USMLE Step 1 and Step 2 Examination Procedures and Guidelines

To better support students in understanding the requirements and options available to them when taking the USMLE Step exams, the Office of Student Experience, Office of Student Learning, and Office of Educational Affairs have developed the following guide with additional dates and procedural information regarding the USMLE Step Examination Policy.

Students are required to submit the USMLE Step 1 Eligibility Verification form at least 5 calendar days prior to their scheduled test day; additional requirements are detailed on this page.

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Academic Year 2026–27 Deadline Dates for USMLE Step Exams

See Eligibility to Apply to Residency Programs and Participate in the Match.

Testing eligibility dates differ by planned graduation year.

• Planned May 2029 Graduation (And December 2028 Graduates)
• Planned May 2028 Graduation (And December 2027 Graduates)
• Planned May 2027 Graduation (And December 2026 Graduates)

For Students in the Planned May 2029 Graduation (And December 2028 Graduates)

For Students in the Planned May 2028 Graduation (And December 2027 Graduates)

For Students in the Planned May 2027 Graduation (And December 2026 Graduates)

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USMLE Step 1

Requirements to take Step 1

Students must meet the following requirements:

1. Successfully pass all requirements of the pre-clerkship curriculum (including any targeted skills development or remediation)
2. Meet the minimum testing threshold as published
3. Take the exam during the dedicated window or during a non-clinical 4th year rotation

You will be required to submit evidence of meeting these requirements. We highly encourage you to submit all CBSSA scores to better inform the program’s risk-based models and future interpretation of student progression through dedicated. Eligibility must be submitted via the USMLE Step 1 Eligibility Verification form and will be available to the Office of Educational Affairs (OEA) as well as your Step coach (if desired).

Taking the exam without meeting these requirements will result in an incident card and may be reviewed by the Student Evaluation, Promotions, and Awards Committee (SEPAC) for consideration of disciplinary action.

Finding a Testing Location

Step 1 is administered at Prometric test centers. Visit the Prometric website to schedule or reschedule an exam, locate a test center, confirm or cancel your appointment, and find information on test center policies.

The college does not manage or control scheduling in the Prometric centers, and we have advocated heavily around challenges in the Spokane region. If you are unable to schedule your test on your preferred testing date, you may need to travel to another Prometric testing site.

Exceptions to the dedicated period related to Prometric barriers will be supported if there is documentation that your testing date is cancelled by the testing center and cannot be rescheduled within the dedicated window. This will allow a rescheduled testing date within the limited extension window.

Coaching Support for Step 1

By the beginning of the academic year in which the student is taking the exam, the Office of Student Learning (OSL) will assign each student a Step Coach. In some cases, the Step Coach may also be the student’s Longitudinal Academic Coach. The Step Coach will partner with the student in the development, planning and monitoring of their study schedule and with assessing test readiness. While engaging in Step coaching is not required, it is strongly encouraged; delayed use of this resource decreases its effectiveness.

Additional resources available through the Office of Student Learning include practice exam vouchers, peer tutoring, limited faculty tutoring, learning specialist resources and support, and content.

Minimum Testing Threshold vs. Readiness to Test

Showing evidence of meeting the minimum testing threshold is necessary to meet COM policy requirements. A score of 65 may be predictive of a step 1 test score in the low-pass range for the NBME and does not guarantee that a student will pass the Step 1 exam.

Student-specific readiness is complex and individualized, and the OLC and your Step Coach are available to individualize these discussions. The NBME insights dashboard also contains individualized passing estimates based on your prior NBME examination data (CBSE, CBSSA).

Students with a CBSE in 512 < 40 will be required to meet with the Assistant Dean of Student Learning and Associate Dean of Undergraduate Medical Education during FMS 513 to discuss scheduling and exam preparation options. A meeting is strongly recommended for students with a 512 CBSE of 40-44. This meeting may also be requested by any student regardless of CBSE score.

Testing During Leave of Absence (LOA)

Voluntary LOA

Some students with academic delays may wish to delay their entrance into the LIC until the following academic year to prioritize Step 1 testing. Testing on voluntary LOA will ONLY be allowed between Year 2 and Year 3 if you identify this need by April 30th in Year 2.

After April 30th, students who not ready to take Step 1 prior to the LIC may still request a voluntary leave of absence but are not guaranteed approval to take Step 1 while on leave. See Medical Student Leave, Withdrawal, and Readmission policy.

The Step Policy Appeals Committee will review requests to take Step 1 during a voluntary LOA on a case-by-case basis but, given the impact on clinical schedules, the committee will generally not approve testing unless the leave request is needed independent of the desire to take Step 1. Students planning a voluntary LOA between Years 2 and 3 may not be informed of a Step Policy Appeals Committee decision until after the leave is processed and should not take a leave of absence with the anticipation of being able to take Step 1.

