Home » Everything You Need to Know About the USMLE Step 1 Pass Rate

Everything You Need to Know About the USMLE Step 1 Pass Rate

12 min


A group of medical school students studying outside for their USMLE Step 1 exam.


The United States Medical Licensing Examination (USMLE) Step 1 is an important exam that medical students must pass in order to pursue a career in medicine. The Step 1 exam is the first of three such exams that students must take to become licensed medical doctors in the United States. Step 1 is usually taken at the end of a student’s preclinical years and is a comprehensive test that evaluates a student’s knowledge and ability to apply foundational science concepts to clinical situations. Achieving a high score on this exam was historically considered important for medical residency applications. However, after the exam became pass/fail, surpassing the Step 1 pass rate is now becoming the main focus. In this post, we will cover Everything You Need to Know About the USMLE Step 1 Pass Rate!



What is USMLE Step 1, and What Has Historically Been the Passing Rate?


The USMLE Step 1 exam is designed to evaluate a student’s ability to apply foundational science concepts to clinical scenarios. The exam covers a broad range of topics, including anatomy, physiology, biochemistry, pharmacology, pathology, microbiology, and immunology. Students must be able to identify and interpret graphs, tables, and other data sets related to clinical scenarios. They must also be able to make accurate diagnoses, develop treatment plans, and understand the pathophysiology of various diseases. The exam is divided into seven 60-minute blocks, with a total of 280 multiple-choice questions. Students must complete the exam in one eight-hour session. The pass rate for the USMLE Step 1 exam has fluctuated over the years.


Before 2022, The USMLE Step 1 exam was scored on a three-digit scale with a passing score of 194. The maximum score a student could receive was 300. The average score for US medical graduates was around 230, while the average score for international medical graduates was around 220. In 2018-2021, the pass rate was ~96% for test takers in US and Canada. The National Board of Medical Examiners (NBME) and the Federation of State Medical Boards (FSMB) report the pass rates annually, which are publicly available on the USMLE performance data page.



How Has the Passing Rate Changed Since Step 1 Became Pass/Fail?


While many students saw the new pass/rate grading system as a blessing, it may actually be a curse in disguise. Experts believe that this change has led to students taking their Step 1 studying less seriously. This is supported by the dropping Step 1 pass rate, which was 91% in 2022. This drop was somewhat expected as the test has changed. Part of this change included a two-point increase in the passing standard, which is used to determine a pass or fail outcome. This means, that when the test is scored, all students scoring below 196 will fail.



Why Does the Step 1 Pass Rate Matter to Medical Schools?


Step 1 pass rates are an important metric for medical schools and students alike. A high pass rate is a sign of a strong medical education program, while a low pass rate can signal the need for curriculum improvements. For medical students, they need to pass the exam to continue their education and become licensed medical doctors in the United States. Additionally, having a good background of Step 1 knowledge can help improve students’ Step 2 scores. This is because there is a lot of overlap between the content of these exams.


The pass rate for the USMLE Step 1 exam is closely monitored by medical schools and accrediting bodies. Medical schools want their students to pass the exam on their first attempt, as failure to do so can negatively impact the school’s reputation and the student’s ability to obtain a residency position. Accrediting bodies, such as the Accreditation Council for Graduate Medical Education (ACGME), require that residency programs maintain a certain percentage of graduates who have passed the exam on their first attempt.



How Do I Increase My Chances of Passing Step 1?


Since Step 1 became pass/fail, trends have been noticed throughout the country. Particularly it appears that the amount of preparation going into Step 1 has also decreased. Some schools have shortened the dedicated study time for Step 1, and students may feel less pressure to do as many anki cards or UWorld questions in order to pass.


However, even though the pass rate has lowered you can still pass Step 1 if you prepare the right way. 


1. Start Early


One of the most critical factors in passing the USMLE Step 1 is starting to prepare early. You need to give yourself enough time to review all the material thoroughly, and there’s a lot of it! We recommend a minimum of five weeks of dedicated study time, but you can even begin preparing during the school year.


2. Create a Study Plan


Before starting your preparation, create a study plan. The study plan should outline what you need to study, when you will study, and how long you will study. You want to make sure that your study guide includes details on content review, practice questions and flash cards to help you study. Not sure where to start? Check out our 5-week or 10-week Step 1 study plans to get you started.


3. Take Practice Tests


Practice tests are essential in preparing for the USMLE Step 1. They help you identify areas where you need improvement and give you an idea of what to expect on the actual exam. Take a look at our post about the best predictors for passing Step 1.


4. Use Multiple Study Resources


Use multiple study resources to prepare for the exam. For Step 1 some favorites include First Aid, Pathoma, Boards and Beyond and Sketchy. Make sure you don’t go overboard. Keep to a few high-yield sources to avoid being overwhelmed by content.


5. Take Care of Yourself


It is crucial to take breaks while studying, to help you stay focused, refreshed, and motivated. During your breaks, do something you enjoy, like exercise, reading a book, or watching TV. It’s also important to take care of your health while studying for Step 1. Eating healthy foods, getting enough sleep, and exercising regularly will help you stay focused and motivated. Taking care of your physical and mental health will help you stay motivated, and you’ll be more likely to succeed on the exam.


6. Ask for Help if You Need it!


Studying for Step 1 can be daunting, but luckily there a lots of great resources out there to help you get to where you need to be. If you are looking for some extra study support, contact us to learn more about Step 1 tutoring!


In conclusion, passing the USMLE Step 1 requires a lot of hard work, dedication, and commitment. After becoming Pass/Fail, the exam has seen a decrease in Pass rate but by starting early, creating a diverse study plan, taking practice tests, and taking care of your health – you can pass this exam! 

Good luck! 

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