USMLE Step 1 Percentiles: What You Need to Know

As a medical student, you need to have a solid understanding of the USMLE Step 1 percentiles and the scoring system. We understand that this exam may be one of your biggest fears. It’s that big hurdle you just want to be over and done with! But, USMLE Step 1 is the first in three exams leading up to the end of your residency internship and can affect your residency matching. So let’s explore what you need to know about USMLE Step 1 and how you can get your best test score!

What's the Average Step 1 Score?

What’s the Average Step 1 Score?

The highest score possible on the USMLE Step 1 exam is a 300. As you read above, even a score of 240 is excellent, putting you into the top 15th percentile. Yet when it comes to a test like the USMLE Step 1, you may be wondering what the average score is. This can give you a benchmark of what you should shoot for if you want to be above the mean of the other test-takers and have a better chance of reaching your career goals.

The average score changes from year to year. Here are the averages from the years 2017 to 2019:

  • 2017: The average score was 229, with a standard deviation of 20.
  • 2018: The average score was 230, with a standard deviation of 19.
  • 2019: The average score was 232, with a standard deviation of 19.

As you can see, there has been an upward trend in averages over the past few years, but only slightly. So, roughly, the average score of the USMLE Step 1 is around the 230-point range.

Note that USMLE Step 1 exams will follow a pass/fail structure effective January 1, 2022.

But some people find themselves asking if they should even care about the average score of the Step 1 exam, and if they should, then why. The reason is that scoring around the average can raise your chances of matching to your preferred specialty. But remember, the average score is found using scores that were higher and lower. Test-takers would have had to score both more and less than this score to come to this number as the average.

This means that people with less than 230 can still be matched with their desired specialty. But the chances of this happening are higher if you score in the average range or better. Try to land in a high USMLE score percentile and you can embark on your new career with confidence.

This average score for such a favorable outcome also puts the test into perspective — 230 is a high Step 1 score and can feel like quite a lofty goal to achieve for some. This reiterates the importance of preparing for the USMLE Step 1 exam, as you’ll want to come away with the best score possible. You can take heart because different specialties will have different average Step 1 percentiles that can still lead to placement in one’s preferred specialty.

In short, you should shoot for at least the average — around a 230. But the more you study and prepare the right way, the higher your chances could be for acing your USMLE Step 1 exam and landing in your chosen specialty!

The Importance of Having the Right Mindset

Being an aspiring medical professional is difficult. You will need to focus on passing your medical school course requirements. And doing this often means sacrificing your leisure time, social relationships and other activities.

However, in spite of this extremely challenging path, the rewards that await you are great. Becoming a doctor (or any medical professional) is truly commendable. It’s a noble profession that allows you to serve humanity and it is rewarding in many aspects. But, making this dream a reality means that you need to put in the necessary effort and study time.

a stethoscope laying on a USMLE textbook

The path of a medical professional is filled with many arduous tests. If you really want to become a physician, then you should be aware of what you’re getting yourself into. You don’t want to waste your time, effort and other valuable resources. You will need to dedicate every waking moment of your life to honing your medical skills. And these examinations are meant to test your resolve and commitment to medicine. How far will you go? How much effort are you willing to expend?


To get into medical school, you have to pass the MCAT exam. This exam covers the basic sciences and is meant to determine your aptitude for the medical field. The great news is that you passed the MCAT! So that should strengthen your resolve as you prepare for your USMLE Step 1 exam.

For those of you thinking of medical school, you should note that schools have different cut-off scores for the MCAT. Some would only accept students in the upper 10th percentile or 20th percentile. You have to meet the score that is standardized by your medical school of choice. You then need to prepare a detailed and sincere letter of intent and submit it with your CV.

While your undergraduate course may have some weight on your application, your exam results and letter of application (as well as your interviews) will matter the most. So make sure that you do great on all of them! Check out how we can help you with your medical school admissions here!

