Ten Most FAQ about USMLE Step 1 - from Tulane University

1. What is the national average USMLE Step 1 score?

The national average is a three-digit score between 215 and 220.

2. What is considered a “good” score on USMLE Step 1?

From my perspective, the test should be a pass/fail test. That is the way the test was designed. Having said that, specific scores are released. As a former residency director, I wanted residents to have passed Step 1 and Step 2 prior to matching with us. I did not really care about the score. Very competitive programs prefer applicants to have scores that are better than average. A commonly used benchmark for these programs is a threshold score of 220.

3. How are these scores used?

The scores are used for state licensure. You need to have passed all three or four steps of the USMLE within a designated time period (1 to 3 years following graduation depending on the state) in order to be licensed by the state board of medical examiners. Upon graduation from medical school, states issue “training licenses” for a limited period of time. Once these expire (within 1 to 3 years) you need to get a permanent medical license in order to continue residency training. To get a permanent license, all parts of USMLE must be passed.

4. Why are there two scores, one two-digit and one three-digit?

The USMLE provides a three-digit score for the exam. Some states require a two-digit score for licensure. The two-digit score is set such that 75 is a passing score. This is NOT a percentile. Percentile scores have not been released since 1999. The three-digit score is commonly used by residency programs and corresponds to overall performance on the exam. A three-digit score of 182 is passing and equates to a two-digit score of 75.

5. What is the maximum score?

This is hard information to come by. Theoretically it is 300. Scores above 280 are virtually unheard of. The high score this year for the class of 2006 was 259.

6. What do I do if I did not pass the exam?

You need to retake the exam. Typically students take one or tow months off during their third year. This time comes from the two months of “vacation” built into the clinical years.

7. Is it necessary to pass?

Beginning with the class of 2007, Step 1 must be passed prior to starting the fourth year and Step 2 CK and CS must be passed for graduation. Practically, it is difficult to match for residency without successful completion of Steps 1 and CS and CK. As mentioned, you need to pass all of the steps to complete your residency because of licensure requirements.

8. What was Tulane's average score?

I will get that information in May or June of 2004. We usually do about the national average and that appears to be the case this year as well.

9. What specialties rely on board “scores”?

ENT, orthopaedics, radiology, ophthalmology, and urology seem to rely on actual scores more than other disciplines.

10. If I want to enter one of these specialties and scored below average, am I doomed?

Hopefully not. Again, the scores are not meant to be used in this fashion. I would advise you to prepare hard for a higher score on Step 2. Additionally, many residency programs look at more than just scores (all should in my opinion). Do an away rotation, get the program to know you, do research in the field, do well on your clinical rotations. All of these things will help.