 Flowchart (PDF)


1This allows students more than the OSLER-recommended 6 weeks of study time.
2Senior Associate Dean for Medical Education
3Deferral of a clerkship means you will be taking the deferred clerkship in your 4th year.  There are no guarantees that you will be able to take your missed clerkship during Clerkship #1 of the next academic year.  4th year students need to take Acting Internships (AIs) early in their 4th year to be competitive for the Match.  Please see the FYOC’s requirements for taking AIs (found in the deferral policy: http://www.ucdmc.ucdavis.edu/mdprogram/medicalstudentpolicies/curriculum.html).
4Doctoring 3 is a required, 3rd year course meant to run concurrently with 3rd year clerkships.  Attendance is mandatory and a student may only miss 2 clerkships.  If a student misses more than 2 clerkships he/she must restart their 3rd year with the next academic class.
51st fail of the USMLE Step 1 exam places a student on Academic Warning, 2nd fail places a student on Academic Probation.
6By completing Clerkship #1, you will have one less clerkship to defer to the 4th year.  See pitfalls of clerkship deferral in footnote 3.  Additionally, you are allowed to miss only 2 clerkships to receive credit for Doctoring 3 (see footnote 4)
7Clerkship #3, if the student did not successfully complete Clerkship #1.