USMLE STEP 1 PREPARATION AND CLINICAL ROTATIONS SCHEDULING POLICY for 2025-2026

Table 1: Take the USMLE exam prior to CF3 and Radiology, begin clinical rotations, receive a score of “Pass” on the exam

I. Clinical Curriculum Timing:

Eligible to complete the MS3+MS4 curriculum in two years

II. Tuition and Fees:

Will be assessed.

III. Financial Aid:

Will be eligible for financial aid.

IV. Specific Considerations:

n/a

V. Personal Leave of Absence:

n/a

VI. Length of Exam Preparation:

n/a

VII. Clinical Schedule:

Barring interruptions, the student will follow the clinical schedule assigned during the MS3 stream selection process.

VIII. Return to Clinical Rotations:

n/a

Table 2: Take the USMLE exam prior to CF3 and Radiology, receive a score of “Fail” on the exam prior to the completion of the CF3 and Radiology sessions that precede clerkships

Option A:

Do not enroll in the SOM summer term

Option B: 

Enroll in a 3-week independent study elective at the start of the term, run by Dr. Wiechmann, with a required learning plan and weekly check-ins with the learning skills team

I. Clinical Curriculum Timing:

May not be feasible to complete the MS3+MS4 curriculum in two years

II. Tuition and Fees:

Option A:  Not assessed for this SOM term.

Option B: Will be assessed for this SOM term.

III. Financial Aid:

Will not be eligible for financial aid.  For some students, this may impact their housing and other benefits.

Option B:  Will be eligible for financial aid with successful completion of this elective (i.e. grade is posted).  The student will only be covered for this SOM term.

IV. Specific Considerations:

n/a

Option B:

1) MS3 elective requirement:  This elective counts towards their MS3 elective requirement, meaning that students may enroll for only one more week of elective time during their MS3 curriculum.

2) Non-clinical elective limits:  This elective counts towards their non-clinical elective time, meaning that students may enroll for only one more week of non-clinical elective time for the remainder of their MS3 and MS4 curriculum. 

3) One-time enrollment:  This elective is limited to MS3 students for USMLE Step 1 preparation and students may only take the elective one time.  If a student requires additional USMLE exam preparation time in subsequent SOM terms, they will not be able to enroll in this elective again. 

V. Personal Leave of Absence:

Option A: Students will be placed on a personal leave of absence with a start date at the beginning of the SOM summer term.

Option B: If the student can receive a passing score on Step 1 and return to the clinical curriculum within four weeks of completing the independent study elective, they do not need to be placed on a personal leave of absence.  Otherwise, they will be placed on a personal leave of absence effective the day after completing the independent study elective. 

Students will need to enroll in the independent study elective at the start of the term, prior to beginning their personal leave of absence.

VI. Length of Exam Preparation:

If a student needs additional exam preparation time beyond this term and extending into future SOM terms:

• The student will not enroll in those subsequent SOM terms, meaning that tuition and fees will not be assessed and the student will not be eligible for financial aid.
• In accordance with the Exam Administration and Procedures policy, "students are eligible for academic probation if they do not pass the USMLE Step 1 within one year of the end of that student’s second-year curriculum.”  The end of the second-year curriculum for the MS2 curriculum in the 2024-2025 academic year is March 21, 2025, so the exam must be passed (not just taken) before March 21, 2026.
• Students have a maximum of 24 months from the end of the second-year curriculum to successfully complete the USMLE Step 1 exam.  Students who do not meet this requirement are eligible for dismissal.

VII. Clinical Schedule:

Option A: The student will be dropped from the entire clinical schedule (all clerkships) assigned during the MS3 stream selection process.

The student will create a new clinical schedule when a passing score on Step 1 is achieved.  This new schedule will be subject to available spots in clerkships and electives and will be different than the one assigned during the MS3 stream selection process.  The timing of passing Step 1 and clerkship/elective availability may prevent a student from completing the MS3+MS4 curriculum in two years.

Option B1: If the student’s first rotation after CF3 is a clerkship, the student will be dropped from the entire clinical schedule (all clerkships) assigned during the MS3 stream selection process.

