USMLE Step 2 CS Permanently Discontinued

Posted January 26th, 2021 by .

Categories: ECFMG, NBME, NRMP, USMLE, xHospital Credentialing.

In what amounts to a fundamental change in the way doctors qualify to practice medicine in the United States, the National Board of Medical Examiners and Federation of State Medical Boards (co-sponsors of the USMLE Program) announced today that the USMLE Step 2 Clinical Skills examination (Step 2 CS) will be permanently discontinued.  Per the announcement, the USMLE Program has “no plans to bring back Step 2 CS, but we intend to take this opportunity to focus on working with our colleagues in medical education and at the state medical boards to determine innovative ways to assess clinical skills.”  The Step 2 CS had been suspended as a result of the COVID-19 pandemic and, until today, the USMLE Program had previously stated that it was working to relaunch a modified Step 2 CS exam.

The announcement has broad implications for medical students and recent medical school graduates seeking to train at an ACGME approved residency training program.  Because of the COVID-19 pandemic, graduates of accredited United States medical schools were not required to have passed Step 2 CS in order to qualify for residency training and state-issued graduate medical education licenses in connection with the 2021 Match.  The impact the announcement will have on the tens of thousands of graduates of non-U.S. medical schools (IMGs) seeking to train in the United States is expected to be even more far reaching.

In order to qualify to train in a U.S. residency training program, IMGs must obtain ECFMG certification, which in the past required an IMG’s medical school diploma and credentials to be primary source verified by ECMFG and for the IMG to pass Step 1, Step 2 CK, and Step 2 CS.  When the pandemic struck and the Step 2 CS exam was cancelled, ECFMG softened its requirements for ECFMG certification, creating the Alternative Pathways to certification so as not to render IMGs who could not take or pass Step 2 CS ineligible to begin residency training and participate in the 2021 Match.  Although the Alternative Pathways opened the door to many IMGs who otherwise might have found themselves ineligible, they were not perfect, and left a large number of IMGs who would have earned ECFMG certification but for the cancellation of Step 2 CS without an available path.  Presumably, ECFMG had hoped to do away with the Alternative Pathways once the USMLE Program launched its modified Step 2 CS exam.  It is uncertain what changes ECFMG will make to its certification requirements going forward in the absence of Step 2 CS in light of its desire to assure training programs, state medical boards, and the public that an ECFMG certified IMG has demonstrated the clinical skills necessary to train and care for patients in the United States.

If you have questions about how the cancellation of Step 2 CS and the policy changes that will inevitably be made by ECFMG, USMLE, and NRMP (which administers the Match) as a result might might affect your career, or if you have questions regarding whether you might qualify to seek an exception to any ECFMG policy or pathway, our attorneys stand ready to assist.

For more than 10 years, Dennis L. Abramson has dedicated a significant portion of his practice to counseling and representing medical students, IMGs, residents, fellows, and practicing physicians in compliance and disciplinary matters related to ECFMG, USMLE, NBME, and NRMP, including responding to and defending allegations of irregular behavior and violations of the Match® agreement. Should you need advice or counsel with a related issue, please contact Mr. Abramson at 610-664-5700 or

Mr. Abramson regularly updates this page with the latest developments related to ECFMG, USMLE, NRMP, ABIM, irregular behavior, and physician licensing and credentialing issues, so check back soon.

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