Step 1 Pass Score: What is the New Passing Score in 2024?

As of January 26, 2022, the Step 1 examination has transitioned from a numeric score to a pass/fail system. But what is the pass score for Step 1 in this new system? How has it changed, and what does this mean for students? In this comprehensive guide, we will delve into the details of the USMLE Step 1 pass score and explore its implications.

Overview of USMLE Step 1

The United States Medical Licensing Examination, commonly known as the USMLE Step 1, stands as a pivotal gateway for every medical student aiming to practice in the U.S. Acting as a foundational test, it encapsulates the breadth and depth of basic medical sciences and their relevance to patient care. While it’s a one-day examination, the ripple effect of its scores can influence residency placements and future medical opportunities. As such, it’s not just about knowing facts but about weaving those facts into the fabric of clinical decision-making.

Step 1 not only assesses one’s understanding in core sciences like anatomy, biochemistry, and physiology but also tests the ability to discern patterns, connect interdisciplinary knowledge, and employ problem-solving skills in simulated clinical scenarios. Furthermore, it demands a student to be well-versed in emerging areas of medical science, reflecting the ever-evolving landscape of medicine. The mastery required for this exam stems from a blend of rigorous classroom learning from the first two years of medical school, combined with self-directed studies that delve deeper into the intricacies of medical theory and its application.

Understanding the Step 1 Pass Score

When discussing the ‘Step 1 pass score’, it’s crucial to understand that the USMLE Step 1 is a pass/fail exam. As of 2022, the minimum passing score for Step 1 is 194. This score was established by the USMLE program, which includes representatives from the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). It’s important to note that the minimum pass score for Step 1 can change, so always check USMLE’s official website for the most accurate information.

The USMLE Step 1 score is a three-digit number that ranges from 1 to 300, with a higher score indicating better performance. This scoring system is designed to measure a test taker’s abilities relative to a predefined standard rather than relative to other test takers.

The ‘pass score for Step 1’ is just one aspect of the scoring system. In addition to the three-digit score, you’ll receive a two-digit score, which some medical licensing authorities use in their pass/fail decisions. As of 2022, the minimum two-digit passing score is 75.

Interpreting your USMLE Step 1 score requires understanding the scoring system and the percentile ranks. A percentile rank indicates the percentage of test-takers who scored lower than you. For instance, if your percentile rank is 90, you scored above 90% of test-takers. Remember, while your score is essential for residency programs, it’s not the only factor. Other elements, such as your medical school performance, letters of recommendation, and interview performance, will also play a significant role.

Transition to Pass/Fail Scoring

In a significant shift from previous years, USMLE Step 1 transitioned to a pass/fail scoring system on January 26, 2022. Before this change, scores for the exam were reported on a three-digit scale, with a higher score indicating better performance. This numeric scoring system has been replaced with a simple pass/fail outcome, removing the pressure for students to achieve a specific numeric score.

The decision to transition USMLE Step 1 to a pass/fail scoring system came after extensive debate, reflection, and consultation within the medical education community. This monumental change was fueled by the desire to reduce the undue stress and anxiety associated with numeric scoring, which often overshadowed the primary intent of the exam: to assess a candidate’s foundational understanding of medical sciences.

Under the prior three-digit scoring system, students frequently felt the weight of every point, often engaging in exhaustive and sometimes detrimental study habits. While meant to be a mere assessment tool, the numeric scores unintentionally became a distinguishing factor in residency applications, sometimes overshadowing other equally significant achievements and attributes of applicants.

The move to pass/fail seeks to level the playing field, encouraging students to focus on a holistic understanding of the subject rather than mere point accumulation. It also nudges residency programs to adopt a more comprehensive view of applicants, emphasizing clinical skills, research contributions, leadership qualities, and interpersonal skills rather than predominantly relying on a single exam score. This transition underscores a broader movement in medical education toward fostering a healthier, more balanced approach to learning and evaluation.

The New Step 1 Pass Score

The seemingly slight adjustment of the USMLE Step 1 pass score from 194 to 196 signifies much more than just a numerical tweak. It represents the medical profession’s ongoing evolution as the knowledge base and the demands on healthcare professionals grow. With rapid advancements in medicine and technology, the bar for competency continues to rise, and this recalibration is a testament to that progression.

