Step 1 Passing Score of 196, and Pass Rates by Year and Group
The Step 1 passing score is 196 on the three digit scale, and USMLE reports your result as pass or fail rather than as a number for every exam taken on or after January 26, 2022. That number comes from the USMLE Examination Results and Scoring page, checked on September 21, 2026. USMLE also states that examinees across the Step exams typically must answer approximately 60 percent of questions correctly to pass. In 2025, 93 percent of first taking MD students from US schools passed Step 1, and 75 percent of first takers from non-US schools did. Every rate below carries the year it belongs to.
USMLE Step 1 passing score and pass mark: 196 on the three digit scale
The USMLE Step 1 passing score is 196 on the three digit score scale, for every Step 1 exam taken on or after January 26, 2022. Candidates who call it the pass mark are asking about the same number: the USMLE Step 1 pass mark is 196. The figure is the footnote to the minimum passing score table on the USMLE Examination Results and Scoring page, checked on September 21, 2026.
You are never shown the 196. Only examinees who fail get feedback on content, per the USMLE page on the move to pass or fail only reporting.
The standard rose from 194 to 196 on the day the exam stopped reporting numbers. At its December 2021 meeting the USMLE Management Committee voted for that two point increase, for examinees testing on or after January 26, 2022. USMLE set it out in its announcement of the change. The committee reviewed the standard again in December 2024 and left it at 196.
USMLE publishes two intervals for that review: typically every three years in the December 2024 announcement, and approximately once every four years on the Examination Results and Scoring page. Counting on from December 2024, the next Step 1 review lands between December 2027 and December 2028, which is this article doing the arithmetic.
| Step 1 period | Passing standard, three digit scale | What the examinee is told | Published in |
|---|---|---|---|
| Step 1 taken up to January 25, 2022 | 194 | A three digit score plus pass or fail | USMLE announcement, December 2021 |
| Step 1 taken on or after January 26, 2022 | 196 | Pass or fail only | USMLE announcement, December 2021 |
| Step 1 standard review, December 2024 | 196, kept unchanged | Pass or fail only | USMLE announcement, December 2024 |
| Step 1 as published on September 21, 2026 | 196 | Pass or fail only | USMLE results and scoring page |
Source: usmle.org Examination Results and Scoring, and the USMLE announcements of December 2021 and December 2024, checked on September 21, 2026.
USMLE Step 1 pass rate by year, 2013 to 2025
Across the 2013 to 2025 series on the USMLE performance data page, checked on September 21, 2026, the Step 1 first taker pass rate for MD students at US schools ran from 98 percent in 2020 down to 91 percent in 2024. Every rate below comes from that page, where 2025 is the newest calendar year published. A 2026 rate does not exist yet.
| Exam and calendar year | MD first takers | MD repeaters | DO first takers | DO repeaters | Non-US school first takers | Non-US school repeaters |
|---|---|---|---|---|---|---|
| Step 1, 2013 | 97% | 72% | 94% | 74% | 79% | 44% |
| Step 1, 2014 | 96% | 68% | 93% | 69% | 78% | 38% |
| Step 1, 2015 | 96% | 68% | 93% | 65% | 78% | 38% |
| Step 1, 2016 | 96% | 64% | 94% | 75% | 78% | 39% |
| Step 1, 2017 | 96% | 67% | 95% | 76% | 78% | 41% |
| Step 1, 2018 | 96% | 67% | 96% | 73% | 80% | 44% |
| Step 1, 2019 | 97% | 66% | 96% | 67% | 82% | 45% |
| Step 1, 2020 | 98% | 67% | 96% | 74% | 87% | 50% |
| Step 1, 2021 | 96% | 66% | 94% | 75% | 82% | 45% |
| Step 1, 2022 | 93% | 71% | 89% | 67% | 74% | 45% |
| Step 1, 2023 | 92% | 70% | 87% | 60% | 72% | 47% |
| Step 1, 2024 | 91% | 70% | 86% | 86% | 73% | 52% |
| Step 1, 2025 | 93% | 71% | 89% | 79% | 75% | 54% |
Source: usmle.org performance data, Step 1 tables for calendar years 2013 to 2025, checked on September 21, 2026.
