Update June 22nd, 2023: As of January 26th, 2022, the USMLE Step 1 has become a pass/fail exam. See more about how this has affected the medical education landscape in some of our other posts:
Observations and Trends After the Switch to USMLE Step 1 Pass/Fail: What Learning Specialists Are Saying
How Will the USMLE Step 1 Pass Fail System Affect Your Step 2 Score?
Standing Out in Residency Applications With a Pass/Fail USMLE Step 1
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Original Post from November 19th, 2020
So you just got your score back from either USMLE Step 1 or Step 2 CK. Perhaps you hit your mark or maybe your score is lower than you expected. Regardless, the next step is understanding your score so you can plan for your next steps. Our goal of this blog post is to breakdown your score and help you interpret how you did.
Score Percentiles for USMLE Step 1
The change by the NBME and FSBM of the USMLE Step 1 to a Pass/Fail system by January 2022 will dramatically change the interpretation of scores for medical students. According to the NBME/FSMB, the passing score for Step 1 in 2018 was 194, up from 192 in years prior. This change will have many ramifications, among them that your Step 2 percentile score will become much more important, while your Step 1 percentile score will become irrelevant.
When examining the nomograms provided by the test-makers, this equates to approximately the 5th percentile. In other words, to pass the exam, you must achieve a score that is better than the lowest 5% of all test-takers. In general, a passing score corresponds to answering 60% of the 280 questions on the exam correctly. While it is unlikely that the percentage of students passing would change meaningfully in the first few years of the new format, it is possible that this will change at some point.
Until the scoring system for Step 1 changes to Pass/Fail, the scores on Step 1 can be interpreted based on historical percentiles. While 194 represents the 5th percentile, the average (50th percentile) falls between 230 and 235. Scores at or just above the mean are good scores! This means you have outscored more than half of the test-takers that year. Not coincidentally, this also places you in the range for many competitive residencies; for competitive surgical subspecialties such as neurosurgery or orthopedic surgery higher scores may be needed. When examined from this perspective, a strong score is simply above average.
Examining the distribution of scores below, it is important to observe the narrow distribution of test scores; this is extremely helpful in figuring out why answering even 5% more correct questions on exam day can dramatically increase your score. If a score of 265 (of a theoretical 300 maximum) represents the 98th to 99th percentile, that means that nearly 93 to 94% of all test takers will score between 194 and 265. With only 71 points between these scores, and all of these test-takers answering 168/280 questions (60%) correctly (5th percentile), there can be rather dramatic jumps in scores by answering only a few extra questions correctly. This explains the importance of adding any extra knowledge and/or test-taking skills to your repertoire, which our EMP tutors are expertly prepared to help you with.
Score Percentiles for USLME Step 2 CK
When interpreting your score from Step 2 CK, you can use a very similar mindset as with Step 1. The main difference is that scores on Step 2 CK are on average 5-10 points higher than on Step 1; the distribution of scores is thus slightly narrower 95% of test-takers scoring between 210 and 275. The passing score on Step 2 CK most recently was 209, representing approximately the 3rd percentile. With the changes discussed to Step 1, it is quite possible that far more test-takers will take Step 2 CK prior to submitting applications. In addition, receiving a high Step 2 percentile score will carry far greater importance with Step 1 reported as Pass/Fail only. Until this change takes place, test-takers can take use the table above to interpret their results.
Score Percentiles for USMLE Step 3
Briefly, scores on USMLE Step 3 are always significantly lower than those on Step 1 and 2 CK. This is largely because the majority of test-takers are in the midst of intern year while taking the exam. The sole exception are international medical graduates who may have the option to take Step 3 prior to beginning residency. The most recent passing score announced by USMLE was 198, which corresponds to approximately the 3rd to 4th percentile.
Looking for In-Depth USMLE Discussions? Join Our Subreddit!
Navigating the changes in the USMLE landscape can be a crucial step in your medical education journey. Join our newly established subreddit, r/ask_a_usmle_tutor, to connect with experienced MD tutors and fellow medical students. Here, you can discuss insights, ask questions, and gain valuable advice on topics ranging from score interpretation to exam strategies.
Join us now at r/ask_a_usmle_tutor and be part of a community that understands the challenges of the USMLE.
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