The USMLE exam series is required for all Medical School Graduates who want to become a Licensed Physician in the United States. The series of exams tests basic sciences, clinical science and patient management. As an International Medical Graduate you will be competing with US Medical Graduates for US Residency and Fellowship positions. USMLE Step 1 and 2 scores are particularly important to help your application to stand out.
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USMLE Step 1 | USMLE Step 2 CK | USMLE Step 2 CS | USMLE Step 3
Below is an overview of USMLE Pass Rates between 2006 and 2008.
| USMLE Step | US & Canadian Graduates Pass Rates (percentage) | International Medical Graduates Pass Rate (percentage) | Passing Score |
| USMLE Step 1 | 91 | 63 | 185 (75) |
| USMLE Step 2 CK | 94 | 74 | 184 (75) |
| USMLE Step 2 CS | 97 | 70 | Pass/Fail |
| USMLE Step 3 | 94 | 71 | 187 (75) |
USMLE Step 1 Pass Rates and Scores
The USMLE Step 1 exam is designed for US Medical Graduates after their 2nd year of Medical School. The exam tests basic sciences, including Anatomy, Physiology, Pharmacology, Pathology, Immunology, Medical Genetics, Biochemistry and Behavioral Science. Many International Medical Graduates struggle with the exam in comparison to US Graduates. US Medical Graduates start their training for the USMLE Step 1 on the first day of Medical School, and the emphasis on areas such as Behavioral Science are greater than in schools internationally.
The pass rates for US Graduates and International Medical Graduates differ considerably. In 2008 91% of US Graduates passed their USMLE Step 1 first time, compared to 63% of non-US Graduates
The passing score for the USMLE Step 1 is 185 (75). The Residency Programs you apply to will see every time you’ve taken your exam, and you can only retake it 6 times in a 7 year period. It is also important that you remember that you can only retake the exam if you fail and that a passing score of 185 is not good enough to gain Residency. The average US Medical Graduate USMLE Step 1 score is 210-230.
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USMLE Step 1 Practice Questions
USMLE Step 2 CK Pass Rates and Scores
The USMLE Step 2 CK is similar in format to the USMLE Step 1 exam. It is a computer based test, asking you to answer Clinical Vignette style, multiple choice questions. This exam is designed for Medical Students after their clinical rotations. It is testing whether students have the necessary knowledge for patient care.
The average pass rates for International Medical Graduates is 74%. This compares with 94% for US Medical Graduates.
The passing score for the USMLE Step 2 CK is 184 (75). The mean USMLE Step 2 CK score for US Medical Graduates who successfully matched to a Residency Program is 230 and for other applicants 213. This highlights the importance of gaining a competitive USMLE Step 2 CK score in order to successfully match to a US Residency Program. For the most competitive Residency Programs such as Dermatology a far higher mean average USMLE Step 2 CK score is seen.
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USMLE Step 2 CS Pass Rates
The USMLE Step 2 CS is a live exam testing your patient interaction and communication skills. You will face 12 Standardized Patient Interactions with actors who present with common clinical problems. You will either receive a pass or fail for this exam, to pass you must pass each interaction and each subcomponent of the USMLE Step 2 CS exam.
The USMLE Step 2 CS administration in 2006-2008 revealed that 97% of US and Canadian Medical Graduates pass the USMLE Step 2 CS exam first time. This is in comparison to International Medical Graduates who have a first time pass rate of 70%. To pass the USMLE Step 2 CS exam, Medical Graduates must pass all Standardized Patient Interactions and three subcomponents; Integrated Clinical Encounter (ICE), Communication and Interpersonal Skills (CIS) and Spoken English Proficiency (SEP).
The weakest area for all International Medical Graduates is Communication and Interpersonal Skills with US Graduates achieving a 99% pass rate and International Medical Graduates passing first time 81% of the time.
The USMLE Step 2 CS differs from similar exams in the UK and Internationally. 85% of your score is given by a Standardized Patient who is an actor. You are not tested on any issues that are not common patient problems. It is important that you practice for this exam, become familiar with the format and the expectations of the exam.
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USMLE Step 2 CS Practice Exam
USMLE Step 3 Passing Scores and Rates
The USMLE Step 3 tests patient management without supervision. It is testing how you would manage patients presenting with different clinical problems in a number of different settings. The USMLE Step 3 is a two day exam with a combination of Multiple Choice Questions and Clinical Case Simulations.
The passing score for the USMLE Step 3 is 187 (75). This exam is required for Board Certification in the US and is usually taken by US Medical Graduates after completion of their first year of US Residency. International Medical Graduates may however decide to take this exam beforehand to gain a H1B Visa – Find out more about Visa’s for US Residency.
To gain a H1B Visa you must take the USMLE Step 3 prior to Residency and achieve a passing score. Results from the 2008 administration of the USMLE Step 3 exam reveal that while 94% of US Medical Graduates pass the USMLE Step 3 exam first time, only 71% of International Medical Graduates pass first time.