Quick Reference Table

Overview

The USMLE Step 1 Prediction Model employs a stratified approach to estimate the likelihood of students passing their initial USMLE Step 1 exam attempt within the standard testing period for their program. Students are categorized into seven distinct strata based on their predicted probability score, each with specific intervention recommendations and support strategies. 

Prediction Stratums

Extremely Likely

• Previous Tier: Will Pass
• Description: Students in this stratum demonstrate exceptional preparedness and are virtually sure to pass on their first attempt. These students typically exhibit strong foundational knowledge, excellent study habits, and consistent performance across assessments.
• Intervention Level: Minimal oversight required
• Recommended Actions:
  • Maintain current study trajectory
  • Focus on test-taking strategies and time management
  • Consider peer mentoring opportunities

Very Likely

• Pass/Fail Classification: PASS
• Previous Tier: Likely Pass
• Description: Students with strong preparation show high confidence for success. They demonstrate a solid understanding of core concepts with minor knowledge gaps that are easily addressable.
• Intervention Level: Light monitoring
• Recommended Actions:
  • Continue structured study plan
  • Address specific weak areas through targeted review
  • Scheduled check-ins with academic advisors

Likely

• Previous Tier: Borderline / Trending Pass
• Description: Well-prepared students are expected to pass with minimal intervention. They show a good grasp of the material but may benefit from focused preparation in select areas.
• Intervention Level: Standard support
• Recommended Actions:
  • Regular progress monitoring
  • Supplemental resources for identified weak areas
  • Study group participation encouraged

Uncertain

• Previous Tier: Borderline
• Description: Students are in a critical decision zone where the outcome is unclear. This represents a pivotal stage that requires careful assessment and potentially intensive intervention to ensure success.
• Intervention Level: Enhanced monitoring and support
• Recommended Actions:
  • Comprehensive diagnostic assessment
  • Development of an individualized study plan
  • Increased faculty mentoring
  • Consider delayed testing if additional preparation is needed

Needs Support

• Previous Tier: Borderline / Trending Fail
• Description: Students who can achieve success with timely, structured intervention. They possess the foundational capability but require significant support to bridge knowledge gaps and improve test readiness.
• Intervention Level: Active intervention required
• Recommended Actions:
  • Mandatory academic support program enrollment
  • Weekly progress assessments
  • Tutoring and additional resources
  • Possible testing delay with a structured remediation plan

At Risk 

• Previous Tier: Likely Fail
• Description: Students requiring substantial, coordinated support to succeed. Multiple interventions and extended preparation time are typically necessary to achieve passing probability.
• Intervention Level: Intensive support and intervention
• Recommended Actions:
  • Comprehensive remediation program
  • An extended study period before testing
  • Multi-modal learning approaches
  • Regular multidisciplinary team meetings
  • Mental health and wellness support

Unlikely

• Previous Tier: Will Fail
• Description: Students with a very low probability of passing at the current preparation level. Requires fundamental reassessment of readiness and potentially significant additional preparation time or alternative pathways.
• Intervention Level: Major intervention/alternative planning
• Recommended Actions:
  • Immediate comprehensive evaluation
  • Extended remediation period (6+ months)
  • Alternative assessment of medical school readiness
  • Consideration of leave of absence for focused preparation
  • Career counseling and support services

Implementation Notes

• Probability Threshold Logic: The model uses specific probability thresholds to ensure clear stratification boundaries
• Dynamic Assessment: Student stratums should be reassessed regularly as preparation progresses
• Individualized Approach: While stratums provide general guidance, individual student circumstances should always be considered
• Early Intervention Principle: Higher-risk strata benefit significantly from earlier and more intensive interventions

Historical Context

This stratification system evolved from the previous tier system (Will Pass, Likely Pass, Borderline, Likely Fail, Will Fail) to provide more nuanced probability-based categorizations that better inform intervention strategies and resource allocation.