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Passing the USMLE: A Scoring Guide

Your USMLE prep should start by identifying ‘good’ or passing scores. By understanding how your test is scored and setting your score goal early on, you will streamline your studies and ensure a manageable workload along the way.

Try our free practice questions or check out our other free resources to get a better feel for where you stand and where to focus your studies.

 

About USMLE Score Reports

The USMLE consists of four tests: Step 1, Step 2 CK, Step 2 CS, and Step 3. Steps 1, 2 CK and 3 are multiple choice exams for which you’ll receive a numerical score between 1 and 300. Step 2 CS is a practical pass/fail exam with no numerical score component.

USMLE Step 1 Going Pass-Fail

Starting no earlier than January 1, 2022, the USMLE Step 1 scoring system will change from a three-digit numerical score to pass/fail. It’s the hope of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME), co-sponsors of the USMLE, that this change will encourage residency programs to view candidates holistically, and in doing so decrease the unnecessary stress placed on residency applicants.

 

What is a Passing USMLE Step 1 Score?

The current USMLE Step 1 passing score is 194. Out of 300 possible points, that might seem like a low bar. But keep in mind that the USMLE Step 1 tests everything you’ve learned in your first two years of pre-clinical medical education. Ideally, you should spend 6-9 months reviewing for the USMLE.

But 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.

[  RELATED READING:  USMLE Step 1 3-Month Study Plan   —   Top Tips for Passing the USMLE Step 1  ]

What is a good USMLE Step 2CK Score?

The current USMLE Step 2 CK passing score is 209. A good score on Step 2 CK can offset a mediocre Step 1 score, which can improve how you’re seen by residency programs. Each question on the Clinical Knowledge 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.

Read more in our Ultimate Guide to the USMLE Step 2CK.

 

What is a good USMLE Step 2CS Score?

Step 2 CS is the only portion of the USMLE not taken on a computer. It’s an interactive test in which you’ll examine and diagnose actors pretending to be patients with specific health conditions, and it is scored as a pass/fail exam. A passing performance will demonstrate your ability to interview patients, conduct physical examinations, fill out medical charts, and explain your findings.

Preparing for the USMLE Step 2 CS can be more difficult than studying for other portions of the USMLE, since Step 2 CS requires you to interact with simulated patients. Start by studying the different physical systems you may encounter, including cardiovascular, musculoskeletal, psychiatric, respiratory, and women’s health, among others. You should then find opportunities to practice on actual simulated patients; waiting until test day to complete your first simulation will increase your chances of failure.

 

What is a good USMLE Step 3 Score?

The current passing score for Step 3 is 198. Step 3 is a two-day exam consisting of multiple-choice questions and computer-based case simulations. While your numerical 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. Step 3 focuses on patient management, lab and diagnostic studies, diagnosis, prognosis, and pathophysiology. Prepare by working your way through as many Qbanks as possible.

 



What are good USMLE Scores for International Medical Graduates?

Although other factors are certainly taken into consideration, International Medical Graduates (IMGs) who successfully match to preferred specialties typically have higher USMLE Step 1 and 2 CK scores than their American graduate counterparts. In 2018, the mean USMLE Steps 1 and 2 CK scores for US and non-US IMGs that matched into their preferred residency specialties were as follows:

  • Step 1: US IMGs: 222; Non-US IMGs: 234
  • Step 2 CK: US IMGs: 232; Non-US IMGs: 240

Some of the top medical specialties for which US and non-US IMGs matched had the following Step 1 and Step 2 CK USMLE scores:

Anesthesiology

Step 1: US IMGs: 231; Non-US IMGs: 240

Step 2 CK: US IMGs: 237; Non-US IMGs: 244

Internal Medicine

Step 1: US IMGs: 225; Non-US IMGs: 236

Step 2 CK: US IMGs: 234; Non-US IMGs: 241

Neurology

Step 1: US IMGs: 227; Non-US IMGs: 236

Step 2 CK: US IMGs: 234; Non-US IMGs: 240

Pathology

Step 1: US IMGs: 226; Non-US IMGs: 230

Step 2 CK: US IMGs: 230; Non-US IMGs: 233

Pediatrics

Step 1: US IMGs: 221; Non-US IMGs: 230

Step 2: US IMGs: 232; Non-US IMGs: 238

 