One grouping changes at the bottom of the table. USMLE counted Canadian school examinees inside the MD and DO groups from 2013 through 2024 and moved them into the non-US group in 2025, so the 2025 non-US figures cover a slightly different set of examinees than the rows above.
First taker rates step down between 2021 and 2022 in every group: 96 to 93 percent for US MD, 94 to 89 percent for US DO, 82 to 74 percent for non-US schools. January 26, 2022 is the date Step 1 went pass or fail and the standard moved to 196, and USMLE publishes no cause for the drop.
USMLE Step 1 pass rate and fail rate by group in 2025
The Step 1 fail rate in 2025 was 7 percent for first taking MD students at US schools, 11 percent for first taking DO students and 25 percent for first takers from non-US schools, which is 100 minus the pass rates on the USMLE performance data page, checked on September 21, 2026. USMLE tested 29,870 examinees from US schools that year and passed 91 percent, and tested 25,660 from non-US schools and passed 72 percent.
| Step 1 group | 2024 number tested | 2024 percent passing | 2025 number tested | 2025 percent passing |
|---|---|---|---|---|
| Step 1, MD degree, US schools | 25,702 | 89% | 25,126 | 91% |
| Step 1, MD first takers | 23,280 | 91% | 23,028 | 93% |
| Step 1, MD repeaters | 2,422 | 70% | 2,098 | 71% |
| Step 1, DO degree, US schools | 4,988 | 86% | 4,744 | 89% |
| Step 1, DO first takers | 4,873 | 86% | 4,623 | 89% |
| Step 1, DO repeaters | 115 | 86% | 121 | 79% |
| Step 1, all US school examinees | 30,690 | 88% | 29,870 | 91% |
| Step 1, non-US school first takers | 22,713 | 73% | 22,066 | 75% |
| Step 1, non-US school repeaters | 3,921 | 52% | 3,594 | 54% |
| Step 1, all non-US school examinees | 26,634 | 70% | 25,660 | 72% |
Source: usmle.org performance data, the two Step 1 tables in the 2025 section, checked on September 21, 2026.
USMLE counted examinees from Canadian schools with the US groups in 2024 and with the non-US group from 2025, per the footnote on the performance data page.
Repeaters from non-US schools are the hardest row on the page: by the same subtraction, 46 percent of them did not pass in 2025.
Students at US osteopathic schools are the DO rows, 4,623 as first takers in 2025. Their own sequence starts with COMLEX-USA Level 1, on the COMLEX Level 1 page.
90 seconds a question: how the Step 1 day is built
USMLE Step 1 is approximately 280 multiple choice questions in fourteen 30 minute blocks, taken in one day of approximately 8 hours, per the 2027 Bulletin of Information published in August 2026, checked on September 21, 2026.
For an exam taken on or after May 14, 2026 the USMLE Step 1 page adds the rest: no more than 20 questions in a block, at least 55 minutes of break time, a 5 minute optional tutorial. Fourteen blocks of 30 minutes is 7 hours, break and tutorial make the eighth hour, and fourteen blocks of 20 questions is 280 items.
Divide 30 minutes by 20 questions and a Step 1 item gets 90 seconds. The post on how many practice questions a day builds a daily target out of that block.
Before May 14, 2026 the same exam ran as seven 60 minute blocks of no more than 40 questions. A page telling you seven blocks of 40 describes the format that ended on May 13, 2026. Counts for the other exams are in the post on how many questions each medical exam has.
How many questions on Step 1 you need to answer correctly to pass
USMLE publishes no count of questions you must answer correctly on Step 1. It publishes a percentage for the Step exams as a class: examinees typically must answer approximately 60 percent of questions correctly to achieve a passing score, and USMLE says that percentage varies by Step and from form to form, per the Bulletin of Information scoring section, checked on September 21, 2026.
Multiply the two published numbers and 60 percent of 280 items is 168 questions. Treat 168 as an illustration: the published percentage is not a Step 1 figure, and the standard sits on the score scale, not on a raw count. No predetermined percentage of examinees passes or fails.