The student will create a new clinical schedule when a passing score on Step 1 is achieved.  This new schedule will be subject to available spots in clerkships and electives and will be different than the one assigned during the MS3 stream selection process.  The timing of passing Step 1 and clerkship/elective availability may prevent a student from completing the MS3+MS4 curriculum in two years.

Option B2: If the student’s first rotation after CF3 is an elective, they can maintain their assigned clinical schedule if they complete Step 1 by the Friday of week 2 of the MS3 curriculum and pass the exam.  If a reporting delay takes place in this scenario, only the student’s first clerkship will be dropped. 

If the student takes the exam after the Friday of week 2 of the MS3 curriculum, the student will be dropped from the entire clinical schedule (all clerkships) assigned during the MS3 stream selection process.

The student will create a new clinical schedule when a passing score on Step 1 is achieved.  This new schedule will be subject to available spots in clerkships and electives and will be different than the one assigned during the MS3 stream selection process.  The timing of passing Step 1 and clerkship/elective availability may prevent a student from completing the MS3+MS4 curriculum in two years.

VIII. Return to Clinical Rotations:

After sitting for the USMLE exam, scores are typically posted 2-4 weeks after sitting for the exam Links to an external site..  Therefore, the student must plan their test date to factor this delay into the planning of their desired schedule.  To return to clinical rotations, the student must complete the following three steps:

1. The student will complete a petition to re-enroll at least three weeks prior to the desired return date.
2. Meet with the scheduling team (comsched@hs.uci.edu) to create a new clinical schedule based on clerkship and elective availability
3. The passing USMLE score must be shared with the scheduling team two business days prior to the start of the desired clinical elective or clerkship.  Students may not start clinical electives or clerkships until a passing score for the USMLE has been confirmed.

Table 3A. Take the USMLE exam prior to CF3 and Radiology, begin clerkship, receive a score of “Fail” on the exam:  Finishes the clerkship with a passing grade

Option A:

Student plans to return to clinical rotations duringthe SOM fall term

Option B: 

Student plans to return to clinical rotations after the SOM fall term as they need additional time for exam preparation.

I. Clinical Curriculum Timing:

May not be feasible to complete the MS3+MS4 curriculum in two years

II. Tuition and Fees:

Will be assessed for the SOM summer term.

SOM summer term:  Will be assessed

SOM fall term:  Will not be assessed

III. Financial Aid:

Will be eligible for financial aid for the SOM summer term.

SOM summer term:  Will be eligible

SOM fall term:  Will not be eligible

IV. Specific Considerations:

While not required, the student may elect to take the 3-week independent study elective.  As described in Table 2, Option B:

1) MS3 elective requirement:  This elective counts towards their MS3 elective requirement, meaning that students may enroll for only one more week of elective time during their MS3 curriculum.

2) Non-clinical elective limits:  This elective counts towards their non-clinical elective time, meaning that students may enroll for only one more week of non-clinical elective time for the remainder of their MS3 and MS4 curriculum. 

3) One-time enrollment:  This elective is limited to MS3 students for USMLE Step 1 preparation and students may only take the elective one time.  If a student requires additional USMLE exam preparation time in subsequent SOM terms, they will not be able to enroll in this elective again. 

The student will not be able to enroll in the study elective during the SOM fall term as they will already be on a personal leave of absence at this time.  While on a personal leave of absence, students are unable to enroll in coursework.

V. Personal Leave of Absence:

If the student can receive a passing score on Step 1 and return to the clinical curriculum within four weeks of completing the clerkship, they do not need to be placed on a personal leave of absence.  Otherwise, they will be placed on a personal leave of absence effective the day after completing the clerkship.

VI. Length of Exam Preparation:

The student will utilize the remainder of the SOM summer term for exam preparation and will follow the guidelines in the following Sections VII and VIII.

If a student needs additional exam preparation time beyond this term and extending into future SOM terms, the student will pursue the pathway described in Option B of this table.

In accordance with the Exam Administration and Procedures policy, "students are eligible for academic probation if they do not pass the USMLE Step 1 within one year of the end of that student’s second-year curriculum.”  The end of the second-year curriculum for the MS2 curriculum in the 2024-2025 academic year is March 21, 2025, so the exam must be passed (not just taken) before March 21, 2026.

Students have a maximum of 24 months from the end of the second-year curriculum to successfully complete the USMLE Step 1 exam.  Students who do not meet this requirement are eligible for dismissal.

