Updated
USMLE Step 1 Pass Rate 2025: 93% for US MD First-Takers
Per USMLE's performance data, 93% of first-time takers from US MD schools passed Step 1 in 2025, along with 89% from US DO schools and 75% from non-US schools. Step 1 has been pass or fail since January 26, 2022, and the passing standard on the old three-digit scale is 196.
Below are a few headline numbers from USMLE, credited and linked, the trend since pass/fail, the attempt rules and what to do after a fail. The full tables are on USMLE's site. Checked November 3, 2026.
What is the Step 1 pass rate in 2025?
- US MD first-takers: 93%, up from 91% in 2024. By our math, about 1 in 14 did not pass, out of 23,028 who took it for the first time.
- US DO first-takers: 89%, up from 86%.
- First-takers from non-US schools, which includes Caribbean schools: 75%, up from 73%. That is about 1 in 4 not passing, by our math.
- Repeaters: 71% of US MD repeat takers passed and 54% of non-US repeat takers.
One change in how USMLE groups people: starting in 2025, examinees from Canadian schools count with non-US examinees rather than US ones, so compare years with care.
Did Step 1 pass rates drop after pass/fail?
For US and Canadian MD first-takers, USMLE reported 98% in 2020 and 92% in 2023, after the switch to pass/fail. For US MD first-takers alone, the rate was 93% in 2025. USMLE's pages don't give a reason for the dip. Per the USMLE Bulletin, the standard is a set level of proficiency, so no predetermined percentage of examinees will pass or fail.
What does it take to pass Step 1?
Reaching the passing standard, which USMLE's score reporting page puts at 196 on the three-digit scale. You get only a pass or fail, and USMLE says future reviews of the standard won't be published as a three-digit score. Results usually arrive within four weeks of the test.
The exam itself changed on May 14, 2026. Per USMLE's Step 1 page, it is now one day of fourteen 30-minute blocks in a single 8-hour session.
How many times can you take Step 1?
Per the USMLE Bulletin, you get 4 attempts at any Step, incomplete attempts included. You can take the same Step at most 3 times in 12 months. A fourth attempt has to wait at least 12 months after your first and 6 months after your most recent. An attempt where you don't open every block may be reported as incomplete on your transcript.
Our worked example: the earliest fourth attempt
An invented student first sits Step 1 on January 15, 2027 and makes a third attempt on September 10, 2027. Twelve months after the first attempt is January 15, 2028. Six months after the third is March 10, 2028. The later date wins, so by our math the earliest fourth attempt is March 10, 2028.
What happens if you fail Step 1?
Your fail score report shows how far you were from passing, with feedback by content area to guide your next study plan. For exams since January 26, 2022, every USMLE transcript shows only pass or fail, including the one residency programs get through ERAS.
Talk with your school before you rebook, use the content feedback to plan, and take a full timed practice exam before you sit again. In residency interviews, a single fail you explain well matters less than one you avoid talking about. Our red flags guide shows how to bring it up.
What does the pass rate mean for you?
A national rate tells you how the exam treats everyone, not how it will treat you. Your school's rate matters more, along with how the school counts it. Caribbean schools publish rates that include only students they let sit, and our Caribbean pass rates page shows six of them with their rules. With Step 1 pass or fail, your Step 2 CK score is the exam number programs see.
Practice question
“Can you tell me about your Step 1 attempt?”
If you failed once, residency interviewers may ask, because the result is on your USMLE transcript. Own it in one sentence, spend most of the answer on what you changed, and point to the result that followed.
Example answer written by Confetto (the applicant is invented)
I failed Step 1 on my first attempt. I had studied alone with question banks and never took a full practice exam under timed conditions, so I didn't see the problem coming.
I took six weeks, met with our learning specialist, and switched to a schedule built around weekly timed blocks and a study partner who quizzed me out loud. I passed on my second attempt, and I kept that routine for Step 2 CK, where I did well. I'm proud of how I handled it, and I still use that weekly review habit on the wards.
Sources: USMLE's performance data, score reporting page, Step 1 page, Bulletin eligibility rules and pass/fail transition page, checked November 3, 2026. A few headline numbers are quoted, and the full tables are on USMLE's site.
Frequently asked questions
What is the USMLE Step 1 pass rate?
Per USMLE's performance data for 2025, 93% of first-time takers from US MD schools passed, 89% from US DO schools and 75% from non-US schools. Repeat takers passed less often: 71% of US MD repeaters and 54% of non-US repeaters. See USMLE's performance data.
What score do you need to pass Step 1?
Step 1 is reported only as pass or fail for exams taken on or after January 26, 2022. On the old three-digit scale, the passing standard is 196. USMLE says future reviews of the standard won't be reported as a three-digit score. See USMLE's score reporting page.
Did the Step 1 pass rate drop after pass/fail?
For US and Canadian MD first-takers it went from 98% in 2020 to 92% in 2023, per USMLE. In 2025, with Canadian schools now counted separately, US MD first-takers passed at 93%. Pass/fail reporting began in January 2022, and USMLE's data doesn't say why rates moved. See USMLE's performance data.
How many times can you take Step 1?
Four attempts in total, incomplete attempts included. After four attempts without a pass you can't apply for any Step. You can take Step 1 at most three times in 12 months, and a fourth attempt must come at least 12 months after your first and 6 months after your most recent. Read USMLE's eligibility rules.
What is the Step 1 pass rate for Caribbean medical schools?
USMLE reports Caribbean schools inside its non-US group, where 75% of first-takers passed in 2025. Schools publish their own rates, which count only students they let sit for the exam. Our Caribbean page compares six schools' published rates. See Caribbean schools' pass rates.