UAB School of Medicine United States Medical Licensing Examination Policy

All students must pass the United States Medical Licensing Examination (USMLE) Step 1, USMLE Step 2 Clinical Knowledge (CK), and USMLE Step 2 Clinical Skills (CS) examinations in order to graduate with the MD degree.

Students intending to participate in that year’s residency match must post passing scores on Step1, Step 2 CK, and Step 2 CS by the date the school must certify their match participation eligibility with the National Residency Matching Program (NRMP).

Number of attempts: Students who fail to record a passing score after the third attempt of USMLE Step 1, USMLE Step 2 CK, or USMLE Step 2 CS examinations are subject to dismissal by the Student Academic Standing Committee (SASC) from the School of Medicine.

USMLE Step 1 time limits: Failure to take USMLE Step 1 within six months of completion of the second-year curriculum may be grounds for dismissal by the SASC. Any exceptions must be approved by the SASC prior to the end of the 6-month time limit. Failure to record a passing score on USMLE Step 1 within twelve months of successfully completing second-year coursework may be grounds for dismissal by the SASC. Any exceptions must be approved by the SASC prior to the end of the twelve-month time limit.

USMLE Step 2 CK time limits: Students with a June graduation date are required to take USMLE Step 2 CK for the first time by November 1 of the academic year in which they will graduate. Students with a June graduation date are required to pass USMLE Step 2 CK at least 1 week prior to the June graduation date. Students graduating in December are required to pass USMLE Step 2 CK at least 1 week prior to the December graduation date.

USMLE Step 2 CS time limits: Students with a June graduation date are required to take USMLE Step 2 CS for the first time by November 1 of the academic year in which they will graduate. Students with a June graduation date are required to pass USMLE Step 2 CK at least 1 week prior to the June graduation date. Students graduating in December are required to pass USMLE Step 2 CS at least 1 week prior to the December graduation date.

Policy Exceptions: Any exception to the time limits established above for Step 1, Step 2 CK, or Step 2 CS must be approved by the Associate Dean for Students. The exception must be requested prior to the end of the time limit. All exceptions must be made in writing and include the basis for the exception request.

Procedures

USMLE Step 1:

    • All students must take USMLE Step 1 before beginning their first clerkship, Scholarly Activity, or any clinical elective, whichever comes first, or before beginning a leave of  absence for any combined or coordinated program (Medical Scientist Training Program (MSTP), MD MPH, or MD MBA, for example).

    •  Students who fail USMLE Step 1 on the first or second attempt have the option to complete any clerkship, Scholarly Activity, or elective currently in progress or withdraw immediately (Note: A grade of WP or WF may be required). Students who fail USMLE Step 1 on the first attempt may not start a new clerkship, elective, or scholarly activity until the examination is retaken. Students who fail USMLE Step 1 on the second attempt may not start a new clerkship, elective, or scholarly activity until they receive a passing score on the examination.

    • Students who fail USMLE Step 1 on the third attempt are immediately withdrawn from coursework and placed on leave of absence pending decision by the SASC for dismissal or to allow a fourth attempt. In cases where the SASC allows a fourth attempt, the student will remain on leave until a passing score is reported.

    • Students who fail USMLE Step 1 must meet with the Director of Academic Success to establish a plan for remediation, to monitor preparation, and to determine readiness for retake.

Actions related to USMLE Step 1 failure.

   Status Continuation in Clerkship or Scholarly Activity  Return to Coursework
 Failure of 1st Attempt

Active with Deficiency or Academic Probation*

Reviewed by SASC

Returned to Active in Good Standing upon receipt of passing score on Step 1 provided no other academic issues need resolution

Required to withdraw from clinical coursework or scholarly activity

Student’s option to complete clinical coursework or scholarly activity currently in progress before withdrawing or to withdraw immediately (Note: A grade of WP or WF may be required)

Leave of absence may be required

After re-taking Step 1 

 Failure of 2nd Attempt

Academic Probation

Reviewed by SASC Returned to Active in Good Standing upon receipt of a passing score on Step 2 CK provided no other academic issues need resolution 

Required to withdraw from clinical coursework or scholarly activity

Student’s option to complete clinical coursework or scholarly activity currently in progress before withdrawing or to withdraw immediately (Note: A grade of WP or WF may be required) 

Leave of absence may be required

Upon receipt of passing score on Step 1 

Failure of 3rd Attempt 

 Academic Probation

Reviewed by SASC with option for dismissal

If allowed to continue, Academic Probation continues until completion of all coursework

Required to withdraw immediately from clinical coursework or scholarly activity currently in progress

Leave of absence required 

Subject to dismissal by the SASC

Return to coursework dependent upon SASC decision 

*Status change depends on whether other academic issues require resolution.

