If you’re looking to take the USMLE Step 1, you probably want to know what an average Step 1 score is. We’re going to take a look at not just what the average USMLE Step 1 score is for a general USMLE Step 1 percentile, but also at how you can do your best with this test. We’ll look at the best scores, the okay scores, and what to do if you just don’t make it the first time around.
Not only that, but we’re going to take a look at the types of prep courses you should be taking and when, so you can make sure you’re prepared. You want to end up with high USMLE scores, and that’s going to mean putting in the hard work and effort (and being prepared before you ever get started). That means taking a look at question banks and prep courses (here’s a spoiler, we definitely recommend them) and not just going at it alone when it comes to studying.
Keep in mind that when you’re looking at average USMLE scores, you need to look at the average for the residency program that you would like to match with. If you look only at the lowest averages or highest averages, you’re not going to set yourself a realistic goal. Keep in mind that it’s good to have at least two residency programs in mind when you’re taking your exam. One may be a little lower than the other, just in case you don’t get quite the score you were hoping for.
When Do You Take USMLE Step 1 and How Long is it?
For most, taking the USMLE occurs after the completion of their second year in medical school. Students must be enrolled in, or graduates from a US or Canadian institution granting an LCME accredited MD degree or enrolled in or graduates from a US institution granting an AOA accredited DO degree. If either of these is the case, you are allowed to take this examination earlier or later than the average. The most crucial factor is that you should be fully prepared and confident you will get a good score.
The test itself is actually offered year-round and covers the application of concepts in medicine as well as putting emphasis on principles related to health, disease, and modes of therapy. It also pays attention to your overall knowledge of the science behind different clinical contexts. If you know all of these things and feel confident in them, you may be ready to take the USMLE Step 1.
So, how long is USMLE Step 1? When taking the exam, you will be scheduled for 8 hours, comprised of 7 60 minute blocks, interspersed with 5-minute breaks, and a 15-minute tutorial to use the computer system. The entire test is taken via a computer and consists of multiple-choice, single answer questions. There are a total of 280 questions on the test, with no more than 40 questions in each 1-hour block, which allows for approximately 90 seconds per question.
What is a Passing USMLE Step 1 Score?
A USMLE Step 1 passing score requires at least 193 points. Out of a possible score of 300 points, this means you need to get nearly 2/3 of the points possible in order to achieve a passing mark. Keep in mind that with only 280 questions on the test, this means that not all questions are weighted the same and that some questions are going to be worth more points than others.
You’ll also want to take a look at what scores most people are getting who match with the specialty that you want to go into. If you would like to match with pediatrics, for example, you can see in the chart below that the average match for pediatrics is 226. On the other hand, the average match for orthopedic surgery is 245. Pay attention to these numbers before you start and work hard at making sure you can get yourself to the number you’re going to need before you decide to take the test.
Just passing the test is a good start, but it’s not going to help you to pass if you can’t get into a residency program or if you’re stuck in a residency program you’re not interested in. Aiming for a good score (which we’ll talk about in a future section) is going to be the best way to go. But keep in mind that a ‘good score’ for you may be different from what’s an excellent score to someone else. It’s all about your goals.
What is the Highest Possible Step 1 Score?
The highest USMLE Step 1 score is 300. This perfect score has not yet been achieved; however, there have been students who have received scores of over 280. Tests continue to change and evolve over time, and while the score range has not changed, the scale by which the tests are each scored does change gradually over time. This means that as different questions are added or removed, the weight on those remaining questions can vary.
Aiming for the highest score possible is a great idea, but don’t be discouraged if you find yourself coming up short on a perfect score. Instead, focus on just getting the best you can and opening up as many opportunities as possible. The higher your score, the more ability you’ll have to choose the residency that you want to get into. If you get a score of over 250, you have beaten the average of every residency program, and you should be able to apply to anything with a reasonable chance of success. A score over 260-270 will almost guarantee you your choice spot, provided the rest of your application is just as stellar.
What is a Good Step 1 Score?
