The USMLE® (United States Medical Licensing Examination) is a standardized professional exam that must be passed in order to practice medicine in the United States. Both two-digit and three-digit scoring systems are used to record USMLE® scores for all three sections of the exam. On a three-digit scale, an 188 for Step 1, 189 for Step 2, and 187 for Step 3 is the minimum required passing score, or a 75 on a two-digit scale for all three sections. Because the exam is adjusted to reflect scoring consistency across time and within each testing group, no USMLE® scores report direct percentiles.
According to the organization’s data, the vast majority of USMLE® scores for each section of the exam fall between 140 and 260 on the three-digit system. The mean score for test takers who are currently attending or have previously attended an accredited US medical school ranges from 200 to 220. The scoring system for each exam section has a consistent 20-point standard deviation.
According to data from 2009, 91 percent of US and Canadian test takers received passing USMLE® Step 1 scores, while 63 percent of test takers from other countries did. Step 2 pass rates in the United States and Canada are 95 percent, while they are 78 percent in other countries. Step 3 passing rates in the United States and Canada were 93 percent and 73 percent, respectively, after the first year of residency for medical doctors.
The percentage of correctly answered questions on each exam determines all USMLE® scores. Correct answers to between 60% and 70% of all questions are usually required for passing scores. Because the test is designed to provide consistent scoring over time with each test group, this number will fluctuate from year to year. As a result, the scores are not calculated using percentiles, and the number of students passing versus failing is not predetermined, as evidenced the varying pass rates for each exam.
When describing USMLE® scores, the two-digit scaling system is rarely used. It is not a percentile score; rather, it is there to provide information for licensing organizations that require a two-digit score of at least 75. Although the three-digit minimum passing score for each section of the USMLE® test varies, 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.