Discontinuation USMLE Step 2CS

Permanent Cancellation of USMLE Step 2CS

The permanent cancellation of the USMLE Step 2CS examination was announced on January 26, 2021, after the exam was initially suspended on March 16, 2020.

The suspension and then discontinuation of the USMLE Step 2CS marked one of the most significant changes the Match has ever seen. Formerly a required benchmark for obtaining ECFMG certification, the suspension left many IMGs wondering if they would be eligible for the 2020-2021 Match. They didn’t have to worry for very long, however.

Upon USMLE’s suspension of the exam, the ECFMG introduced 5 alternative Pathways to certification. Each Pathway provided a way for IMGs to satisfy the clinical skills portion of ECFMG Certification. Since the permanent discontinuation of the Step 2CS exam, the ECFMG has refined the 5 Pathways and added a 6th. You can read more about the Pathways at our ECFMG Pathways for IMG Certification in 2022 Residency Match blog.

See below for more details on the suspension and discontinuation of the Step 2CS exam and the ECFMG Pathways as they stand for the 2022 Match.


The USMLE Step 2CS exam was initially suspended for the 2021 Match amidst COVID-19 concerns with the intention of maximizing safety–and minimizing exposure. The initial suspension was predicted to be for 12-18 months. Accordingly, the ECFMG developed 5 alternative Step 2CS Pathways.

Cancellation of the USMLE Step 2CS

On January 26th, 2021, the USMLE announced that they had “no plans to bring back Step 2 CS,” but instead would “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.”

This news was well-received by critics of the Step 2CS exam who said it was “too expensive and time-consuming” and suggested that the exam “often pos[ed] unnecessary barriers for medical students.”

The USMLE also issued a statement acknowledging the importance of independent standardized assessments of clinical skills:

“In the absence of Step 2 CS, elements of clinical reasoning and communication will continue to be assessed on other exams (Steps) in the USMLE sequence. Computer-based case simulations in Step 3 and communication content recently bolstered in Step 1 are examples of these efforts that will continue. While not a replacement for Step 2 CS, these formats continue to contribute positively, e.g., measuring critical knowledge of medical communication.”

Moving Forward

IMG applicants for the 2022 Match cycle must meet the requirements for one of the 6 Pathways. Per the ECFMG, “The Pathways allow ECFMG Certification to continue to perform its critical function of providing assurance to the public and U.S. graduate medical education (GME) programs that IMGs are ready to enter supervised training. They also allow qualified IMGs to continue to pursue ECFMG Certification and to compete for positions in U.S. GME.”

For more information regarding the 6 alternative Pathways, head over to our blog ECFMG Pathways for IMG Certification in 2022 Residency Match or visit the ECFMG’s page Requirements for ECFMG Certification for 2022 Match.

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