USMLE Step 1 Percentiles: What You Need to Know

How your USMLE Step 1 percentile could make or break your residency application

Throughout the first two years of medical school, you might find yourself thinking about USMLE Step 1. Of all of the exams in med school (and there’s certainly no shortage), this one tends to create the most anxiety. Step 1 is known for being a difficult exam, and the results can be hugely important to your residency applications. This is why many medical students invest a great deal of time in studying for it, hoping that a high USMLE Step 1 percentile will help them to match with the residency of their choice later on.

What do the scores on this test actually mean? What would be a passing score, a decent score, a great score? Most importantly, what can you do to improve your performance on this crucial exam?


Usmle step 1 percentiles


It’s no surprise to anyone that medical students are excellent test takers. Keep in mind that everyone taking the USMLE also took the MCAT – and they did well enough to get into medical school. That was after they’d likely also performed well on previous standardized tests (such as the SAT). When you take USMLE Step 1, you’re competing against a group of people who may very well be the best test takers in the nation.

This is why percentiles are so important. When a residency program is considering applicants, they won’t just be looking at your score in isolation; they’ll be looking at it relative to the scores of other applicants. If you want your Step 1 score to help you stand out from the crowd, then you’ll want to score in as high a percentile as possible.

USMLE Step 1 percentiles

The exam itself has 280 questions (7 blocks of 40 questions each). The top score is theoretically 300, although nearly all scores are in the range of 140 to 260. (The exact formula for calculating the score is a bit of a mystery, although we do know that it takes into account the calculated difficulty of your version of the test, since each person who takes the exam sees a slightly different version of it.)

Data provided by the National Board of Medical Examiners, which administers the USMLE, indicate that the median score (the 50th percentile) for Step 1, for US medical graduates who are taking the test for the first time, is about 232. The 25th percentile is around 217, while the 75th percentile is around 244. This means that if you score at or below 217, you’re in the bottom 1/4 of test takers, while if you score at or above 244, you’re in the top 1/4. If you score 232, you’re right in the middle of the pack.

Do USMLE Step 1 percentiles actually matter?

Ultimately, the pressing question on every medical student’s mind is whether their score on Step 1 will matter for their residency application. The answer is a resounding yes. In fact, your score on Step 1 is one of the primary factors that goes into deciding whether a residency program will even offer you an interview, and also on how highly they will rank you in the Match.

The minimum passing score for Step 1 is 194. You’ll need at least this score in order to eventually become licensed to practice medicine independently. However, it’s likely that you want to do more than just pass. The more competitive the specialty that you’d like to enter, the higher the score that you should be aiming for.

According to 2020 data provided by the National Residency Match Program (NRMP), which administers the Match, the mean (average) score for US medical graduates who matched to their top specialty choice was 234. The median score varied a lot between specialties, with the median Step 1 score for those who matched to a competitive specialty (like dermatology or plastic surgery) being around 250, while the median for those in the least competitive specialty (family medicine) was around 220. When you take Step 1, you won’t have spent time in your clinical rotations yet, and so you might not be certain which specialty you’d prefer to match in. In order to keep your options open, the best plan is to score as highly as possible on Step 1.

Match data regarding Step 1 percentiles
This data from the NRMP shows the Step 1 scores of medical graduates matching into various residency programs.

Do you have a study plan for USMLE Step 1?

If you’d like to score in the higher range of USMLE Step 1 percentiles, then you’ll need a good study plan. Remember that you’re competing against the best test takers in the nation; if you want to stand out, then you’ll need to be diligent about preparing for the exam. Creating a schedule is essential to keep you on track and ensure that you’re meeting your study goals.

Individual help in creating your study plan for Step 1 could make a huge difference in your score. Our professional tutors will help assess your strengths and weaknesses, and create a personalized plan that helps you to improve your performance on the exam. All of our Medlearnity tutors have scored 250+ on their USMLE exams, so they know what it takes to succeed. (What does it take to score 250+? Here are some of our tips!) They can walk you through the process of thinking through an exam question, and help you identify your weak areas so that you can target your studying effectively. Our students report improvements of 20 to 50 points on their USMLE scores after receiving tutoring.

Some students choose tutoring because they’re concerned about failing the exam, or perhaps they have failed in the past. Others choose it because they’re already doing fine, but they want to achieve a great score so that they can set themselves apart on their residency applications. Still others have test anxiety, and want the guidance of a professional so that they can feel more confident and perform at their best. For all of these students, having someone in their corner who’s been through this process and who’s invested in their success can be extremely valuable.

You can try out a free one-hour session to get an idea of what it would be like to have professional guidance as you go through this demanding process. Learn more or book your session here.

About the author 

Medlearnity Staff

Medlearnity is an elite tutoring and consulting company that specializes in medical school and residency test preparation, coursework, and admission applications. We pride ourselves on offering the highest quality medical tutoring and consulting in the industry, which starts with our incredibly accomplished, experienced and compassionate tutors who deeply care about student success. For over 8 years, we have helped hundreds of aspiring doctors accomplish their goals on USMLE, COMLEX, Shelf Exams and NBME, Residency Board Exams, Residency Admissions, MCAT, Medical School Admissions, and Medical Coursework.

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