There are some changes coming to the USMLE Exams - primarily related to the focus of the questions. USMLE Step 2 and Step 3 exams will see greater changes than the Step 1 Exam.

According to the handout release, the change in Step 1 is detailed in one sentence: "In 2014 and 2015, examinees will see an increased focus on quality improvement principles and safety science."

http://www.usmle.org/pdfs/Changes_to_USMLE_2014-2015_handout_FINAL.pdf