On February 12
th
, 2020, and after a yearlong discussion, the National Board of Medical Examiners (NBME) announced that the reporting of the U.S. Medical Licensing Examination (USMLE) step one exam will transition to pass/fail reporting system and is expected to kick in as early as 2022. The decision was met with various responses, especially by the IMG community. In this paper, we discuss this change and its effect on IMG trainees and their selection process.