When such changes are instituted, they are not made lightly. Extensive consultations and deliberations within the medical community drove the decision to increase the passing score. Key stakeholders, from experienced educators in medical schools to seasoned hospital clinicians, provided their insights and perspectives, ensuring that the modified threshold aligned with contemporary medical practice.

The crux of this change is not merely about making the exam more challenging. It’s about reinforcing the credibility of the USMLE Step 1 and ensuring its alignment with current medical standards. The elevated score signifies that every passing student has demonstrated an understanding of medical concepts deep enough to meet today’s rigorous demands.

Amidst the complexities of modern healthcare—with its advanced technologies, new treatment modalities, and multidisciplinary approaches—it’s imperative for medical students to have a solid grasp of foundational knowledge. The Step 1 exam, even in its pass/fail incarnation, serves as a crucial litmus test. It assesses whether students are ready to move forward academically and primed to navigate the intricate landscape of patient care, medical ethics, and the evolving world of medicine.

Impact of the New Scoring System on Pass Rates

The shift to a pass/fail system significantly impacted the pass rates for Step 1. Before the change, the overall pass rate for Step 1 ranged from 86% to 92% from 2017 to 2021. However, with the 2022 change to pass/fail, the overall pass rate dropped to a historic low of 82%. This decline in pass rates reveals that passing the Step 1 exam is more challenging than most people realize.

Many medical students feared that with Step 1 becoming pass-fail, the passing score could go substantially higher. However, 2022’s data did not support this reasoning. It was suggested that the medical education system might be why passing Step 1 is more challenging than many think. Some of the issues highlighted include most professors needing to be paid for teaching, difficulties in coordinating between professors, and a need for more understanding by many professors about the student’s level of knowledge or year of study.

As for the pass rates in 2024:

  • The overall pass rate for Step 1 in 2023 was 87%, a slight increase from the historic low of 82% in 2022
  • The pass rate for MD degree examinations was 94%, an increase from 91% in 2022.
  • The pass rate for DO degree examinations was 92%, an increase from 89% in 2022.
  • The pass rate for IMG examinations was 74%, an increase from 71% in 2022

As such, the pass rates improved somewhat in 2023 compared to 2022, but they are still lower than the pass rates before the introduction of the pass-fail system in 2022.

Regarding how many times a student can take the USMLE Step 1, the policy, as of my knowledge, a cutoff in September 2021 allows students to take the exam up to six times. After failing an attempt, a student must wait at least 60 days before retaking the exam, and they can only take the exam up to three times within 12 months.

Factors Contributing to the Scoring Change

The USMLE Management Committee adjusted the Step 1 passing score after a thorough review undertaken every 3-4 years. This review drew from physician recommendations, stakeholder surveys, examinee performance trends, and the implications of score precision. The shift to pass/fail and the raised score also spotlight potential gaps in medical education, such as misalignment among faculty and a gap in understanding student needs. Simply put, this wasn’t a snap decision but a well-considered move influenced by wide-ranging factors in medical education. Here’s a deeper look into the influencing factors:

Regular Review and Updates: The USMLE Management Committee consistently reviews the passing standards for Step 1 to keep pace with the medical field’s evolving needs.

Expert Recommendations: A wide array of physicians provided crucial feedback, ensuring the decision was grounded in the collective wisdom of the medical community.

Stakeholder Feedback: Inputs from educators, doctors, and students gave a complete perspective on the desired standards for upcoming doctors.

Performance Data Analysis: Examining performance trends over time offer insights into whether the current standards align with students’ capabilities.

Score Precision Impact: The committee thoroughly assessed the scoring system’s accuracy, ensuring a fair representation of a student’s skills.

Highlighting Medical Education Challenges: The new scoring system underscores potential issues in medical education, calling for increased coordination among faculty and a better grasp of student challenges.

In essence, the USMLE’s scoring modification symbolizes the shifting landscape of medical education, advocating for heightened standards and excellence.