VII. Clinical Schedule:

After completion of the current clerkship, the student will be dropped from the remaining clerkships assigned during the MS3 stream selection process.

The student will create a new clinical schedule when a passing score on Step 1 is achieved.  This new schedule will be subject to available spots in clerkships and electives and will be different than the one assigned during the MS3 stream selection process.  The timing of passing Step 1 and clerkship/elective availability may prevent a student from completing the MS3+MS4 curriculum in two years.

VIII. Return to Clinical Rotations:

See Table 2, Section VIII for further guidance

Table 3B: Take the USMLE exam prior to CF3 and Radiology, begin clerkship, receive a score of “Fail” on the exam:  Options to withdraw from the clerkship or take an “Incomplete”

Option A: If a student receives a score of “Fail” on the USMLE Step 1 on day 5 or earlier of the clerkship, they may choose to “Withdraw” from the course without any record of enrollment after the start of the course in accordance with the Withdrawal policy.

If a student receives a failing step 1 score after day 5 of the clerkship, they must choose one of the following:

Option B1: Stop the clerkship and immediately pursue a personal leave of absence, resulting in an “Incomplete” for the clerkship. 

Option B2: Continue and complete all of the clerkship, take the OSCE, but defer the NBME shelf examination, thereby receiving an “Incomplete” for the course.

I. Clinical Curriculum Timing:

May not be feasible to complete the MS3+MS4 curriculum in two years

II. Tuition and Fees:

If the student withdraws, student must petition for a refund of tuition and applicable fees

Will be assessed for the SOM summer term

The student must petition for a refund of tuition and applicable fees if their desired leave of absence date occurs before 60% of the clerkship has elapsed.  This is further defined as:

60% of a 4-week clerkship:

2 weeks, 3 calendar days have elapsed

60% of a 6-week clerkship:

3 weeks, 5 calendar days have elapsed

60% of an 8-week clerkship:

4 weeks, 6 calendar days have elapsed

Will be assessed for the SOM summer term

III. Financial Aid:

If the student withdraws, they will not be eligible for financial aid.

Any dispersed financial aid must be returned.

If the desired leave of absence date occurs before 60% of the clerkship has elapsed, dispersed financial aid must be returned.

If the desired leave of absence date occurs at 60% or after 60% of the clerkship has elapsed, dispersed financial aid will not need to be returned.

Will be eligible for financial aid for the SOM summer term.

Dispersed financial aid will not need to be returned

IV. Specific Considerations:

There will be no record on the transcript that the student started and withdrew from this clerkship.  Therefore, when they return to clinical rotations, they must re-enroll and take the clerkship in its entirety.

After withdrawing, the student may enroll in the 3-week independent study elective.  If they do so, tuition and fees will be assessed and the student will be eligible for financial aid.

The student must follow the guidance and requirements as listed in the Table 2, Option B, Sections II-V

By pursuing an immediate personal leave of absence, the student is not eligible to enroll in the 3-week independent study elective.

The student will need to work with the clerkship director and the scheduling team on the logistics of resolving this “Incomplete” and finishing the clerkship.  The student may be required to make up additional time based on clerkship schedules and team assignments.

The student must resolve the clerkship grade of “Incomplete” by completing the clerkship and any requirements within 1 year of the date of their leave of absence.  If a student is unable to meet this requirement, the incomplete grade will convert to a grade of “Fail”  in accordance with the Grading policy.

The student must resolve the clerkship grade of “Incomplete” by passing the NBME subject exam and successfully completing all other requirements within 1 year of the date of their leave of absence.  If a student is unable to meet this requirement, the incomplete grade will convert to a grade of “Fail”  in accordance with the Grading policy.

V. Personal Leave of Absence:

If the student can receive a passing score on Step 1 and return to the clinical curriculum within four weeks of completing CF3 and Radiology, they do not need to be placed on a personal leave of absence.  Otherwise, they will be placed on a personal leave of absence effective the day after completing CF3 and Radiology.

If a student chooses to take the 3-week independent study elective and if they can receive a passing score on Step 1 and return to the clinical curriculum within four weeks of completing the independent study elective, they do not need to be placed on a personal leave of absence.  Otherwise, they will be placed on a personal leave of absence effective the day after completing the independent study elective

The student will be placed on a personal leave of absence on the date they decide to put this clerkship on hold.

