On February 12th, 2020, the United States Medical Licensing Exam was announced to be changed from a three-digit score to only a pass/fail grade. For all medical students with high aspirations this is a threat to achieving their dreams. The Step 1 exam, one of the exams of the USMLE, is a standard exam taken by all medical students. The result of this score, usually taken shortly after the second year of medical school, is a major factor in determining the specialties one is able to apply to after completing medical school. A correlation has been found between doing well on the USMLEs and passing board exams after residency (training) to be able to practice. This system gave all students of medicine, whether an International medical graduate, a student of osteopathic medicine (DO), or a student of allopathic medicine (MD), a chance to stand out in the eyes of residency programs with a great score.

With the proposed change, the Step 2 Clinical Knowledge, the only remaining numeric score, will become the new measure of aptitude. The problem with this is that it is usually taken during the final year of medical school, and one won't be able to determine which specialties they are competitive for until it is almost too late. This is important because a numeric step score gives students an idea what kind of research to get involved in and what kinds of elective rotations to apply for. Students who didn't do particularly well on step 1 used to have a chance to show improvement by doing better on step 2, giving them another chance to prove themselves. This will increase stress, as this one exam will make or break one's medical dreams.

A focus will be shifted to which medical school one attended, which furthers the gap between students at top 20 medical schools and those at lesser-known ones. Furthermore, students at top schools have better connections and available resources, giving them an unfair advantage for competitive residencies over students at other medical schools. Residency programs will miss out on brilliant students who had to attend their state medical school due to financial contstraints, and these students will be unfairly hurt by a change supposed to benefit all medical students.

Grades during the clinical rotations will also play more of a role in determining applicant competitiveness, yet these grades are almost completely subjective and require luck with which resident or attending doctor one is placed with. The doctor having a bad day will almost certainly give a lower score to a student with a similar performance whose doctor is feeling great.

Students with a passion for one field of medicine will have their dreams crushed if they find out they don't have competitive scores for their specialty, but they don't have time to do research in a field they will be competitive for. Already almost $200,000 in debt, taking a gap year for research is unfeasible.

Not proceeding with the proposed change will keep the process of becoming a doctor more objective and will keep opportunities more equal for all students of medicine. While there does have to be change, as the US faces a doctor shortage that will rise to almost 122,000 by 2030 (AAMC), this is not the correct first step.