The USMLE Step 1 (more commonly just Step 1 or colloquially, The Boards) is the first part of the United States Medical Licensing Examination. It aims to assess whether medical school students or graduates can apply important concepts of the foundational sciences fundamental to the practice of medicine. US medical students who wish to seek licensure to practice medicine in the US typically take Step 1 at the end of the second year of medical school. Graduates of international medical schools (i.e., those outside the US or Canada) must also take Step 1 if they want to practice in the US. Graduates from international medical schools must apply through ECFMG, and the registration fee is $915. For 2020, the NBME registration fee for the test is $645, with additional charges for applicants who choose a testing region outside the United States or Canada. Prior to January 2022, Step 1 scoring is a three-digit score, theoretically ranging from 1 to 300, with a passing score of 194. It was announced on February 12, 2020 that beginning no earlier than January 2022, USMLE Step 1 would transition to a Pass/Fail scoring system. In July 2020, the USMLE stated that "All scores for Step 1 exams taken prior to the date of the policy change will continue to be reported using the three-digit numeric score on all USMLE transcripts. The USMLE program does not retroactively alter transcripts." History Prior to 1992, the NBME Part I examination served as the staple basic science examination for medical students at the end of their second year. Upon the launch of the three-part United States Medical Licensing Examination, NBME Part I exam was carried forward in its new format, the USMLE Step 1 examination, which has since evolved to become an increasingly clinically-applied examination of the foundational sciences. The exam became computer-based several years later. In May 2015, the USMLE began emphasizing concepts regarding patient safety and quality improvement across all parts of the USMLE exam series, including Step 1. While the USMLE Step 1 has traditionally been taken after students complete foundational sciences and before core clinical clerkships. In recent years, a number of medical schools have reformed their curricula to have students take the USMLE Step 1 after core clinical clerkships or preliminary clinical training. Top medical schools such as Harvard Medical School, University of Colorado School of Medicine, Vanderbilt University School of Medicine, Penn