Step 1 testing on voluntary LOA after completion of the LIC is allowed. Please see Taking Step 1 outside the dedicated window for testing options in year 4.

Students who have previously attempted Step 1 but failed can take Step 1 on any voluntary LOA regardless of timing.

Administrative LOA

For Step 1 testing, only students who do not test by the end of Year 4 and do not wish to extend Year 4 will be considered by the SEPAC for a required administrative LOA. This change is effective for students beginning the LIC in Academic Year 2025-26.

Non-step-related administrative leaves may still be required for students based on decisions by SEPAC. See the Medical Student Leave, Withdrawal, and Readmission policy for more details.

For more information about LOAs, please see this Student Handbook’s Leave of Absence Information.

Limited Extension Window

Rescheduling of the Step 1 examination will be allowed for a student who has met the eligibility requirements and is ready to take the exam at the end of the dedicated preparation period, but who may have an acute illness, personal/family emergency, or Prometric cancellation. You may be asked for proof of eligibility to take the exam (meeting minimum threshold) or documentation of scheduled test that had to be cancelled, as examples.

These short-term extensions do not support ongoing or lost preparation time. They can be requested to reschedule a testing date, typically within the next week, pending Prometric availability. The limited extension window is provided.

To request a short-term extension, student must submit a request via email to medicine.educationalaffairs@wsu.edu.

The Step Policy Appeals Committee is made up of the Vice Dean of Learner Engagement, the Vice Dean for Educational and Faculty Affairs, the Associate Dean of Undergraduate Medical Education, and student’s Regional Associate Dean. The committee will review all requests and follow up directly with students.

Students who are not ready to take the exam at the end of their testing window will enter the LIC and may not take Step 1 during the LIC. The post-LIC testing options are detailed below.

Requirements Leading up to the LIC

When entering the LIC, you will be required to communicate with your campus to complete onboarding paperwork in a timely manner. Some clinical sites require onboarding to be completed up to 90 days prior to your clinical placement.

Taking Step 1 Outside the Dedicated Window

Timing to take the exam after the dedicated window is more limited due to the requirement to focus on clinical work during the clerkship curriculum.

Students may not take the exam during the LIC.

Students can take the exam during their Year 4 discretionary time or virtual courses but may not take the exam during required or clinical Year 4 courses.

Students can choose to continue into Year 4 or take a voluntary leave of absence after the LIC to further prepare and test. Students can take Step 1 on any voluntary leave of absence occurring after the LIC.

Students should also refer to Eligibility Requirements to Apply to Residency Programs established jointly by the Offices of Educational Affairs and Student Experience to consider whether they are able to take and pass Step 1 and Step 2 in addition to completing Year 4 requirements within Year 4 or would benefit from a voluntary LOA.

USMLE Step 2

Preparing for Step 2

Students should review the guidance from the Career Advising Program about Step 2 Timing Based on Specialty if planning on applying to residency.

Students are encouraged to meet with the Office of Student Learning to review study strategies and identify an appropriate testing date.

Timeline to Take Step 2

There is no dedicated period for USMLE Step 2. Students may begin taking Step 2 during the last week of the LIC and must attempt Step 2 by November 1st to graduate in December. Students must attempt Step 2 by April 1st to graduate in May. Step 2 testing on voluntary LOA after the LIC is allowed.

When helping to develop the Year 4 schedule with their campus team, students may request discretionary time to prepare. Students should be mindful of required specialty away rotations which are often completed prior to ERAS application release in September of Year 4.

Students must have a passing score on Step 2 by January 31st to be verified in the Match in that year (regardless of May or December graduation). See Eligibility Requirements to Apply to Residency Programs for more information.

Both Exams

Requesting Testing Accommodations for USMLE Exams

The NBME determines whether testing accommodations for USMLE Step exams are fully or partially granted or denied. Support for applying for NBME accommodations is provided through the Office of Student Learning. It is recommended that students begin working on their request to the USMLE one year prior to testing (April of Year 1 for most students).

• April–May: Review guidelines, determine what documentation is needed
• June–August: Draft personal statement
• September: Complete New Request application and upload all supporting documentation
• October: Register for exam
• November: Submit accommodations application
• December–March: Receive decision and schedule exam

Additional Resources

• Docs with Disabilities: USMLE Accommodations Guide
• USMLE: Test Accommodations
• Quick Guide to the USMLE Accommodations portal

The Director of Disability Resources and Learning Support can also support you in considering whether internal accommodations of relevant policies or procedures, such as the limited extension window, are appropriate for disability-related barriers.

Eligibility to Apply to Residency and Participate in Match

Students should review the deadlines and the Eligibility Requirements to Apply to Residency Programs information in order to apply for residency and participate in the NRMP Match and/or ERAS SOAP.