The United States Medical Licensing Examination (USMLE®) is a standardized, professional exam that must be passed in order to become a doctor in the US. USMLE® scores for all three sections of the exam are recorded on both two-digit and three-digit scoring systems. The minimum required passing score is a 188 for Step 1, a 189 for Step 2, and a 187 for Step 3 on the three-digit scale, or a 75 on the two-digit scale for all three sections. No USMLE® scores report direct percentiles because the exam is adjusted to reflect scoring consistency across time as well as within each testing group.
According to the organization’s released data, the vast majority of USMLE® scores fall within the range of 140 and 260 on the three-digit system for each section of the exam. For test takers who are attending or who have attended an accredited US medical school, the mean score ranges from 200 to 220. There is generally a consistent 20-point standard deviation for each exam section’s scoring system.
In 2009, data indicates that 91% of US and Canadian test takers received passing USMLE® scores for Step 1, and 63% of test takers from other countries received passing scores. Step 2 pass rates are at 95% for US and Canadian examinees and at 78% abroad. Passing rates for Step 3, which occurs after the first year of residency for medical doctors, were 93% in the US and Canada and 73% abroad.
All USMLE® scores are derived from the percentage of correctly answered questions on each exam. Passing scores usually require correct answers for between 60% and 70% of all questions. This number will fluctuate from year to year because the test is designed to provide consistent scoring over time with each test group. As a result, the scores are not based on percentiles, and the number of passing versus failing students is not predetermined, as indicated by the varied pass rates for each exam.
The two-digit scaling system is not generally used when describing USMLE® scores. It is not a measurement of percentile, but rather it is there to provide data for certain licensing organizations that require a two-digit score, which is a minimum of 75. Although the minimum passing score for each section of the USMLE® test varies on the three-digit scale, the two-digit score is designed to convert the three digits into a system in which the minimum passing score is always a 75, regardless of the exam section.