In 2024, 91% of first-time test-takers from U.S. MD schools passed USMLE Step 1, along with 86% from U.S. DO schools and 73% of international medical graduates (IMGs), according to official USMLE performance data. Those rates sit below the pre-pass/fail era, but they have stabilized after a dip that bottomed out in 2023.
This is the number most people get wrong online, because a lot of published figures still quote 2022 or 2023 data, and many blur first-time takers together with repeaters. Below are the current rates straight from the USMLE, broken out by group and by attempt, plus what actually moved the numbers.
- In 2024, first-time Step 1 pass rates were 91% (U.S. MD), 86% (U.S. DO), and 73% (international/IMG), per USMLE performance data.
- Interim 2025 figures are a touch higher: 93% MD, 89% DO, 75% IMG.
- Pass rates fell after Step 1 went pass/fail in January 2022 (first-time U.S. MDs dropped from 95% in 2021 to 90% in 2023), then leveled off.
- Repeaters pass far less often: about 70% for U.S. MD and 52% for international first-repeaters in 2024.
- The passing standard is 196 (raised from 194 at the pass/fail switch). Step 1 is reported as pass/fail only, with no three-digit score.
What is the current USMLE Step 1 pass rate?
The single number most people mean by "the Step 1 pass rate" is the first-time, U.S. MD rate, because it describes the typical student sitting the exam for the first time. For 2024 that was 91%, according to the USMLE performance data. U.S. DO students passed at 86% and international graduates at 73%.
USMLE Step 1 first-time pass rates by examinee group, 2024. Source: USMLE Performance Data (usmle.org).
The gap between groups is the real story. A first-time U.S. MD student sits about 18 points above an international first-timer, and that spread has held steady for years. So the honest reference point depends entirely on which group you are in.
USMLE Step 1 pass rates by examinee group
Here are the official first-attempt rates for the two most recent reporting years. The 2025 column is interim data (a partial-year snapshot), and starting in 2025 the USMLE groups Canadian schools with non-U.S. examinees, so read the newest column as a preview rather than a settled full year.
| Examinee group (first attempt) | 2024 | 2025 (interim) |
|---|---|---|
| U.S. MD schools | 91% | 93% |
| U.S. DO schools | 86% | 89% |
| Non-U.S. / international (IMG) | 73% | 75% |
Repeaters are a different picture. In 2024, U.S. MD repeaters passed at 70% and international repeaters at just 52%, so failing once and retaking drops the odds sharply. Blend first-timers and repeaters together and the all-attempts totals come out lower: 88% for U.S. schools and 70% for non-U.S. schools in 2024. That blending is exactly why "the Step 1 pass rate" looks different depending on which table someone is quoting.
How USMLE Step 1 pass rates have changed
Step 1 pass rates are not static. First-time U.S. MD rates sat in the mid-90s before 2022, slid after the exam went pass/fail, bottomed out in 2023, and have edged back up since. Here is the recent trajectory using USMLE figures and a 2024 peer-reviewed review in the Avicenna Journal of Medicine:
USMLE Step 1 first-time pass rates, 2021 to 2025. Sources: USMLE Performance Data and Avicenna Journal of Medicine (2024).
For first-time U.S. MD students, the line runs 95% in 2021, 91% in 2022, 90% in 2023, back to 91% in 2024, and 93% in the interim 2025 data. U.S. DO and international graduates followed the same shape one and two tiers lower. The all-student pass rate fell from 88% in 2021 to 82% in 2022, the sharpest single-year move in the series.
Why USMLE Step 1 pass rates dropped after pass/fail
The decline lines up almost exactly with the January 2022 switch to pass/fail scoring, and the peer-reviewed analysis points to three overlapping causes.
A higher passing standard. When Step 1 went pass/fail, the minimum passing score rose from 194 to 196. A higher bar mechanically fails a few more people. On its own, though, that does not explain a six-point drop in the overall rate. When the standard last went up, from 192 to 194 in 2018, the pass rate actually ticked up that year, so a small bar change is not usually enough to move the needle this much.
Pandemic disruption. The 2020 and 2021 classes had their preclinical training and testing scrambled by COVID-19, and those effects carried into 2022 exam takers. Step 1 is comprehensive, so gaps in foundational coursework show up across the whole exam.
Less studying. This is the one most people underestimate. Once the three-digit score disappeared, the incentive to grind for a high number disappeared with it, and students reported completing fewer practice questions during dedicated prep. The exam did not get much harder; a slice of test-takers simply prepared less intensely for a bar they assumed was easy to clear.
What is the passing score for USMLE Step 1?
The current minimum passing standard is 196, up from 194 before 2022. But you will never see that number on your score report. Since January 26, 2022, Step 1 has been reported as pass or fail only, with no three-digit score, per the official USMLE transition notice. The 196 works behind the scenes as an equated standard; your report simply says whether you cleared it.
Because there is no score to show off, residency programs shifted the weight they used to put on Step 1 onto Step 2 CK, which is still scored. Passing Step 1 is now a gate to get through, not a number to maximize, which changes how you should budget your effort.
How Step 1 pass rates compare to Step 2 CK
Step 1 rates look low next to Step 2 CK, and that gap is part of why programs lean on Step 2 now. In the 2024 to 2025 cycle, first-time Step 2 CK pass rates ran 98% for U.S. MD students, 96% for U.S. DO students, and about 90% for international graduates, per the same USMLE performance data. Step 2 CK is taken later, after clinical rotations, by students who have already cleared Step 1, so the tested pool is stronger and better prepared. The planning takeaway is simple: Step 1 is the harder gate to clear, and it deserves the heavier share of your dedicated study time.
Why repeaters and international graduates pass at lower rates
Two groups pull the headline "all candidates" figure down, and both drops are structural rather than random.
Repeaters. By definition, repeat testers are the people who did not clear the bar the first time, so a lower pass rate is expected. The size of the gap is still worth respecting: U.S. MD repeaters passed at 70% in 2024 versus 91% for first-timers. If you fail, treat the retake as a full reset of your study plan, not a light touch-up.
International graduates. IMGs face variable preclinical curricula, exams in a second language for many, and preparation timelines that often run alongside clinical work back home. A 73% first-time rate is far better than the ~52% repeater rate, which again underlines how much easier the first honest attempt is than a rushed one.
What the Step 1 pass rate does and does not tell you
A pass rate is a population statistic, not your personal probability. Your realistic odds depend on your NBME self-assessment scores, your question-bank performance, and whether you have finished your first two years of coursework, far more than on the group average. Use the number for context, not as a prediction.
It also does not measure difficulty in a vacuum. When a rate moves, it usually reflects who is testing and how they prepared, not a change in the exam blueprint. The 2022 dip is the clearest example: same exam, different behavior.
How to give yourself the best shot at passing
The students who clear Step 1 comfortably tend to do the same handful of things. It helps to first understand what Step 1 actually is and what it takes to pass, decide when to sit it, and build a week-by-week study plan. If you want the full USMLE resource landscape, start here:
- Do a real question bank, thoroughly. Working UWorld's Step 1 question bank and reading every explanation is the single most reliable predictor of readiness. The fewer questions you do, the worse the odds, which is exactly the pattern behind the post-2022 dip.
- Anchor everything to First Aid. First Aid for the USMLE Step 1 is the shared outline the whole ecosystem maps to; annotate it as you go, and here is how to use First Aid the right way.
- Lock in retention with spaced repetition. The free AnKing Step Deck is how most high scorers keep thousands of facts from slipping.
- Take the official practice. A timed USMLE Free 120 and NBME self-assessments late in dedicated are the best readiness signal you can get, and they are the closest thing to the real exam.
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Frequently asked questions
What is the USMLE Step 1 pass rate in 2026?
The most recent full-year data comes from 2024, when 91% of first-time U.S. MD students, 86% of U.S. DO students, and 73% of international graduates passed Step 1. Interim 2025 figures are slightly higher at 93%, 89%, and 75%. Blended across first-timers and repeaters, the all-attempts totals were 88% for U.S. schools and 70% for non-U.S. schools.
What is the passing score for USMLE Step 1?
The minimum passing standard is 196 (raised from 194 in 2022). However, Step 1 has been reported as pass/fail only since January 26, 2022, so you do not receive a three-digit score, only a pass or fail outcome.
Why did USMLE Step 1 pass rates drop after it went pass/fail?
Three factors overlapped: the passing standard rose from 194 to 196, COVID-19 disrupted the training of 2020 to 2022 test-takers, and, most importantly, many students studied less and completed fewer practice questions once there was no numeric score to chase.
Is USMLE Step 1 hard to pass now that it is pass/fail?
The exam itself did not get easier or harder when it went pass/fail. First-time pass rates actually fell afterward, largely because some students underprepared. Treat it as a serious exam, not a formality.
How do repeater pass rates compare to first-time rates?
Repeaters pass at much lower rates. In 2024, U.S. MD repeaters passed at 70% versus 91% for first-timers, and international repeaters passed at just 52%. A first, well-prepared attempt is by far your best shot.
Does Step 1 still matter for residency if it is pass/fail?
Yes, but differently. You must pass to move forward, and a fail is a serious flag for programs. Since there is no score to compare, programs now put more weight on Step 2 CK, which remains scored.
Sources
- USMLE Performance Data (usmle.org)
- USMLE Step 1 Transition to Pass/Fail Only Score Reporting (usmle.org)
- Assessing the Impact of USMLE Step 1 Going Pass-Fail, Avicenna Journal of Medicine (2024)
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