USMLE Step 3 Pass Rate by Year, the 200 Passing Score and the Fee

Written by Julian. Checked on October 4, 2026.

The USMLE Step 3 pass rate in 2025 was 96 percent for first takers from US MD granting schools, 97 percent for first takers from US DO granting schools and 88 percent for first takers from non-US schools, from the USMLE performance data page, checked on October 4, 2026. The Step 3 passing score is 200 on a 1 to 300 scale for exams taken on or after January 1, 2024, and the application fee for 2026 and 2027 is USD 955.

USMLE Step 3 pass rate by year and group

In 2025, 96 percent of first takers from US MD granting schools passed Step 3, against 88 percent of first takers from non-US schools, from the USMLE performance data page, checked on October 4, 2026. Step 3 figures are reported by calendar year, and 2025 is the newest year published. USMLE grouped examinees from Canadian schools with US examinees through 2024 and moved them to the non-US group starting in 2025.

Step 3 group, percent passing	2020	2021	2022	2023	2024	2025
US MD granting schools, first takers	98	98	98	97	97	96
US DO granting schools, first takers	91	97	96	95	93	97
Non-US schools, first takers	90	91	91	92	89	88
US MD granting schools, repeaters	73	73	76	77	73	77
Non-US schools, repeaters	57	62	64	64	64	63

Source: usmle.org performance data, the Step 3 administration tables for 2020 through 2025, checked on October 4, 2026. The US rows include Canadian schools through 2024. USMLE counts repeater rows as examinations given, not examinees.

The counts behind the 2025 column, from the same page:

Step 3 group, 2025	Number tested	Percent passing
US MD granting schools, first takers	21,589	96 percent
US DO granting schools, first takers	129	97 percent
All examinees from US schools	22,630	96 percent
Non-US schools, first takers	12,480	88 percent
All examinees from non-US schools	14,304	85 percent

The US MD first time rate has stayed between 96 and 98 percent in every year from 2020 to 2025. The DO group is small, 11 first takers in 2020 and 129 in 2025, so its rate moves more from year to year. USMLE does not report DO repeaters for 2025 because that group held fewer than 5 examinees.

Step 3 passing score: 200 on a 1 to 300 scale

The Step 3 minimum passing score is 200, for every Step 3 exam administered on or after January 1, 2024, from the USMLE Examination Results and Scoring page, checked on October 4, 2026. Reported Step 3 scores range from 1 to 300, per the USMLE Score Interpretation Guidelines updated August 17, 2026.

The USMLE Management Committee sets the standard and reviews each Step approximately once every four years. On its scores and transcripts page, USMLE says examinees typically must answer approximately 60 percent of items correctly to pass, and that the share varies by Step and from form to form.

The case simulations count toward that score. Performance on them affects the Step 3 score and could affect whether you pass, and their weight is no greater than their share of the testing time, per the USMLE scoring and score reporting section. The Step 1 and Step 2 CK standards, 196 and 218, are covered in the posts on the Step 1 passing score and Step 2 CK percentiles.

Average Step 3 score and percentiles

The mean Step 3 score was 227, with a standard deviation of 15, for first takers from LCME accredited medical schools in each of the calendar years 2023, 2024 and 2025, from Table 1 of the Score Interpretation Guidelines, updated August 17, 2026 and checked on October 4, 2026. A percentile is the percent of that group who scored lower.

Step 3 score	Percentile rank
260	99
250	93
240	80
235	69
230	56
225	43
220	31
210	12
200	4

Source: USMLE Score Interpretation Guidelines, Table 2, 64,576 first takers from LCME accredited schools who tested between January 1, 2023 and December 31, 2025, updated August 17, 2026 and checked on October 4, 2026.

The passing score of 200 sits at the 4th percentile, 27 points under the mean, which is this article's arithmetic on the two tables. The guidelines put the standard error of measurement at approximately 5 points for Step 3 and the standard error of difference at approximately 7, and they treat two scores as likely to reflect different proficiency only when they differ by two or more standard errors of difference, about 14 points by this article's arithmetic. They also warn that a Step 3 score and a Step 2 CK score are not comparable: a 220 on one is not a 220 on the other.

Step 3 format: Day 1 and Day 2

Step 3 is a two day exam with 232 multiple choice items on Day 1 and 180 items plus 13 to 14 computer-based case simulations on Day 2, from the USMLE Step 3 exam content page, checked on October 4, 2026. That is 412 multiple choice items across both days, this article's sum.

