Is 60% a pass on USMLE Step 1? Passing score and pass rates explained
Understand the 196 passing standard, pass rates for US MD, DO and international students, NBME readiness checks and retake rules.
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To pass USMLE Step 1, you need to reach the passing standard, which USMLE sets at 196 on its three-digit score scale. Your report will only say pass or fail, though, because Step 1 hasn't shown a number since January 26, 2022. USMLE doesn't set a fixed percent-correct cutoff, but its Bulletin says examinees typically need about 60% of questions right to pass. Use that as a rough guide and check your readiness with NBME self-assessments taken close to test day.
What is the USMLE Step 1 passing score?
The official answer is 196. USMLE's scoring page says the passing standard is 196 on the three-digit scale. It also says Step 1 results for exams taken on or after January 26, 2022 are reported only as pass or fail. The standard went up from 194 to 196 on that same date, as set out in USMLE's December 2021 notice.
Your performance is still measured on the three-digit scale. You just won't see the number, and neither will residency programs. USMLE has also said that future reviews of the Step 1 standard won't be reported as a three-digit score, so 196 is the last number it will publish.
The USMLE Management Committee sets the passing standard. It reviews each exam's standard, typically every three to four years, and decides whether it should change.
Is 60% a pass on USMLE Step 1?
Roughly, yes, but no one can promise it. The 60% figure comes from USMLE itself. Its Bulletin of Information says examinees "typically must answer approximately 60% of questions correctly to achieve a passing score," and that the percentage varies from form to form. It's a typical figure, not a fixed cutoff. Estimates also vary. Blueprint's estimate, based on NBME score reports, puts the equivalent of 196 closer to 65%.
A single percentage can't be exact, for a few reasons:
- Step 1 is reported on a scaled score, and different students see different questions.
- Your question bank average comes from other questions, written by another company, and often answered in tutor mode.
- A percentage built up over months of study includes your early weeks, when you knew less.
So if you're scoring around 60% or higher on new, timed, mixed blocks late in your dedicated period, you're in the right range. For a firmer answer, use a practice test built to predict Step 1.
USMLE Step 1 pass rates since 2022
Most people pass Step 1 on their first try. According to USMLE performance data, 93% of first-time takers from US MD schools passed in 2025, along with 89% from US DO schools and 75% from non-US schools.
| Exam year | US MD schools | US DO schools | Non-US schools |
|---|---|---|---|
| 2022 | 93% | 89% | 74% |
| 2023 | 92% | 87% | 72% |
| 2024 | 91% | 86% | 73% |
| 2025 | 93% | 89% | 75% |
Source: USMLE performance data, first-time takers. Canadian schools were grouped with US schools through 2024 and with non-US schools from 2025. Last checked: November 13, 2026.
Repeat attempts pass less often. In 2025, 71% of repeat attempts from US MD schools passed, compared with 79% from US DO schools and 54% from non-US schools. USMLE counts repeaters by the number of exams taken, not the number of people.
If you're an international medical graduate, these are your clearest benchmarks: about three in four first-time takers from non-US schools have passed each year since 2022. That's a good reason to plan your NBME checkpoints carefully and to book your exam once your results back you up.
How to read NBME and UWSA results before test day
NBME's Comprehensive Basic Science Self-Assessment (CBSSA) is the closest thing to a Step 1 readiness check, because NBME also writes Step 1. Its CBSSA guidance says to read three things together:
- An equated percent correct from 0 to 100, adjusted for small differences in difficulty between forms.
- An estimated probability of passing Step 1, from 1% to 99%, based on a large group of examinees who took Step 1 for the first time within a week of their self-assessment.
- Your likely score range compared with the Step 1 low-pass range. NBME says you're likely ready if your range sits completely above the low-pass range, and that any overlap calls for extra caution.
That one-week window matters. A form taken six weeks before your exam shows where you are today. Test day depends on the weeks in between. NBME also points out that a 90% probability of passing still means 1 in 10 students at that level would fail, and that it doesn't mean you know 90% of the content.
UWorld Self-Assessments (UWSA) give you a second view. They come from a question bank company, so use them as a cross-check alongside your NBME forms.
| What you see | What it suggests | Next step |
|---|---|---|
| Rising across forms | On track | Keep doing timed mixed blocks |
| Flat or falling | A plateau | Review missed questions by system |
| One high, others low | Unsettled | Take another form before deciding |
| High, one weak system | A gap | Target that system this week |
A simple routine helps you turn these numbers into a decision:
- Take a baseline NBME form before your dedicated study period starts.
- Take another timed form every one to two weeks.
- Log each result with your weakest systems and a plan for the next week. You can download the practice test tracker to keep it all in one place.
- Take a final form in the week before your exam, which matches the window NBME's estimate is based on.
- If your recent forms are low or falling, talk to your school or advisor about moving your date before you sit the exam.
Pacing is part of being ready, too. For exams on or after May 14, 2026, the Step 1 format is fourteen 30-minute blocks of up to 20 questions each, in one 8-hour day with at least 55 minutes of break time. Set your question bank to timed blocks of 20 questions in 30 minutes, so the real thing feels familiar.
Between NBME forms, Medly can help you work on the systems your reports flag. You get exam-style practice questions with step-by-step explanations, plus an AI tutor you can ask why an answer was wrong.
What happens if you fail USMLE Step 1?
If you don't pass, your report shows how far your overall performance was from the passing standard, along with feedback by content area, as set out in USMLE's pass/fail reporting notice. Results are usually ready within four weeks of your test date.
The retake rules are in the USMLE Bulletin of Information:
- You get four attempts at each Step, and incomplete attempts count.
- You can't take the same Step more than three times in 12 months.
- A fourth attempt must be at least 12 months after your first and at least six months after your most recent.
- You generally can't retake a Step you've already passed.
Before you rebook, use the content feedback to rebuild your plan around your weakest areas. Then take a new NBME form to check your progress, rather than relying on the result you had before.
How residency programs view a Step 1 fail
Programs can see every attempt on your USMLE transcript. In the 2024 NRMP Program Director Survey, 90% of programs cited a Step 1 pass as a factor when choosing who to interview, according to the NRMP report. The AMA reported that 77% of programs considered failed attempts on any Step.
A fail makes matching harder, but you can recover from it. In the same survey, 30% of programs required MD applicants to meet a target Step 2 CK score for an interview. That makes a strong Step 2 CK one of the clearest ways to show your progress. Honest, specific answers about what you changed after a fail also help in interviews.
Frequently asked questions
How much score is required to pass USMLE Step 1?
You need to reach USMLE's passing standard of 196 on the three-digit scale. Your report only shows pass or fail, so you'll never see the number itself.
Is 60% a pass on Step 1 in 2026?
Roughly. USMLE says examinees typically need about 60% correct to pass, though the figure varies by form, and one prep-company estimate puts 196 closer to 65%. A recent NBME self-assessment gives you a more reliable read.
Do residency programs see my exact Step 1 score?
No. Since January 26, 2022, programs see only whether you passed. They can also see how many attempts you took.
How many times can you take USMLE Step 1?
Four times in total, with no more than three attempts in any 12-month period. Incomplete attempts count toward the limit.
What is the Step 1 pass rate for international medical graduates?
In 2025, 75% of first-time takers from non-US schools passed, up from 73% in 2024. Repeat attempts from non-US schools passed 54% of the time.
How long do Step 1 results take?
USMLE says results are usually available within four weeks of your test date. It tells you to allow at least eight weeks.