A good score for the USMLE Step 1 is at least over 220 or 230 – 240, which will generally get you a match with most specialties. We’ll talk in the next section about the specific score you want to get in order to have the highest chance of matching with your chosen specialty. For now, keep in mind that you want to aim for a score of at least 220 and preferably in the mid-200’s in order to have the most versatility and the highest chance of actually matching with a specialty that you would enjoy.
Don’t be afraid to reach a little when it comes to your applications, either. Keep in mind that the numbers we’ve talked about below are actually averages. That means some people got in with lower scores, and some got in with higher scores. If you’re a little lower than the average, that doesn’t mean you shouldn’t apply. If you have a great application to back up your slightly lower scores, you may have a better chance than someone with a high exam score but not so great everything else.
What are the Average Step 1 Scores for Different Specialties?
If you are hoping to get into a specific specialty for your residency program, it’s essential to take a look at what most applicants in that field are getting. You want to make sure that you are hitting at least the average for matches, not just for students that apply for that program. Take a look at the chart below with the specialties currently available and the average Step 1 score by specialty of those who have actually matched within that specialty.
| Anesthesiology | 230 |
| Child Neurology | 229 |
| Dermatology | 247 |
| Diagnostic Radiology | 241 |
| Emergency Medicine | 230 |
| Family Medicine | 218 |
| General Surgery | 232 |
| Internal Medicine | 231 |
| Internal Medicine/Pediatrics | 233 |
| Neurological Surgery | 244 |
| Neurology | 230 |
| Obstetrics and Gynecology | 226 |
| Orthopedic Surgery | 245 |
| Otolaryngology | 248 |
| Pathology | 231 |
| Pediatrics | 226 |
| Physical Medicine and Rehabilitation | 220 |
| Plastic Surgery | 245 |
| Psychiatry | 220 |
| Radiation Oncology | 241 |
| Vascular Surgery | 237 |
Where to Find USMLE Step 1 Scores by Residency Programs?
If you’re looking for residency program scores, you can take a look at the chart above, or you can check out the National Resident Matching Program. This organization provides a list of not just the scores from USMLE Step 1 and 2, but also a number of other demographics and rankings. This can help you better understand who is matching with different programs and how you can make sure that you are getting the match you want.
These scores and rankings are also listed with just about every company that offers USMLE Step 1 question banks or prep courses. They want to make sure you know the average that you should be aiming for before you start studying so you can see what the most up-to-date numbers are and what you should be aiming to get in order to have the highest chance of the match that you’re looking for.
What to Do if You Fail Step 1?
The first thing you should know if you have failed Step 1 is that you are definitely not alone. In fact, the research shows that as us 2015, approximately 22% of people taking the USMLE Step 1 failed. That’s actually a relatively large percentage of the population taking the exam in the first place, and that’s just the people who were taking it for the very first time. So, don’t feel like you’re all alone in this when you get your USMLE Step 1 results.
Accept failure. Next, you need to be okay with the fact that you failed. This is going to be difficult because it means you’re going to have to wait a full year again before you can enter into a residency program. But think of that year as more time to practice, to study, and to really be prepared so that next time you’ll be able to pass and not just pass but do it with a high score so you can get into the residency program that you really want.
Share your story. Once you’ve gotten the results and you know how you did, it’s time to be open about it. You probably don’t want to tell the whole world that you failed, but the best thing you can do is tell at least the people closest to you. Sharing it will help you feel better than just trying to keep it all in. Not to mention, you’re going to have someone there that can help and support you and quiz you when you get back to studying.
Get back to studying. You also want to make sure that you do jump back into it. It can be discouraging and disappointing to be back to the studying while your classmates are applying to their residencies, but you want to make sure you use this full year to prepare for your next chance, and that means throwing yourself right back into the mix and making sure you take what you learned from the test to prepare for the next time.
Change your habits. Keep in mind that you want to change up the way that you’ve been studying this time around. After all, studying that way didn’t work out so well for you before. Now it’s time to start looking at new methods of studying, new topics you may have skipped, or just better time management to make sure you answer every question. Making changes is the only way you’re going to be able to improve.
