Purpose: While known by many names, qualifying exams function as gatekeepers to graduate student advancement to PhD candidacy, yet there has been little formal study on best qualifying exam practices particularly in biomedical and related STEM PhD programs. The purpose of this study is to examine the current state of qualifying exams through an examination of the literature and exploration of university-wide policies. Design/methodology/approach: The authors conducted a literature review of studies on qualifying exams and completed an external evaluation of peer institutions' and internal institutional qualifying exam requirements to inform our discussion of qualifying exams practices in PhD training at a research-intensive US institutions. Findings: This study identified the need for more research on qualifying exams to establish evidence-based best practices. The authors found a wide variety of qualifying exam formats, with little evidence in support for specific formats. The authors also found little evidence that student expectations are made clear. The lack of evidence-based best practices coupled with insufficient clarity for students has a real potential to disadvantage PhD students, particularly first generation, underrepresented minority, international and/or other trainees who are not privileged or socialized to navigate training environments with vague landmarks such as the qualifying exams. Originality/value: There are very few studies that evaluate qualifying exams in US doctoral education, particularly in STEM fields, and to the authors' knowledge, there has been no analysis of campus-wide policies on qualifying exams reported. The lack of evidence for best practices and the need for to evaluate the implementation and effectiveness of qualifying exams are discussed.