Junior Member
15+ Year Member
Jan 24, 2002
Cambridge, England
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Hello Everyone,
I need you guys to answer a question for me. I was speaking to a USMLE Co-ordinator and she told me and my fellow collegues that the USMLE Step 1 has now gone to the "CAST" method. That means that when a student answers a question correctly, the next one is harder and so on. PLEASE tell me if this is true or not. I know that they "want" to go to this style, but this particular person has said that they are ALREADY there. PLEASE HELP.



PGY-4 Neuro
10+ Year Member
15+ Year Member
Dec 23, 2000
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  1. Fellow [Any Field]
If you get a reply from the NBME about whether or not the USMLE has switched its testing modalitiy (i.e. the following question depending upon the answer to the preceding answer) could you please post it? I haven't seen any information on this, but I have heard that that both the USMLE and COMLEX would like to move to this method. I just didn't think it would happen so fast.



7+ Year Member
15+ Year Member
Jan 7, 2002
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A friend of mine took step 2 last August and he felt that the questions were of increasing difficulty(which is logical with this system u r referring to, since he finally scored a 95). Furthermore, when he went for his interviews on December, he heard about this change from a lot of people. So, if it hasn t happened yet, it s not going to be long before it does.
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I am sitting for USMLE step one at the end of March, and I scan this section periodically to learn from those who have taken the exam, for "do's and dont's", but it annoys me when I read things about the exam changing as it is not good for ones Psyche. Instead you should spend less time investigating and more time studying to insure a higher level of success and to be the most competent physician that you can. According to the people at Kaplan the exam has not changed, and all of the Medical School Deans in the company of NBME at their latest meeting frowned upon such changes. So make sure yo get your information straight as not to add any more stress to those that are dealing appropriately.


Junior Member
7+ Year Member
15+ Year Member
Feb 12, 2002
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To your question whether the USMLE has gone into the CAST system, the answer is no. I emailed the USMLE people and just received a definitive no as the answer. Unless they are not telling me the truth, we do not have to worry about CAST for awhile longer.
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