[9] Physicians with a Doctor of Medicine (MD) degree are required to pass the USMLE for medical licensure.
However, those with a Doctor of Osteopathic Medicine degree (DO) are required to take the COMLEX-USA (COMLEX) exams but may also sit for the USMLE as well.
USMLE claimed it was done with the intention of orienting the examination to support the licensing decisions made by medical boards, transitioning the exam to a competencies schema and emphasizing the importance of scientific foundations of medicine throughout the examination sequence.
Second, the pandemic crisis exacerbated existing resentment towards the high-stakes nature of the exam: namely, several students and physicians were upset that the USMLE refused to move up the 2022 deadline of making Step 1 into a pass or fail exam.
[28][29][30][31] A study conducted in 2020 showed differences in USMLE Step 1 scores attributable to race and ethnicity, with lower mean scores for self-identified Black, Asian, and Hispanic examinees when compared with self-identified White examinees.
[34][35][36][37] In 2020, the American Academy of Family Physicians and the Association of American Medical Colleges expressed their support for changing Step 1 to pass or fail, in part to reduce racial bias.
[38][39][33] The US Medical Licensing Examinations have received criticism due to their high cost.
As of 2023, the USMLE charges (in U.S. dollars): As part of a broader public plea for systemic changes to the improper use of USMLE exams, STAT wrote that this "multimillion-dollar industry has exploited the opportunity to extract thousands of dollars from already overly indebted students.