To the Editor: On February 12, 2020, the National Board of Medical Examiners announced that United States Medical Licensing Examination (USMLE) Step 1 would be reported as a pass/fail outcome. Since the decision to no longer assign a numerical score was a surprising change, we conducted a study to analyze the online medical education community’s response (known as #MedEd) to this announcement on Twitter. We used the program Tweet Archivist to capture tweets containing the hashtags #USMLE, #Step1, and/or #USMLEPASSFAIL posted during the 72-hour period surrounding the announcement. We categorized the authors; sorted tweets as irrelevant, neutral, in favor, or against the change; and tallied reasons for opinionated tweets. Following the announcement, we captured 2,056 relevant tweets (695 original, 1,361 retweets). Of these, about one-third were in favor of the change (34%), about two-thirds were neutral (59%), and a small minority were against the change (8%). Of physicians, slightly less than half tweeted in favor (42%) and neutrally toward the change (40%), while about one-fifth tweeted against it (18%). The distribution for students was similar: 39% tweeted in favor, 40% tweeted neutrally, and 21% tweeted against it. On average, tweets in favor were retweeted significantly more than those in opposition (1.5 vs 0.2 times). The majority of original tweets were sent by physicians (57%), followed by students (26%) and users who could not be classified (18%). The 3 most common reasons tweeted by those in favor of the change were as follows: (1) clinical knowledge will be improved as students will no longer focus heavily on Step 1, (2) Step 1 is a poor test that was never designed to rank applicants, and (3) this will foster holistic review. Conversely, the 3 most common concerns tweeted by those against the change were the following: (1) the importance of a Step 1 score will be replaced by another metric, such as the Step 2 Clinical Knowledge score, (2) this change will hurt international medical graduates, and (3) a standardization tool is necessary to compare applicants. These concerns are not without merit as they are the same top 3 concerns shared by program directors in a recent study by Makhoul and colleagues.1 Overall, the Step 1 score change announcement was well received on #MedEd Twitter. More users tweeted in favor of the change than against it, and positive tweets were retweeted more often than negative ones.