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USMLE Step 1 - Key Stats

Recommended Preparation Time: 4 - 6 months

Subjects tested: Anatomy, Physiology, Pathology, Pharmacology, Biostatistics, Epidemiology, Behavioral Sciences, Microbiology, Genetics

Questions: About 280 questions (7x 35-40 question sections)

Exam Cost: $645

What is the process to fully pass the USMLE?

The USMLE is a difficult and rigorous process, even for top students, but you’re not alone - approximately 40,000 US and international students take the USMLE Step 1 each year.

Most US medical students take the USMLE Step 1 in their second or third year of medical school (MS2 or MS3), and then Step 2 is taken in MS4 or before graduation. International students typically test all steps after graduation or post graduation - passing the USMLE Step 1, Step 2, and Step 2 CS is required to be eligible for ECFMG (Educational Commission for Foreign Medical Graduates) certification.

The following is a rough breakdown of how long to expect each step to take, assuming you pass each exam on the first try and are doing the entire USMLE in one go. At a minimum, you should expect it to take at least one year to complete:

  • Step 1: 4 - 6 months
  • Step 2 CK: 4 months
  • Step 2 CS: 1 month
  • ERAs: 1 month

In terms of importance, the USMLE Step 1 is the most looked at score. According to NRMP MATCH 2018 program director survey, 94% of program directors state USMLE Step 1 score as the most important factor they consider for selecting applicants to interview.

What's a good USMLE Step 1 score?

If you want to get matched with a top program, you probably have already heard the advice of “260 or bust”. 260+ is an excellent score, but there’s plenty of room for success and great matches between 210 and 260. Here’s our score breakdown, based on UMMS, AAMC, and NRMP MATCH data:

260+: The fabled 260+ score is a ticket to any program you want, assuming you follow it up with comparable scores in the remaining two exams. Obviously no single thing will guarantee admission to your top choice program, but a 260+ shows program directors that you have an exceptional grasp of the material, the work ethic needed to prepare to this extent for the exam, and the endurance necessary to maintain attention to detail across an eight hour test.

Mean program scores in this range: None (they're all lower).

250 - 260: This is an excellent score that will single handedly improve your chances to match with a top program. You do not have to worry about being under a ‘cutoff’ or whether you’re competitive enough for a certain program - with this score, you are.

Mean program scores in this range: None (they're all lower).

240 - 250: This is the start of scores that are a positive on your resume with any program director. Follow this up with similar scores on the other sections and you’ll be a strong candidate anywhere.

Mean program scores in this range: Diagnostic radiology (240), Orthopedic surgery (248), Otolaryngology (248), Dermatology (249), Plastic surgery (249).

230 - 240: Now we’re getting somewhere. This score, followed up by good scores on the remaining steps, will form a good basis for an application to any program or specialty.

Mean program scores in this range: Anesthesiology (232), Emergency Medicine (233), Internal Medicine (233), Pathology (233), General Surgery (236).

210 - 230: Acceptable, if not great, score for the top matches - 229 was the average USMLE Step 1 score in 2018. As with lower scores, it’s not a death sentence - just focus on getting solid scores on the remaining exams.

Mean program scores in this range: Family Medicine (220), Psychiatry (226), Pediatrics (227), OBGY (230).

Passing (194) - 210: Low, but it is a passing grade and that’s the most important part. Schools look at your failed attempts in addition to your scores on passed attempts. If you have a score in this range, you still have two other critical Class A criteria where you can make up ground.

Mean program scores in this range: None (they're all higher).

Learn from the best
Our content was written exclusively for Achievable by GraceUSMLE's founder Sujata Arecanteparamb, M.D. A 250+ USMLE scorer with more than 10 years experience as a clinician and medical tutor, Sujata has taught hundreds of students as a part of GraceUSMLE and has now expanded her program through Achievable.
Sujata Arecanteparamb - Achievable USMLE expert
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