USMLE Step 2 CK:

    • Students who fail Step 2 CS on their first attempt have the option to continue in coursework while preparing for their Step 2 CS retake. Students who choose to withdraw from coursework may withdraw immediately or upon completion of coursework in progress (Note: A grade of WP or WF may be required).

    • Students who fail USMLE Step 2 CS on their second attempt must withdraw from coursework. Students have the option to complete coursework in progress or to withdraw immediately (Note: A grade of WP or WF may be required).

    • Students who fail USMLE Step 2 CS on the third attempt are immediately withdrawn from coursework and placed on leave of absence pending decision by the SASC for dismissal or to allow a fourth attempt. In cases where the SASC allows a fourth attempt, the student will remain on leave until a passing score is reported.

    • Students who fail Step 2 CS must meet with Assistant Dean for Clinical Activities to establish a plan for remediation, to monitor progress, and to determine readiness for retake.

Actions related to Step 2 CS failure.

   Status Continuation in Coursework  Return to Coursework
Failure of 1st Attempt 

Active with Deficiency or Academic Probation*

Reviewed by SASC Returned to Active in Good Standing upon receipt of passing score on Step 2 CK provided no other academic issues need resolution

Student’s option to withdraw or remain in clinical coursework

Students who choose to withdraw from coursework have the option to complete clinical coursework currently in progress before withdrawing or to withdraw immediately (Note: A grade of WP or WF may be required)

Leave of absence may be required 

Students are not required to withdraw from coursework 

Failure of 2nd Attempt 

 Academic Probation

Reviewed by SASC

Academic Probation continues until completion
of all coursework

Required to withdraw from clinical coursework

Student’s option to complete coursework currently in progress before withdrawing or to withdraw immediately (Note: A grade of WP or WF may be required)

Leave of Absence may be required

After retaking Step 2 CK 

 Failure of 3rd Attempt

Academic Probation

Reviewed by SASC with option for dismissal

If allowed to continue, Academic Probation continues until completion of all coursework

Required to withdraw immediately from coursework currently in
progress

Leave of Absence required

Subject to dismissal

Return to coursework dependent upon SASC decision 

USMLE Step 2 CS:

    • Students who fail Step 2 CS on their first attempt have the option to continue in coursework while preparing for their Step 2 CS retake. Students who choose to withdraw from coursework may withdraw immediately or upon completion of coursework in progress (Note: A grade of WP or WF may be required). 

    • Students who fail USMLE Step 2 CS on their second attempt must withdraw from coursework. Students have the option to complete coursework in progress or to withdraw immediately (Note: A grade of WP or WF may be required). 

    • Students who fail USMLE Step 2 CS on the third attempt are immediately withdrawn from coursework and placed on leave of absence pending decision by the SASC for dismissal or to allow a fourth attempt. In cases where the SASC allows a fourth attempt, the student will remain on leave until a passing score is reported.

    • Students who fail Step 2 CS must meet with Assistant Dean for Clinical Activities to establish a plan for remediation, to monitor progress, and to determine readiness for retake.

Actions related to Step 2 CS failure.

   Status Continuation in Coursework   Return to Coursework
Failure of 1st Attemp 

Active with Deficiency or Academic Probation*

Reviewed by SASC

Returned to Active in Good Standing upon receipt of passing score on Step 2 CS provided no other academic issues need resolution 

Student’s option to withdraw or remain in clinical coursework

Students who choose to withdraw from coursework have the option to complete clinical coursework currently in progress before withdrawing or to withdraw immediately (Note: A grade of WP or WF may be required)

Leave of absence may be required 

Students are not required to withdraw from coursework 

Failure of 2nd Attempt 

Academic Probation

Reviewed by SASC

Academic Probation continues until completion of all coursework

Required to withdraw from clinical coursework

Student’s option to complete coursework currently in progress before withdrawing or to withdraw immediately (Note: A grade of WP or WF may be required)

Leave of Absence may be required 

After retaking Step 2 CS 

Failure of 3rd Attempt 

Academic Probation

Reviewed by SASC with option for dismissal

If allowed to continue, Academic Probation continues until completion of all coursework

Required to withdraw immediately from coursework currently in progress

Leave of Absence required

Subject to dismissal

Return to coursework dependent upon SASC decision

 * Status change depends on whether other academic issues require resolution.

The UAB School of Medicine United States Medical Licensing Examination Policy was approved by the UA System Office on September 9, 2019. This School of Medicine policy is in effect as of April 1, 2020.