An unanswered question is counted as a wrong answer, so a guess is free and a blank is not, per the Step 1 formats and questions page. And an exam where you leave a block unopened may not be scored, with the attempt reported as an incomplete on your USMLE transcript, under Incomplete Scores on the Examination Results and Scoring page. An incomplete attempt still counts toward the limit of four.
| Step 1 item | Number | Where it comes from |
|---|---|---|
| Step 1 passing standard, three digit scale | 196 | USMLE results page |
| Questions typically needed correct, all Steps | approximately 60% | USMLE Bulletin |
| Step 1 questions on the exam | approximately 280 | USMLE 2027 Bulletin |
| Step 1 blocks, exams from May 14, 2026 | fourteen 30 minute blocks | Step 1 page |
| Step 1 questions per block | no more than 20 | Step 1 page |
| Step 1 testing session | approximately 8 hours | USMLE 2027 Bulletin |
| Step 1 break time | at least 55 minutes | Step 1 page |
| Step 1 optional tutorial | 5 minutes | Step 1 page |
| Step 1 time per question | 90 seconds | Arithmetic, 30 minutes over 20 |
| Step 1 items correct at 60% of 280 | 168 | Arithmetic, illustration only |
| Step 1 attempt limit, lifetime | 4 attempts | USMLE Bulletin |
| Step 1 attempts inside 12 months | 3 attempts | USMLE Bulletin |
Source: usmle.org results and scoring, the Bulletin of Information, the Step 1 page and the 2027 Bulletin, with the two arithmetic rows marked in the table, checked on September 21, 2026.
What is a good USMLE Step 1 score, and where the percentiles went
There is no good Step 1 score to aim at, because a report for an exam taken on or after January 26, 2022 carries an outcome and no number. The USMLE Score Interpretation Guidelines, updated August 17, 2026 and checked on September 21, 2026, print the Step 1 cell of the table of means for calendar year 2025 as a single sentence: the examination is reported as pass or fail only. No mean, no standard deviation, no percentile.
People ask what the 196 is out of. USMLE reports results on a three digit scale, and the Step 1 passing standard of 196 sits on that scale, per the Examination Results and Scoring page. Step 2 CK and Step 3, the two Steps that still hand the examinee a number, report from 1 to 300.
| Exam | Minimum passing score | Applies to exams on or after | Score range reported |
|---|---|---|---|
| Step 1 | Reported as pass or fail | January 26, 2022 | No number given to the examinee |
| Step 2 CK | 218 | July 1, 2025 | 1 to 300 |
| Step 3 | 200 | January 1, 2024 | 1 to 300 |
Source: usmle.org Examination Results and Scoring for the scores and dates, and the Score Interpretation Guidelines updated August 17, 2026 for the range, checked on September 21, 2026.
Step 2 CK still hands the examinee a number, and a program director can still read it against a mean and a percentile rank, which is why the Step 2 CK page and the post on the Step 2 CK percentile table, the 218 passing score and the pass rates carry weight Step 1 no longer has.
What is a good NBME score for Step 1
NBME publishes no threshold on its Step 1 self-assessment, the CBSSA. Its guidance on gauging readiness for Step 1, dated September 2026 and checked on September 21, 2026, reports four things: an equated percent correct score on a 0 to 100 scale, a likely score range, a Step 1 low pass range, and an estimated probability of passing that runs from 1 percent to 99 percent.
NBME states that on a retest with no learning or forgetting, your score would fall within 4 points of the reported score two thirds of the time. Take a reported score of 62 as an example. The 4 point band puts it at 58 to 66, two times in three, which is most of the gap people read into two self-assessments taken a week apart.
A 90 percent estimated probability of passing Step 1 within a week still means about 1 in 10 examinees with comparable performance would be expected not to pass. The low pass range is performance above the passing standard but near it, and NBME says any overlap with your likely score range warrants extra caution. NBME draws that band on a figure with no numeric boundary, so the 70 and 75 percent thresholds quoted on prep sites are not NBME numbers.
How many times can you take USMLE Step 1
USMLE Step 1 allows four attempts in a lifetime, per the USMLE Bulletin of Information, checked on September 21, 2026. Four failed or incomplete attempts at one Step make you ineligible to apply for any Step in the USMLE sequence, and attempts at the formerly administered Step 2 Clinical Skills count toward that limit, per the Bulletin of Information eligibility section.
You may not take the same Step more than three times within a 12 month period, and a fourth attempt must come at least 12 months after your first attempt at that exam and at least six months after your most recent one, incomplete attempts included.