Getting into medical school is a great accomplishment. However, now you need to focus on acing the USMLE test series!

Why is the USMLE Called a Test Series?

The United States Medical Licensing Examination (USMLE) is not just a single exam. It’s a series of multiple tests conducted at different times in the course of your medical studies. The main purpose of the USMLE exams is to make sure that each student is able to assume the role of a practicing physician in the future. After all, medicine is a sensitive and intricate discipline. It’s not enough to just “want” to become a doctor. You have to be qualified to become a doctor.

There are three parts to the USMLE. Well, four, if we count the two sections in USMLE Step 2 separately. These tests are USMLE Step 1, USMLE Step 2-CK, USMLE Step 2-CS and USMLE Step 3. Note that Step 2-CS isn’t offered currently until further notice.

These parts are administered at different times throughout your study, with the last one being taken after you’ve completed your internship residency. Each test has a different set of objectives. However, each test seeks to measure your capacity and aptitude to further pursue the profession. But just because you’re at Step 1 doesn’t mean you should take it easy. If anything, you should go all out on the very first step to avoid problems later on.

What’s Included in the USMLE Step 1 Exam?

The USMLE Step 1 exam is a knowledge test. It’s a multiple-choice exam consisting of 280 items in total and is divided into 7 sections, each having 40 questions. The examinee has 1 hour to complete each section (about 1 minute and 30 seconds per question). The exam is 7 hours long, and you get a 45-minute break to eat and another 15-minute break to review. So Step 1 lasts for a full workday (or 8 hours).

Is USMLE Step 1 going to be difficult? Well, yes, but not in the way you think it’ll be.

The Step 1 exam evaluates how much you’ve learned in your first two years of medical school. It covers basic sciences as well as all the subjects you have taken in these two years. So what makes the USMLE Step 1 exam difficult is the volume of material to cover. You must plan your study schedule well so that you can cover all the material that is included in the exam. We have plenty of study resources as well as a quick guide to help your study schedule, so be sure to check it out!

USMLE step 1 scores and percentile chart

What’s the Score to Pass USMLE Step 1?

For the USMLE Step 1 exam, the score you should aim for depends on the medical sub-discipline that you intend to practice. We all know by now that Step 1 weighs heavily among all the USMLE exams, as it is what impacts your internship application for residency the most. When students score well on this first test, they are advised to avoid taking USMLE Step 2 right away. It would be better to send out your applications first before taking the second step. This is because the new scores may affect the overall impact of your application. It’s not that we don’t believe that you will have a passing score in the additional exams. It’s just best to be very cautious.

USMLE Step 1 Percentiles To Aim For

For USMLE Step 1, a good score to aim for is 240. Yes, it’s a little high, but that’s exactly what you want. Being in the upper 15th percentile is a goal to focus on. It will make your application look promising no matter which sub-discipline or specialized practice you enter later on. If you’re thinking of getting into general practice (or becoming a family doctor), then a score of around 220 is also okay. But, if you intend to go into surgical practice, the you need to aim for and even higher score.

You Can Ace Your USMLE Step 1 Exam!

It’s important that you understand the scoring system of Step 1 and get the best score in the USMLE Step 1 percentiles. Many students work very hard each day to get that perfect score. If that’s you, you want all the help that you can get. At Medlearnity, we have many expert physicians available to guide you in preparing for USMLE Step 1. Our exceptional tutorial services are just what you need to ace the exam. Book your free 1-hour session today to see how we can help to make your perfect USMLE Step 1 score a reality!

About the author 

Akshay Goel MD

Dr. Goel is a body-trained radiologist and an expert in medical education and imaging informatics. He completed his Radiology Residency at Columbia University Medical Center and his fellowship at Weill Cornell Medicine. Dr. Goel has guided several students and doctors into successful careers over the past decade. He continues to help Medlearnity tutors optimize their educational methodology to drive the highest tutoring and admissions impact possible.

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