Impact of the Step 1 Pass Score on Residency Applications

The transition to a pass/fail system for the USMLE Step 1 has ushered in a new era for medical residency applications. This profound change has altered the dynamics of test preparation and reshaped the criteria and considerations for residency admissions. As the medical community grapples with these modifications, it’s essential to understand the deeper ramifications on the future of medical education and professional pathways. Its repercussions are observed across various dimensions:


  • Reduced Score Stress: With the shift to pass/fail, students aren’t pressured to achieve a specific numeric score. This change aims to promote a more holistic and stress-free learning experience.
  • Holistic Application Review: Without numeric scores, residency programs may weigh other aspects of an applicant’s profile more heavily. Clinical experiences, research contributions, and letters of recommendation might now play an even more pivotal role.
  • Leveling the Field: In the past, a high Step 1 score could eclipse other achievements. Now, all applicants are on a more even footing concerning USMLE scores, making the process more equitable.
  • Highlight on Education Gaps: The drop in pass rates under the new system underscores potential issues in medical education, indicating a need for curriculum and teaching method reforms.
  • New Evaluation Methods: With the removal of numeric scores, residency programs might adopt alternative assessment methods, such as scenario-based evaluations or detailed personal interviews.

As the medical community navigates through this new era of residency applications, it’s clear that the shift is more than just procedural. It represents a broader evolution in how future physicians are assessed, trained, and eventually integrated into the healthcare ecosystem.

The Transition of Step 1 Score into Pass/Fail System: What is the Step 1 Pass Score in 2024?

The USMLE Step 1 examination, an integral part of medical education and the journey to becoming a practicing physician in the United States has significantly changed its scoring system in recent years. As of 2022, the shift to a pass/fail scoring system and an increase in the passing score from 194 to 196 marked a substantial transformation in how medical students are assessed. By 2024, the impact of these changes has started to reveal itself, from altered pass rates to a renewed focus on holistic residency application reviews. While the reasons for these modifications are many, they underscore a broader effort within the medical community to maintain high standards, alleviate undue stress, and produce well-rounded physicians. As the medical profession evolves, so will its assessments, ensuring that tomorrow’s doctors have the knowledge and skills they need to provide exceptional patient care. Aspiring doctors and medical educators will undoubtedly pay close attention to future shifts in the Step 1 exam and their broader implications.

Key Takeaways and Their Implications

Significant changes, like the ones we’ve seen with the USMLE Step 1, can shake things up for everyone involved. Here’s what we’ve gathered from the recent shift:

  1. The Game Changer: Starting in 2022, the USMLE Step 1 went from dishing out specific scores to telling med students if they passed or failed. It’s like swapping a detailed report card for a simple thumbs-up or thumbs-down.
  2. Raising the Bar: They didn’t just change the scoring; they nudged the passing score from 194 to 196. It’s their way of saying, “We’re keeping standards high.”
  3. Dips in the Chart: Few people passed the test in 2022. The passing rate slid from 86-92% to 82%. That’s a noticeable dip!
  4. The Residency Hustle: Med students will have to lean more on other achievements with no scores. Think about research projects, hands-on clinic work, and solid recommendations. This could mean a busier med school life, with students trying to make their mark beyond exams.
  5. A Closer Look at Training: The drop in pass rates is like a loud alarm bell. It’s making folks wonder if medical schools need to tweak how they prepare students. It could be the teaching methods or resources; there’s much to consider.

This change in USMLE Step 1 is more than just a switch in grading. It’s pushing students, schools, and the medical community to rethink and recalibrate. The journey to becoming a doctor just got a fresh twist, and everyone’s watching to see how it pans out.

The change to a pass-fail system has significantly impacted pass rates. The overall passing rate for Step 1 ranged from 86% to 92% from 2017 to 2021. However, in 2022, the overall passing rates dropped to a historic low of 82%, with nearly 10,000 people failing Step 1. This is the lowest pass rate since at least 2013.

Frequently Asked Questions

What score do you need to pass step 1?

As of 2022, the USMLE Step 1 is scored on a pass/fail basis, so there is no specific score you need to pass. Before this change, the passing score was 196 on a scale from 1 to 300, with most scores ranging from 140 to 260

What is the new pass score for Step 1?

Step 1 of the USMLE became pass-fail on January 26, 2022. On the same date, the passing score for Step 1 was raised to 196 from 194. The USMLE Management Committee raised the passing score based on recommendations from independent groups of physicians, results of surveys from various groups (including residency program directors, medical school faculty, state licensing representatives, and examinees), data on trends in examinee performance, and the effect of score precision on the pass/fail outcome.

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