Understanding the average USMLE Step 1 score is critical for medical students preparing for this crucial exam. Hence, this article provides insights into the typical Step 1 score ranges and how they align with residency program expectations.
We will discuss effective preparation strategies, including the importance of question banks and prep courses, to help you achieve a competitive score. Additionally, we will emphasize the value of setting realistic goals by considering multiple residency programs, accounting for variations in their average score requirements.
When Do You Take USMLE Step 1 and How Long is it?
When Do You Take USMLE Step 1 and How Long is it?The USMLE Step 1 is a critical examination for medical students in the United States. It is typically taken at a specific point in their academic journey. Below are two detailed sections, one discussing the timing of the exam and when medical students often take it and the other concerning the duration of the exam.
When To Take USMLE Step 1?
Most take the USMLE after completing their second year in medical school. Students must be enrolled in, or graduates from a U.S. or Canadian institution granting an LCME-accredited MD degree or enrolled in or from a U.S. institution granting an AOA-accredited DO degree.
If either is the case, you can take this examination earlier or later than the average. The most crucial factor is being fully prepared and confident that you will get a good score.
The test itself is offered year-round, covers the application of concepts in medicine, and emphasizes principles related to health, disease, and modes of therapy. It also highlights your overall knowledge of the science behind different clinical contexts. If you know all these things and feel confident, you may be ready to take the USMLE Step 1.
However, since the USMLE Step 1 became a pass/fail exam in January 2022, some students have begun taking the exam earlier in their second year, as the pressure of performing well has reduced due to the pass/fail criteria.
Duration of USLME Step 1
So, how long is USMLE Step 1? The USMLE Step 1 is an 8-hour examination, as their website states. The exam is divided into seven 60-minute blocks. It is administered in one 8-hour testing session. The number of questions per block may vary but will be at most 40, with the total number of items on the exam not exceeding 280.
You don’t have to worry about taking a break. There is a minimum allotment of 45 minutes of break time and a 15-minute optional tutorial. The time available for breaks may be increased if a block of test items or optional tutorial is finished before the allotted time expires.
What is a Passing USMLE Step 1 Score?
Since the transition to a pass/fail scoring system in January of 2022, the previous numeric score format was replaced. Now, you simply need to pass or fail the exam, and the exact score you attain won’t matter. However, the minimum passing score for the USMLE Step 1 exam is 196, with the maximum possible score being 300. This change in the passing score from 194 to 196 happened on January 26, 2022. This is also when the Step 1 exam transition to a pass/fail scoring system.
This decision was made to reduce the stress and mental health burden on medical students, as well as to address the exam’s disproportionate impact on certain demographic groups.
Hence, you need to get nearly 2/3 of the points to achieve a passing mark. Remember that with only 280 test questions, not all are weighted the same and that some questions will be worth more points than others.
You’ll also want to look at what scores most people are getting that match with the specialty 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 to ensure you can get to the number you need before you decide to take the test.
Passing the test is a good start, but it won’t help you to pass if you can’t get into a residency program or are stuck in a program you’re not interested in. Aiming for a good score (which we’ll discuss in a future section) will be the best way to go.
But remember that a ‘good score’ for you may differ from an excellent score for someone else. It’s all about your goals.
What is the Highest Possible Step 1 Score?
The highest possible score on the USMLE Step 1 is 300. While achieving a perfect score is extremely rare, some students have scored in the high 280s. However, keep in mind that since January 2022, USMLE Step 1 scores are reported as pass/fail, focusing less on numerical scores and more on meeting the standard of medical knowledge required for safe and effective patient care.
The USMLE Step 1 exam consists of up to 280 multiple-choice questions. These are divided into 60-minute blocks, with each block containing a maximum of 40 questions. The exam is administered in a single 8-hour session, including break time and an optional tutorial.
Hence, while there exists a highest possible Step 1 score, the transition to pass/fail eliminates the need to achieve such a high numerical value. Instead, your focus should be on being able to demonstrate your utmost understanding and expertise in the field to be able to pass the exam.
What is a Good Step 1 Score?
Since January 2022, the USMLE Step 1 has transitioned to a pass/fail scoring system, as mentioned earlier. This eliminates the numerical scoring that once defined a “good score.” However, prior to this change, a good score was often considered one that is significantly above the passing threshold.
So, 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. In the next section, we’ll talk about the specific score you want to get to have the highest chance of matching with your chosen specialty.
For now, remember that you want to aim for a score of at least 220, preferably in the mid-200, to have the most versatility and the highest chance of matching with a specialty that you would enjoy.
Don’t be afraid to reach a little regarding your applications, either. Keep in mind that the numbers we’ve talked about below are averages. That means some people got in with lower USMLE 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 USMLE scores, you may have a better chance than someone with a high exam score but not so great in everything else.
What Are the Average Step 1 Scores for Different Specialties?
If you hope to get into a specific specialty for your residency program, it’s essential to look at what most applicants in that field achieve. You want to ensure you are hitting at least the average for matches, not just for students applying for that program.
Look at the chart below with the available specialties and the average Step 1 score by specialty of those who have matched within that specialty. The data is drawn from statistics from AMBOSS from 2022:
| Anesthesiology | 236 |
| Child Neurology | 228 |
| Dermatology | 244 |
| Diagnostic Radiology | 244 |
| Emergency Medicine | 231 |
| Family Medicine | 222 |
| General Surgery | 235 |
| Internal Medicine | 232 |
| Internal Medicine/Pediatrics | 236 |
| Neurological Surgery | 247 |
| Neurology | 230 |
| Obstetrics and Gynecology | 231 |
| Orthopedic Surgery | 246 |
| Otolaryngology | 248 |
| Pathology | 229 |
| Pediatrics | 226 |
| Physical Medicine and Rehabilitation | 239 |
| Plastic Surgery | 251 |
| Psychiatry | 226 |
| Radiation Oncology | 240 |
| Vascular Surgery | 244 |
When Do USMLE Step 1 Scores Come Out?