If the student can receive a passing score on Step 1 and return to the clinical curriculum within four weeks of deferring the shelf examination, they do not need to be placed on a personal leave of absence.  Otherwise, they will be placed on a personal leave of absence effective the day after the clerkship concluded.

The student will not be able to enroll in the study elective during the SOM summer or fall term as they will already be on a personal leave of absence at this time.  While on a personal leave of absence, students are unable to enroll in coursework.

VI. Length of Exam Preparation:

See Table 2, Section VI for further guidance

See Table 2, Section VI for further guidance

As described in Section IV, the student must resolve the grade of incomplete for their clerkship within 1 year of the date of their leave of absence or the incomplete grade will convert to a grade of “Fail.”

See Table 2, Section VI for further guidance

As described in Section IV, the student must resolve the grade of incomplete for their clerkship within 1 year of the date of the original NBME subject examination for that instance of the clerkship or the incomplete grade will convert to a grade of “Fail.”

VII. Clinical Schedule:

The student will be dropped from the entire clinical schedule (all clerkships) assigned during the MS3 stream selection process.

The student will create a new clinical schedule when a passing score on Step 1 is achieved.  This new schedule will be subject to available spots in clerkships and electives and will be different than the one assigned during the MS3 stream selection process.  The timing of passing Step 1 and clerkship/elective availability may prevent a student from completing the MS3+MS4 curriculum in two years.

The student will be dropped from the remaining clerkships assigned during the MS3 stream selection process.

The student will create a new clinical schedule when a passing score on Step 1 is achieved.  As the student must resolve the grade of incomplete for the first clerkship within 1 year of the date of their leave of absence, they likely will need to complete the remaining requirements of the starting clerkship first. 

This new schedule will be subject to available spots in clerkships and electives and will be different than the one assigned during the MS3 stream selection process.  The timing of passing Step 1 and clerkship/elective availability may prevent a student from completing the MS3+MS4 curriculum in two years.

VIII. Return to Clinical Rotations:

See Table 2, Section VIII for further guidance

See Table 2, Section VIII for further guidance

See Table 2, Section VIII for further guidance

Before returning to clinical rotations, we strongly recommend that students use this time to prepare for and successfully complete their outstanding NBME subject examination before returning to active clinical rotations.  See Section IV for further information about the timing of the NBME shelf examination.

Table 3C:  Take the USMLE exam prior to CF3 and Radiology, begin clinical electives, receive a score of “Fail” on the exam: Options to successfully complete the elective or take an “Incomplete”

Option A:  The student receives a score of “Fail” on the USMLE Step 1, is enrolled in an elective at the start of their MS3 curriculum and finishes the elective with a passing grade

Option B:  The student receives a score of “Fail” on the USMLE Step 1, is enrolled in an elective at the start of their MS3 curriculum but chooses to immediately go on a leave of absence

I. Clinical Curriculum Timing:

May not be feasible to complete the MS3+MS4 curriculum in two years

II. Tuition and Fees:

Will be assessed for the SOM summer term

Will be assessed for the SOM summer term

If the student has completed less than three weeks of the elective, they must petition for a refund of tuition and applicable fees

III. Financial Aid:

Will be eligible for financial aid for the SOM summer term if the student completes a total of three weeks of electives.

If the student has completed at least three weeks of the elective, the student will be eligible to keep their financial aid disbursement

If the student wishes to start their leave of absence prior to completing three weeks of their elective, they must return any financial aid that was disbursed.

IV. Specific Considerations:

If a student is enrolled in less than three weeks of electives and wishes to keep their financial aid, the student will be allowed to enroll in the independent study elective to meet the three week enrollment minimum requirement for financial aid.  In order to enroll, students must first successfully complete their previously scheduled elective.

The guidelines for the elective are described in Table 2, Option B, Sections IV and V.

The student will need to resolve the elective grade of “Incomplete” by completing the elective and any requirements within 1 year of the date of their leave of absence.  If a student is unable to meet this requirement, the incomplete grade will convert to a grade of “Fail”  in accordance with the Grading policy.

