Passing the USMLE: A Scoring Guide

You will receive a detailed USMLE Score Report two to four weeks after taking each Step. When your report is ready, you will get an email from the organization that registered you for the exam. The USMLE Step 1 has recently transitioned to pass/fail, but you will still receive a numerical score for USMLE Step 2 CK and Step 3. See an example of a USMLE Score Report so you know what to expect after completing each exam.

USMLE Step 1 Transition to Pass/Fail

On January 26th, 2022, the USMLE Step 1 scoring system transitioned from a three-digit numerical score to a pass/fail outcome. The hope of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME), co-sponsors of the USMLE, is that this change will encourage residency programs to view candidates holistically and decrease the unnecessary stress placed on residency applicants. This change won’t affect residency applications for most medical students, nor does this test change require them to change their USMLE Step 1 study strategy. It does, however, affect the residency application process. With less detailed scoring information, medical schools will need to develop alternative methods of assessing the qualifications of residency applicants.

The USMLE Step 1 tests everything you’ve learned in your first two years of preclinical medical education. If you are just finishing up your preclinical medical courses, then you should spend 6-9 weeks of intensive study to prepare to take your USMLE Step 1 exam. If you finished your preclinical medical coursework six months or more prior to this, you should expect to spend 6-9 months preparing. Before you begin to parse through exactly how and what to study for the USMLE Step 1—like strategies for different question types or how to pick the best answers—start by developing a study plan that works for you.

[  KEEP STUDYING: How to Pass USMLE Step 1: Top 5 Tips ]

USMLE Step 2 CK Passing Score

In July 2022, the USMLE Management Committee increased the passing score for the USMLE Step 2 CK from 209 to 214. This means that examinees must earn approximately 71% of the points on Step 2 CK to achieve a passing score. Now that the USMLE Step 1 is reported as pass/fail, residency committees will look more closely at your Step 2 Score percentiles. Ultimately, your goal should not only be to pass the USMLE Step 2 CK, but to earn a good score so you can be a competitive candidate for residency programs.

What is a good USMLE Step 2 CK Score?

A good USMLE Step 2 CK score is between 240 and 260. However, what qualifies as a “good” score ultimately depends on the residency program you are applying to. If you want to match to your first-choice program, you should aim for a score at or above 256. The highest possible score for the USMLE Step 2 CK is 300, but no one has ever achieved a “perfect” score; a score around 280 would be considered a top Step 2 CK score.

Learn what your USMLE score means by reviewing the score percentiles for Step 2 CK.

Each question on the Clinical Knowledge (CK) portion of the USMLE is composed entirely of clinical scenarios describing patients. You’ll be required to answer questions about diagnoses, prognoses, indications of underlying mechanisms of disease, and next steps in medical care (including preventative measures). We recommend using a Qbank to familiarize yourself with the test and question format. Get more information on how to earn a good USMLE Step 2 CK score in our guide to the USMLE Step 2 CK.

USMLE Step 3 Passing Score

Currently, the passing score for USMLE Step 3 is 198. As the last test in the series, it’s easy to underestimate the USMLE Step 3, especially when you have less time to study. That being said, passing this final examination in the USMLE sequence leads to what you’ve been working toward for years: a license to practice medicine without supervision. Passing the USMLE Step 3 is an incredible achievement, demonstrating your medical knowledge and proficiency.

What is a good USMLE Step 3 score?

A good USMLE Step 3 score is any score above 230. While your score on Step 3 is less important than whether you pass or fail, a high score can compensate for a mediocre Step 2 CK performance. A competitive Step 3 score can also bolster your application for a fellowship.

See how your score stacks up against the competition by reviewing USMLE Step 3 score percentiles.

USMLE Step 3 is a two-day exam consisting of multiple-choice questions and computer-based case simulations. It is the final assessment of physicians assuming independent responsibility for delivering medical care. You’ll be tested on patient management, lab and diagnostic skills, diagnosis, prognosis, and pathophysiology. Prepare for the exam by working your way through as many Qbanks as possible, and set yourself up for success by taking an on-demand or live online USMLE Step 3 prep course.

What are good USMLE Scores for International Medical Graduates?

What constitutes a “good” USMLE score for international medical graduates (IMGs) depends on which residency program is your top choice because some are more competitive than others. Residency programs rely on USMLE scores to help evaluate applicants. Since Step 1 transitioned to pass/fail in 2022, Step 2 scores have factored more heavily into residency program admissions. 

In 2022, the average USMLE Step 2 CK score for US and non-US IMGs that matched into their preferred residency specialties were as follows:

• Step 2 CK: US IMGs: 230; Non-US IMGs: 240

Some of the top medical specialties for which US and non-US IMGs matched had the following Step 2 CK USMLE scores: