Frequently asked questions.

Yes — since January 2022, Step 1 results are reported as pass or fail, not as a three-digit score. The exam still tests the basic-science foundations, and the passing standard was raised from 194 to 196 at the transition. What changed is how programs use it: Step 1 no longer stratifies applicants by score, so the distinguishing exam moved to Step 2 CK. A first-attempt pass on Step 1 remains the expected baseline — a failure is visible to programs.

Step 2 CK. It is the scored exam, and since Step 1 went pass/fail it has become the primary quantitative comparison between applicants. Programs use it to screen interview invitations, and the national mean was 249 in 2023–24. Step 1 is the expected-pass baseline; Step 3 is taken during residency, after the match for most students, so it carries little selection weight.

Context matters — competitiveness depends on specialty and program — but the national mean score was 249 across 2023–24, and the passing standard was raised to 218 in July 2025. Our companion site, SI Step 2 CK, digs into what the match data says about score competitiveness by specialty. Always benchmark against the same year's national figures, not anecdotes.

Yes — failed Steps can be retaken, subject to USMLE attempt-limit and waiting-period rules (confirm the current rules at usmle.org, as they change). The bigger cost is strategic: failed attempts are reported to residency programs, and in the 2024 NRMP program-director survey 77% of respondents said they consider failed Step attempts when deciding whom to interview. A retake also needs to fit your school's progression policies and the application cycle.

In general, no. USMLE policy has historically prohibited retaking a Step solely to improve a passing result, with only narrow exceptions. This is a long-standing policy but should be confirmed at usmle.org before acting on it.

Yes — USMLE policy has included an overall time window in which all three Steps must be completed, in addition to per-Step attempt limits. The specifics have changed over the years, and state licensing boards can layer on their own requirements (for example, about when Step 3 must be done). Treat this as one of the items to verify at usmle.org and with your state board, not as a fixed rule to memorize from a secondary source.

In general terms: DO graduates complete the COMLEX series for osteopathic licensure. Many DO students also take USMLE Step 1 and Step 2 CK because some residency programs — particularly highly competitive ones — prefer or expect a USMLE score, and the USMLE first-time pass rates for DO takers run slightly below the MD figures (Step 2 CK 2022–2024: 96% US DO vs. 98% US MD). Whether the extra exams are worth it depends on your specialty targets; discuss it with your school's advisors rather than deciding from internet forums.

In general terms: IMGs must complete the USMLE Steps as part of the certification pathway for entry into US residency (administered through the ECFMG). The sequence is the same — Step 1, Step 2 CK, then Step 3 — but eligibility, timing relative to graduation, and the certification process differ from the US-student pathway. The authoritative source is the ECFMG, and scheduling details live at usmle.org.

After your preclinical coursework is complete — most commonly at the end of the second year in traditional four-year curricula, following a dedicated study period. Your school's policies matter as much as the national norm: many schools gate the transition to clerkships on a Step 1 pass. Our timing guide walks through the full arc.

That's strategy, and it lives on our deep-dive sites rather than this overview hub: SI Step 1 covers the pass/fail-era study design, and SI Step 2 CK covers the scored-exam strategy. As a rule of thumb, study around your school's curriculum first — the exams reward the same knowledge your coursework tests — and use national practice-exam performance, not vibes, to decide when you're ready.

In general terms, licensure boards and residency programs expect recent scores, and the overall time window for completing all three Steps (see the time-limit question above) effectively constrains how old a score can be. Programs may also prefer scores within the last few years when evaluating applicants. The binding rules are at usmle.org and with your state licensing board.

usmle.org — run jointly by the Federation of State Medical Boards and the NBME — is the authoritative source for the exam program: eligibility, scheduling, fees, passing standards, score reporting, and attempt policies. nbme.org is the NBME's own site, with practice materials and performance data. For how residency programs actually use scores and attempts, see the NRMP's program-director survey reports at nrmp.org. This hub is unofficial and independent — useful for orientation, never a substitute for the source.