A Step you have passed cannot be retaken, except to meet a time limit set by a licensing authority, and most licensing authorities require Steps 1, 2 and 3 within a seven year period that starts when you pass your first Step, per the USMLE common questions on scores.
Each attempt costs the USD 695 application fee again for the 2026 and 2027 fee years, plus a USD 210 region fee outside the United States and Canada, from the Apply for Exams page: USD 905 from Lagos or Manila against USD 695 from a US seat.
Practice questions for USMLE Step 1 from your own notes
The people who write the exam give away more than 100 Step 1 questions. They sit on the Step 1 formats and questions page as an interactive test and as a PDF, checked on September 21, 2026.
After those run out, this site turns your own material into more. Pick a body system on the Step 1 page, upload a pathology chapter or a physiology lecture, ask for 20 single best answer questions, and set a 30 minute timer so the set matches a Step 1 block at 90 seconds a question. Each question prints the sentence it was written from and the page it sits on, so a wrong answer sends you to a page instead of a guess. This is not an NBME or USMLE question bank and has no connection to either organization.
The sample exam runs without an upload or an account. A guest gets 60 verified questions after that, an account gets 300 a month free, and pricing lists a 90 day Exam Pass at USD 19.99 and a 500 question pack at USD 5.99. Neither renews.
Questions people ask
What is the USMLE Step 1 passing score in 2026?
The USMLE Step 1 passing score is 196 on the three digit score scale, unchanged since January 26, 2022, and that is still what the USMLE Examination Results and Scoring page states on September 21, 2026. The USMLE Management Committee reviewed the standard in December 2024 and voted to keep it. You are not shown the number: exams taken on or after January 26, 2022 report pass or fail only, and future reviews of the standard are not published as a three digit score.
When are USMLE Step 1 scores released?
Two to four weeks after your test date is typical, and USMLE asks you to allow at least eight weeks when you choose a date or ask about a result. Results are processed continuously and scores are reported weekly, so releases follow a weekly cycle rather than one published calendar date. Your score report stays on the website of the organization that registered you for approximately 365 days from the date of the email notification.
Is there a USMLE Step 1 pass rate by school?
Not from USMLE. The performance data page breaks Step 1 down by MD degree, DO degree and non-US schools, each split into first takers and repeaters, and stops there, checked on September 21, 2026. A pass rate for one named school comes from that school, usually in its own student handbook or program pages, so read it as the school reporting on itself rather than as an official USMLE figure.
Is USMLE Step 1 hard?
Hard enough that 7 percent of first taking MD students from US schools did not pass in 2025, and 25 percent of first takers from non-US schools did not, which is 100 minus the 93 percent and 75 percent USMLE published for that year. The day runs about 8 hours at 90 seconds a question, and USMLE says examinees typically need approximately 60 percent of questions correct across the Steps.
How many practice questions are there for USMLE Step 1?
USMLE publishes more than 100 free Step 1 sample questions, as an interactive test and as a PDF, and that is the only practice question count the owner of the exam publishes. The exam itself is approximately 280 items in fourteen blocks of no more than 20. Commercial question banks advertise their own totals, and none of those figures comes from USMLE or NBME, so read a bank size as a product claim.
What happens if you fail USMLE Step 1?
Your report tells you how far you were from passing and gives content based feedback for the next attempt, which examinees who pass do not receive. You can retake it, inside a limit of four attempts at any one Step, incomplete attempts included, and no more than three attempts in a 12 month period. Each retake costs the USD 695 application fee again, plus the USD 210 region fee outside the United States and Canada.
How many questions are on an NBME Step 1 self assessment?
NBME publishes no unambiguous question count for its Step 1 self-assessment, the CBSSA, checked on September 21, 2026. The page prints four sections of 50 questions, but the sentence introducing that block names the clinical science self-assessment instead, so the count cannot be read as the Step 1 number. What the page does state for the CBSSA: seven forms, a price from USD 62, and a block of 1 hour 15 minutes standard paced or 5 hours self paced.
How many questions on USMLE Step 1 are experimental?
USMLE answers that one directly: the exam carries no experimental items in the sense of unreviewed questions or questions unrelated to the content blueprint, and every item that appears, scored or unscored, goes through the same review, per the USMLE Common Questions page, checked on September 21, 2026. No count of unscored items is published for Step 1, and the 2027 Bulletin of Information never uses the word unscored or the word pretest.
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