Step 3 fact	Day 1: Foundations of Independent Practice (FIP)	Day 2: Advanced Clinical Medicine (ACM)
Multiple choice items	232	180
Blocks	12 blocks of 18 to 20 items, 30 minutes each	9 blocks of 20 items, 30 minutes each
Case simulations (CCS)	None	13 to 14 cases, each allotted up to 10 or 20 minutes of real time
Test session	About 7 hours	About 9 hours
Breaks and tutorials	55 minutes of break time, 5 minute optional tutorial	At least 45 minutes of break time, 5 minute optional tutorial, 6 minute CCS tutorial

Source: USMLE Step 3 exam content and the 2027 Bulletin of Information, checked on October 4, 2026.

Day 1 covers foundational science, biostatistics and epidemiology, reading the medical literature, ethics, communication and patient safety, plus diagnosis. It includes item formats built on scientific abstracts and pharmaceutical advertisements. Day 2 covers prognosis, screening and health maintenance, therapeutics and medical decision making. Step 3 is given only in the United States and its territories, and if you take Day 1 but not Day 2 the exam may be reported as incomplete.

Step 3 eligibility and who you register with

To take Step 3 you need passing results on Step 1 and Step 2 CK, plus an MD or DO degree from an LCME or COCA accredited US school, or the equivalent degree from a school outside the US listed in the World Directory of Medical Schools as meeting ECFMG requirements together with ECFMG Certification and a valid, unexpired ECFMG Certificate. From the USMLE eligibility page, checked on October 4, 2026.

USMLE recommends that applicants have completed, or be near completion of, at least one postgraduate training year in an accredited US graduate medical education program. Its common questions page says Step 3 is usually taken during the first or second year of postgraduate training.

Where you apply depends on your school. On the USMLE apply page, checked on October 4, 2026, students and graduates of LCME or COCA accredited US programs apply through NBME on the MyUSMLE portal, and graduates of schools outside the US apply through FSMB. You test inside a three month eligibility period assigned when you apply, per the USMLE common questions, and the 2027 Bulletin says scheduling may not be available more than six months in advance.

Step 3 fee for 2026 and 2027: USD 955

The Step 3 application fee is USD 955 for 2026 and 2027, for US and international graduates alike, from the USMLE apply page, checked on October 4, 2026. Step 1 and Step 2 CK cost USD 695 each on the same page, so the three Steps come to USD 2,345 before any region fee, this article's sum.

USMLE exam	2026 and 2027 application fee	Region fee outside the US and Canada
Step 1	USD 695	USD 210
Step 2 CK	USD 695	USD 235
Step 3	USD 955	None listed; given only in the US

Source: USMLE apply for exams, checked on October 4, 2026.

Moving your date within the last 45 calendar days before the appointment costs a fee, and a one time extension of the eligibility period is also charged, per the 2027 Bulletin, which does not print either amount. NBME runs a fee assistance program for students and residents with demonstrated financial need, linked from the apply page.

Step 3 attempts and retakes

You get four attempts at Step 3, the same limit as every USMLE Step, and incomplete attempts count. You may not take Step 3 more than three times in 12 months, and a fourth attempt must come at least 12 months after your first and six months after your most recent, from the USMLE eligibility page, checked on October 4, 2026.

A passed Step may be retaken only to meet a time limit set by a US licensing authority. If you retake a passed Step 1 or Step 2 CK for that reason and fail it, you are no longer eligible for Step 3. Many state boards require all Steps inside a set time frame. The limits for ten other exams sit in the post on how many times you can take Step 1, the NCLEX, the MCAT and PLAB 1.

When Step 3 scores come out

Step 3 results are typically available within four weeks of your test date, and USMLE asks you to allow at least eight weeks, from the Examination Results and Scoring page, checked on October 4, 2026. The 2027 Bulletin puts the usual wait at two to four weeks.

Scores are released on Wednesdays and generally cover examinees who tested within the four weeks before the release, per the USMLE common questions on scores. The organization that registered you sends the email, and the report stays on its site for approximately 365 days. None of the USMLE pages read on October 4, 2026 printed a Step 3 score delay for the rest of 2026 or for 2027.