 

USMLE Pass Rates

The percentages of examinees that passed each USMLE step in 2018 are as follows:

  • Step 1: US/Canadian Schools: 94%; Non US/Canadian schools: 75%
  • Step 2 CK: US/Canadian Schools: 96%; Non US/Canadian Schools: 78%
  • Step 2 CS: US/Canadian Schools: 94%, Non US/Canadian Schools: 73%
  • Step 3: US/Canadian Schools: 97%, Non US/Canadian Schools: 86%


Expert Advice: How to Pass the USMLE

Read on to hear from members of the Kaplan Medical Honor Society about their top USMLE study habits and advice for future board examinees.

Phuong Min Nguyen, Kaplan Medical Honor Society

Can you tell us about your studying habits?

“I started using Kaplan Qbanks at the beginning of the study as my adviser suggested and I also increased the number of questions I did daily as I went further later on. I preferred study alone during the reading and learning phase. However, when I started doing NBME, I joined a Facebook group discussion.”

What advice do you have for fellow IMG preparing for the USMLE?

  • “Stick to your adviser and his/her plan for you.”
  • “Keep your progress noted and up-to-date with your adviser.”
  • “Avoid procrastination. Don’t steer yourself too far from your schedule.”
  • “Don’t skip your day off. You definitely need a day free of USMLE study. Free up your RAM memory, and fill your day off with joy and your family.”
  • “Keep your mind fresh and durable. Take care of yourself literally above all. Do exercise and eat healthy food.”
  • “Don’t rely too much on caffeine beverage, it could crush you later on when you are too dependent on it.”
  • “Finally and most important, regarding USMLE questions, DON’T pick an answer choice just because you feel like it. Pick it with confidence, not with fear. If you pick an answer doubtfully, you might waste a lot of time thinking back and forth, checking it again and again. That’s my two cents.”
Michèle Relton Obert, Kaplan Medical Honor Society

Can you tell us about your studying habits?

“I like a mixed-study style. There are certain topics that I prefer to study alone with music on, while other topics I prefer to study with a group and discuss with classmates. I love studying using Qbanks as opposed to watching videos, and I learn best by writing things out so whiteboards are very important to me.”

What advice do you have for fellow IMG preparing for the USMLE?

“Give yourself enough time to study, but also know that over-studying can also hurt you by burning you out before you even sit for the exam. Get to know your study style and what works for you, but choose 1-3 resources and stick to them. Otherwise, you will get overwhelmed by the amount of resources out there.”

Jose Aguilar, Kaplan Medical Honor Society

Due to the importance of USMLE scores for the residency application process, I decided to receive formal preparatory courses with Kaplan Medical. I was interested in the optimal study environment that was provided by the In-center courses. Being surrounded by peers with similar study goals as myself helped to keep me motivated. Furthermore, the adequate levels of comfort, silence, and support helped minimize distractions, something especially beneficial considering that I prefer to study by myself.

The Kaplan courses also provided a complete and thorough review of all relevant topics. The USMLE’s involve numerous topics throughout the vast field of medicine, but the methodical structure of the Kaplan courses facilitated an efficient mental organization of key points. They provided an excellent base of knowledge that was not only vital for tackling intricate exam questions, it was also useful for mastery of the basic principles that form the core and essence of Medicine.

A bit of advice I have for IMGs would be to set aside some dedicated time to study for the USMLEs, especially for Step 1. Having multiple unrelated things in your head will split your focus and might get in the way of an excellent score. Having other responsibilities simultaneously to your studies might also make it difficult to find time to relax; resting occasionally is something I found very useful.”

 

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