Medical education’s mission includes ensuring students have a growing fund of knowledge and the skills needed to apply this knowledge appropriately to clinical situations. Assessments can motivate learners to learn and evaluate whether they have gained the breadth and depth of knowledge required for practice. Traditionally, assessment of medical knowledge has relied heavily on multiple-choice questions (MCQs) in the pre-clerkship years. Advantages of MCQ-based assessments include, but are not limited to, reliability and validity. In addition, because the format of USMLE Step 1 was MCQ-based, MCQs have generally been accepted as the format of choice. With the change in USMLE Step 1 scoring from three-digit to pass/fail as of January 2022, medical educators are liberated to consider novel forms of assessment. A goal of medical educators should be to assess learning through problem-solving and application of knowledge to address clinical and scientific problems. A key advantage to open-ended questions (OEQs) is that they enable students to describe their reasoning, thereby demonstrating their abilities to explain the application of basic science principles to clinical problems and prepare them for interactions with patients. The purpose of this session is to engage the medical education community in conversation about the possibilities of using OEQs as a novel assessment strategy that promotes learning in the context of a change in USMLE Step 1 scoring