V. Personal Leave of Absence:

If the student can receive a passing score on Step 1 and return to the clinical curriculum within four weeks of completing their electives, they do not need to be placed on a personal leave of absence.  Otherwise, they will be placed on a personal leave of absence effective the day after completing their electives.

Students will be placed on a personal leave of absence on the date they decide to put this elective on hold.

VI. Length of Exam Preparation:

See Table 2, Section VI for further guidance

VII. Clinical Schedule:

The student will be dropped from the entire clinical schedule (all clerkships) assigned during the MS3 stream selection process.

The student will create a new clinical schedule when a passing score on Step 1 is achieved.  This new schedule will be subject to available spots in clerkships and electives and will be different than the one assigned during the MS3 stream selection process.  The timing of passing Step 1 and clerkship/elective availability may prevent a student from completing the MS3+MS4 curriculum in two years.

The student will be dropped from the remaining clerkships assigned during the MS3 stream selection process.

The student will create a new clinical schedule when a passing score on Step 1 is achieved.  As the student must resolve the grade of incomplete for the first clerkship within 1 year of the date of their leave of absence, they likely will need to complete the remaining requirements of the starting elective first. 

This new schedule will be subject to available spots in clerkships and electives and will be different than the one assigned during the MS3 stream selection process.  The timing of passing Step 1 and clerkship/elective availability may prevent a student from completing the MS3+MS4 curriculum in two years.

VIII. Return to Clinical Rotations:

See Table 2, Section VIII for further guidance

Table 4.  Delay taking the USMLE exam until after successfully completing CF3 and Radiology courses

Option A:

Do not enroll in the SOM summer term

Option B: 

Enroll in a 3-week independent study elective at the start of the SOM summer term, run by Dr. Wiechmann, with a required learning plan and weekly check-ins with the learning skills team

I. Clinical Curriculum Timing:

Will not be feasible to complete the MS3+MS4 curriculum in two years

The student will not start clerkships or clinical electives at the beginning of the SOM summer term.

II. Tuition and Fees:

See Table 2,Option A, Section II for further guidance

See Table 2, Option B, Section II for further guidance

III. Financial Aid:

See Table 2, Option A, Section III for further guidance

See Table 2, Option B, Section III for further guidance

IV. Specific Considerations:

See Table 2, Option A, Section IV for further guidance

See Table 2, Option B, Section IV for further guidance

V. Personal Leave of Absence:

See Table 2, Option A, Section V for further guidance

See Table 2, Option B, Section V for further guidance

VI. Length of Exam Preparation:

See Table 2, Section VI for further guidance

VII. Clinical Schedule:

The student will be dropped from the entire clinical schedule (all clerkships) assigned during the MS3 stream selection process.

The student will create a new clinical schedule when a passing score on Step 1 is achieved.  This new schedule will be subject to available spots in clerkships and electives and will be different than the one assigned during the MS3 stream selection process.  The timing of passing Step 1 and clerkship/elective availability may prevent a student from completing the MS3+MS4 curriculum in two years.

If the student’s first rotation after CF3 is a clerkship, the student will be dropped from the entire clinical schedule (all clerkships) assigned during the MS3 stream selection process.

The student will create a new clinical schedule when a passing score on Step 1 is achieved.  This new schedule will be subject to available spots in clerkships and electives and will be different than the one assigned during the MS3 stream selection process.  The timing of passing Step 1 and clerkship/elective availability may prevent a student from completing the MS3+MS4 curriculum in two years.

If the student’s first rotation after CF3 is an elective, they can maintain their assigned clinical schedule if they complete Step 1 by the Friday of week 2 of the MS3 curriculum and pass the exam.  If a reporting delay takes place in this scenario, only the student’s first clerkship will be dropped. 

If the student takes the exam after the Friday of week 2 of the MS3 curriculum, the student will be dropped from the entire clinical schedule (all clerkships) assigned during the MS3 stream selection process.

The student will create a new clinical schedule when a passing score on Step 1 is achieved.  This new schedule will be subject to available spots in clerkships and electives and will be different than the one assigned during the MS3 stream selection process.  The timing of passing Step 1 and clerkship/elective availability may prevent a student from completing the MS3+MS4 curriculum in two years.

VIII. Return to Clinical Rotations:

See Table 2, Section VIII for further guidance