https://www.city-journal.org/article/united-states-medical-licensing-exam-pass-fail-grading
Medical schools and institutions are now among the zealous champions of progressive ideology. Within days of George Floyd’s death in May 2020, the Association of American Medical Colleges demanded that the nation’s medical schools “employ anti-racist and unconscious bias training.” The following year, the American Medical Association called on physicians to “dismantle white supremacy, racism, and other forms of exclusion and structured oppression.” But efforts to enhance diversity among the medical student body—too often by compromising standards of excellence—have long been in place at America’s medical schools, from affirmative action policies to pass-fail grading of courses and clinical rotations.
In a recent Journal of the American Medical Association commentary, however, four Stanford University-affiliated scholars pushed back on these changes—a ripple that suggests a potential academic shift. In their essay, Drs. James Agolia, David Spain, and Jeff Choi, and medical student Allen Green, denounce the “diminishing objectivity” of the residency-admissions process. “We believe that some objective standards are necessary,” they write, “for programs to identify candidates who best fit their program in a fair, consistent, transparent, and efficient fashion.”
Specifically, the authors lament that the United States Medical Licensing Exam made its initial test pass-fail. The USMLE, which all would-be doctors take, is administered in three parts. Step 1 is taken after the second year in medical school to test pre-clinical medical knowledge; Step 2 is taken after the fourth or final year to assess clinical knowledge; and Step 3 is taken after the first year of residency to evaluate clinical decision-making.
The change was several years in the making. The exam’s co-sponsors, the National Board of Medical Examiners and the Federation of State Medical Boards, first recommended making Step 1 pass-fail in 2019. Other groups, including the AMA and AAMC, collaborated in developing the proposal, which was eventually adopted in 2022.