Step 3 practice questions from your own notes

A Step 3 block is 30 minutes for up to 20 items, so 20 questions on a 30 minute clock is the unit worth practicing. This site builds that block from your own material. Upload a rotation handout or your residency notes, ask for 20 single best answer questions, and time yourself. Each question comes back with the verbatim sentence it was written from and the page number, checked against the stored text of that page, so you can reread the source when you miss one.

The generator writes multiple choice questions only. It does not build CCS case simulations, so for Day 2 cases use the six practice cases in the USMLE Step 3 interactive testing experience, which the USMLE common questions page points to. This site has no connection to USMLE, NBME or FSMB. The sample exam runs with no upload and no account, and pricing lists the free monthly allowance and the paid options.

Questions people ask

What is the USMLE Step 3 pass rate?

In 2025, 96 percent of first takers from US MD granting schools passed Step 3, as did 97 percent of 129 first takers from US DO granting schools and 88 percent of 12,480 first takers from non-US schools. Across all examinees from US schools the rate was 96 percent, and from non-US schools 85 percent. USMLE performance data page, checked on October 4, 2026.

What is the passing score for Step 3?

The Step 3 minimum passing score is 200 on a scale that runs from 1 to 300, for every Step 3 exam administered on or after January 1, 2024. The USMLE Management Committee reviews each standard approximately once every four years. USMLE Examination Results and Scoring page and Score Interpretation Guidelines updated August 17, 2026, both checked on October 4, 2026.

What is the average Step 3 score?

The mean was 227 with a standard deviation of 15 for first takers from LCME accredited medical schools in each of 2023, 2024 and 2025. A 230 is the 56th percentile and a 240 the 80th, and the passing score of 200 is the 4th, among 64,576 first takers tested from January 1, 2023 to December 31, 2025. USMLE Score Interpretation Guidelines, updated August 17, 2026 and checked on October 4, 2026.

How much does USMLE Step 3 cost?

The Step 3 application fee is USD 955 for 2026 and 2027, the same for graduates of US and non-US schools. Step 3 is given only in the United States and its territories, and the apply page lists no region fee for it. A reschedule inside 45 days of the appointment or an eligibility period extension costs extra. USMLE apply page and 2027 Bulletin, checked on October 4, 2026.

How many questions are on Step 3?

Step 3 has 232 multiple choice items on Day 1, in 12 blocks of 18 to 20, and 180 multiple choice items on Day 2, in 9 blocks of 20, plus 13 to 14 computer-based case simulations on Day 2. That is 412 multiple choice items in total. Day 1 runs about 7 hours and Day 2 about 9. USMLE Step 3 exam content page, checked on October 4, 2026.

How long do Step 3 results take?

Step 3 results are typically available within four weeks of the test date, and USMLE says to allow at least eight weeks. Scores are released on Wednesdays and generally cover people who tested in the four weeks before. The email comes from the organization that registered you. USMLE Examination Results and Scoring page and common questions on scores, checked on October 4, 2026.

Who do I register with for Step 3?

On October 4, 2026 the USMLE apply page sent students and graduates of LCME or COCA accredited US programs to NBME, through the MyUSMLE portal, and graduates of schools outside the US to FSMB. International graduates also need ECFMG Certification with a valid, unexpired certificate, and every applicant needs passing results on Step 1 and Step 2 CK.

How many times can you take Step 3?

Four times, counting incomplete attempts, with no more than three attempts in any 12 months. A fourth attempt must come at least 12 months after the first and six months after the most recent. In 2025, 77 percent of repeat Step 3 attempts by US MD graduates passed, and 63 percent from non-US schools. USMLE eligibility and performance data pages, checked on October 4, 2026.

More exam numbers

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UK exams

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All exams

How Many Questions: Step 1, NCLEX, MCAT, PLAB The question count, the testing time and the computed pace for the eleven exams on this site, from USMLE Step 1 at about 280 questions to PLAB 1 at 180, each row naming the exam owner's document it came from, checked on September 21 and 26, 2026.
How Many Times You Can Take the NCLEX, Step 1, MCAT, PLAB 1 The attempt limit for all eleven exams in one table: the NCLEX eight a year, four per USMLE Step, seven MCAT attempts in a lifetime, five NAPLEX attempts, five PLAB 1 attempts with the fifth by application, six at MRCP Part 1.

Published October 4, 2026.