The USMLE Step 1 scores are typically released two to four weeks after the exam. However, several factors influence the exact timing of the score release, such as the test-taker volume and the testing schedule.
Generally, the USMLE program aims to release scores on Wednesdays, and candidates will receive an email notification when their USMLE Step 1 results are ready for viewing.
You might be wondering if the transition to a pass/fail exam changed the reporting or timing of the process. As of January 26, 2022, all Step 1 exam score outcomes are reported as pass/fail only. Despite this change, the process of score release remains the same, with a two to four-week timeframe as a guideline.
However, you are advised to allow at least eight weeks to receive notification of your score report, to accommodate any potential delays. These delays might be due to high-traffic periods, technical issues, test center availability, and non-business days like federal holidays and weekends.
Once your scores are ready, you can access them through the online portal where you initially registered for the USMLE. The USMLE Step 1 score report will be available 365 days from the date of the email notification. After this period, scores will only be available as an official transcript for a fee.
What to Do if You Fail Step 1?
The first thing to know about failing Step 1 is that you’re not alone. According to the performance data released by USMLE, a high percentage of people failed the exam in 2022. The pass rate varied based on the background of the examinees. Below is a breakdown of USMLE Step 1 percentile regarding those who failed in 2022:
Below is a breakdown of the fail rates for further analysis:
- First-time takers from US/Canadian MD schools: 7%
- Repeaters from US/Canadian MD schools: 29%
- First-time takers from non-US/Canadian schools: 26%
- Repeaters from non-US/Canadian schools: 55%
These percentages indicate a significant difference in performance based on the educational background of the examinees and whether they are taking the exam for the first time or as a repeated attempt.
But let’s assume you failed Step 1. What do you do now? Here are some tips to follow:
- Reflect and assess: First, take time to process your emotions. Failing an important exam like Step 1 can be disheartening, but it is important to move past the initial disappointment and start planning your next steps. Reflect on why you may have struggled – was it content knowledge, test-taking strategy, or other factors like stress or time management?
- Seek feedback and advice: Consult with medical school advisors or mentors. They can provide personalized advice and help you identify areas for improvement. Additionally, reaching out to peers or joining online forums like Student Doctor Network can offer insights from those who have been in similar situations.
- Inform your medical school: Notify your school and academic advisor about what happened. Medical schools usually have procedures and resources to help students who need to retake Step 1. They may offer additional resources like tutoring or assistance in rearranging your schedule to allow more study time.
- Self-evaluation: Analyze what went wrong in your previous attempt. Review your USMLE Score Report to find weak areas in your knowledge. Consider factors like time management, test-taking strategies, or specific content areas needing improvement.
- Develop a structured study plan: Create a targeted study plan focusing on your weak areas. Utilize resources like UWorld, First Aid, and Pathoma effectively. Also, check out the Emory Step 1 Study Guide to help you create your individualized schedule. Also, engage in active learning techniques like spaced repetition and self-testing. According to advice shared by previous students, doing a high volume of practice questions and reviewing explanations is key.
- Consider professional help: If you feel like you need additional support, consider enrolling in a Step 1 preparation course or seeking tutoring. Some candidates find that structured guidance can significantly improve their performance.
- Improve test-taking skills: If test anxiety or poor test-taking strategies contributed to your failure, work on these aspects. For instance, practice under timed conditions and learnt o approach questions methodically.
- Retake the exam with confidence: It goes without saying that you will eventually sit down for the exam again. However, when you do, remember to let the confidence sweep over you and let it guide you. Remember, many students have successfully passed USMLE Step 1 on their second attempt.
- Plan for the future: Understand that a single failure does not define your medical career. Focus on excelling in the remaining parts of your medical education. That includes the USMLE Step 2 exam. Also, work on building a strong application for residency.
- Take care of your mental health: You might disregard this, and ignore your mental health. However, throughout your preparation, you should prioritize your well-being. Hence, engage in activities that reduce stress and maintain a healthy balance between studying and your personal life.
Keep in mind that every medical student’s journey is unique. Also, a setback like failing Step 1, while difficult, can be overcome with the right approach and mindset. Hence, join an online forum, discuss your issues with people, and seek feedback and help from professionals.
Remember that failing Step 1 does not mean you cannot secure a medical residency. According to the American Association of Medical Colleges (AAMC), many U.S. applicants who fail Step 1 on the first attempt match into a residency program.
When Should You Take USMLE Step 1 Prep Course, If At All?
Let’s start with whether you should 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 learn. These prep courses are designed by people who understand the test and how different people study best. So, don’t skip out on this step.
The next thing to figure out is when to take that prep course. The truth is that the sooner you start studying, the better it will be for you, but you’ll pay by the month for most prep courses. 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 start 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
In summary, the average USMLE Step 1 score is a crucial benchmark for medical students aiming to match with residency programs. Understanding the typical score ranges and aligning them with specific residency program expectations is essential. However, it is important to remember that the numerical value reflecting the average USMLE Step 1 score is not an important metric anymore.
Since January 2022, when the exam became a pass/fail test, the numerical value of your score won’t matter as much anymore. Instead, the focus falls on whether you pass or fail. Hence, your focus should not fall onto attaining the highest grade. Rather, you simply need to focus on passing the exam through our tips above!