Make a plan. Plan out what you’re going to do and how you’re going to work on improving over the course of the next year. Make sure that you’re paying close attention to what you did well and what you didn’t do so well the last time and create a system that you feel is going to be more successful this time around. You may want to talk with your peers or with others who have taken the test in the past to find out what recommendations they have to help you do better.
Don’t give up. Make sure that you don’t let this break you down. Sure, it’s going to be really frustrating, and you’re probably going to feel pretty bad about it, but don’t let it derail your dream. You really want to be a doctor, right? Think about the reason that you want to be a doctor. That reason hasn’t gone away just because of a single failed test. So get yourself back up and keep right on going. You can do it, and you’ll end up with a better score and a better match because you got more time.
When Should You Take USMLE Step 1 Prep Course, If At All?
Let’s start with, should you take a prep course? The answer to that is absolutely. You want to make sure that you’re taking a prep course because it’s going to help you know what to study and it’s going to help you understand just how to study. These prep courses are designed by people who understand the test and understand how different people study best. So, don’t skip out on this step.
The next thing to figure out is just when you should be taking that prep course. The truth is that the sooner you start studying, the better it’s going to be for you, but most prep courses you’ll pay by the month. That means, rather than paying a set fee and having unlimited access forever, you get unlimited access for 30 days, 60 days, 90 days, etc. You get to choose the plan you want, and you can extend your plan, but you have to remember that if you start early, you’ll end up paying more.
If you’re looking to take multiple prep courses, you may want to take a look at starting the first one early, meaning toward the beginning of your pre-clinical period or within the first part of your year two. This will give you time to go over more than one course and review multiple different sets of questions. You can also get a good idea of which version works best for you and then start to evaluate where you want to go back or where you want to spend a little more of your study time.
Wrapping Things Up: Average USMLE Step 1 Score Takeaways to Remember
When it comes down to it, there are a few things that you should be keeping in mind when it comes to your USMLE Step 1. Let’s take another look at these here.
Aim for average. If you can get a score of between 220 and 240, you can get into most residency programs. While a higher score is going to give you more leverage and a better chance at the program you really want to match with, at least a 220 will still give you some options, so you can feel confident sending out your applications.
No one is perfect. The perfect score for USMLE Step 1 is a 300, but no one has actually gotten that score yet. Don’t feel bad that you don’t reach it either. Sure, the higher the score that you get, the better the chance that you’re going to match in the areas that you want most, but you can absolutely do that without having to get a perfect score. The highest anyone has gotten yet is a 282, so aim for your best, and if you can get over a 250-260, you’re going to have your pick of areas.
Don’t let failure take you down. It’s going to be discouraging and frustrating if you fail the USMLE Step 1 the first time around, but you want to keep going. Don’t give up. Take a little time to feel upset and frustrated but then pick yourself back up and get back to studying. There’s a reason that you want to be a doctor. Remember that reason and use it to make yourself try again. 22% of people fail the first time around. Don’t feel alone in this.
Take it when you’re sure you’re ready. Don’t pressure yourself to take this exam when you’re not ready. It’s a huge part of your medical school process, and if you take it too early, you’re going to set yourself up for failure. Instead, take the time to study hard and to really get confident about the material before you schedule your test. It’s available year-round, so there’s no reason to rush yourself.
Take a prep course. Don’t skip out on a prep course. They can be a great way to prepare yourself for the exam format as well as helping you to get some additional advice. Some courses even offer feedback and help directly from doctors, so you can get firsthand advice on what the exam is going to look like. Look for the top courses and try out at least one and maybe more.
When you’re ready to take the USMLE, make sure that you know about the average scores, the way you need to perform to get the right match. Once you’re finished, take a look at your USMLE Step 1 score report and make sure you choose the best possible residency to create the future you want.
If you liked this post, check out our post on what a good USMLE Step 2 score is here.
Make sure to also check out our medical school study tips.
