How many times can I retake Step 1?

You can take the USMLE Step 1 a maximum of four times in your lifetime, with specific rules about time between attempts: no more than three times within 12 months, and your fourth attempt must be at least 12 months after the first and 6 months after the third. Failing after four attempts generally makes you ineligible, though rare exceptions for a fifth attempt might be possible through state medical boards like New York or Florida, requiring an appeal and specific criteria.

How many times can you retake USMLE Step 1?

Attempt Limit

What is the USMLE policy on attempt limits? The total number of attempts allowed per Step is four (4). Examinees who have attempted any USMLE Step (including Step 2 CS) four or more times and have not passed are ineligible to apply for USMLE Steps.

What happens if you fail Step 1-4 times?

If you have attempted a Step four or more times, including incomplete attempts, and have not passed, you are ineligible to apply for any Step in the USMLE sequence.

How many attempts do you have for Step 1?

You may take Step 1 up to 4 times — 3 initial attempts plus 1 final attempt. You must wait at least 60 days before retaking the exam, and you cannot take Step 1 more than 3 times in a 12-month period. Failing Step 1 can feel discouraging, but it does not mean the end of your medical career by any means.

What is the 7 year rule for USMLE?

The USMLE 7-year rule, primarily for International Medical Graduates (IMGs) seeking ECFMG Certification, mandates completing all required USMLE Steps (1, 2 CK/CS, and eventually 3) within seven years of passing the first exam; failure to do so invalidates earlier scores, requiring retakes, though waivers or extensions may be granted for documented issues like PhD programs, severe illness, or certain military service. Most U.S. medical licensing boards also enforce this timeframe for state licensure, starting from the first successful Step pass. 

"Failed USMLE Step 1. How do I pass when re-taking it?"

Is 60% enough to pass Step 1?

Yes, around 60% correct is generally considered the approximate pass mark for USMLE Step 1, though the exact percentage varies with each exam form, and the score is reported as Pass/Fail, not a number, so consistently scoring higher (like 65-70%) on practice exams (NBMEs) is recommended for a comfortable pass. The official passing score (around 196 before 2022, now just "Pass") isn't a fixed number of questions, as some are experimental, but aiming for about 60% on practice tests is a good benchmark, with 70%+ being a safer target for a strong pass. 

What happens if you fail USMLE?

You can recover, but it's important to keep in mind residency programs can see how many times you've taken the test. Residency admissions committees see their students as investments. If you fail Step 1, it makes you a much riskier investment compared to someone who passed the first time.

What is a 90% chance of passing Step 1?

A 90% chance of passing USMLE Step 1, often from an NBME practice test, means that for every 100 people with that score, 90 pass, but 10 still fail, so it's a strong indicator but not a guarantee, highlighting the need to focus on weak areas identified in the report, especially for Step 1's new pass/fail format where recent pass rates hover around 90-92%.
 

Can residency programs see if you fail Step 1?

Does a Pass on Step 1 Affect Your Residency Chances? Now that Step 1 is pass/fail, residency programs can't compare students based on Step 1 scores anymore. Instead, they focus on other factors: Step 2 CK scores: This is now the most critical numerical exam result.

Is Step 1 the hardest exam ever?

While USMLE Step 1 is notoriously difficult, often considered the hardest among medical licensing exams due to its vast knowledge base and high stakes, calling it the absolute "hardest in the world" is subjective; exams like China's Gaokao are also cited for extreme pressure, but Step 1's challenge lies in consolidating foundational medical science before clinical focus in later steps. Many students find it uniquely stressful as a major hurdle in becoming a doctor, testing broad concepts and clinical reasoning.
 

How common is failing Step 1?

While most people pass USMLE Step 1, failure rates have increased, especially since the scoring change to pass/fail in 2022, with overall pass rates for first-time test-takers dropping, and international medical graduates (IMGs) and repeat test-takers facing significantly lower odds, though the exact number varies yearly, with thousands failing in recent years (e.g., over 11,000 in 2023). For MD students, first-time pass rates were around 90-93% in 2022-2023, compared to 82-83% for DO students and ~72% for IMGs in 2023, with repeaters seeing even lower success.
 

Can I do residency in Canada with USMLE?

While US graduates may have completed the United States Medical Licensing Examination (USMLE) series during their training, these exams do not fulfill the requirements for Canadian residency. Instead, US graduates must pass the Medical Council of Canada Qualifying Examination (MCCQE) Part I.

Can I pass Step 1 with only UWorld?

Is UWorld Enough to Pass Step 1? UWorld alone is not enough. You should use UWorld along with these tips to effectively prepare for Step 1: Combine UWorld with other resources, such as First Aid and NBME self-assessments.

What is a 75% on Step 1?

A 75% on USMLE Step 1 usually refers to a high performance level, often meaning you scored better than 75% of other test-takers (75th percentile) or got around 75% of questions correct on practice exams, indicating a very high chance of passing, as a ~65% correct on NBMEs often predicts passing. While Step 1 is now pass/fail, historically, a score in the 75th percentile (around 240-250+ on the old scale) was considered strong for residency applications, and 70-75% on practice NBMEs suggests near-certain success on the actual exam.
 

Is Step 1 harder than the mcat?

Most sources suggest the USMLE Step 1 is generally considered harder than the MCAT due to its immense content depth in basic sciences and higher stakes (though its scoring changed), while the MCAT is often seen as a broader critical thinking/reading test; however, opinions vary, with some finding the MCAT's abstract, interdisciplinary nature more challenging than Step 1's deep science focus. Step 1 covers a vast amount of medical science (physiology, pharmacology, etc.) after two years of med school, whereas the MCAT tests foundational sciences and reasoning for med school entry, often seen as tricky or abstract, per Reddit users and this YouTube video. 

Do you have to pay to retake Step 1?

If you fail Step 1 (or any USMLE Step exam), you can retake it after reapplying and paying for the registration and scheduling fees. Similar to registering for Step 1 the first time, for the retake you'll be given a scheduling token after you select an eligibility period.

Can you still be a doctor if you fail Step 1?

Know this: One failing score on a Step exam doesn't preclude you from being a physician. “Someone who failed Step 1 and went on to successfully pass it and do well—one of the things we look for in resident candidates is resilience and that's pretty good evidence of resilience,” Dr. Marzano said.

What are red flags in residency applications?

Residency application red flags are issues that can signal potential challenges, primarily revolving around academic/exam performance (failed/low USMLE/COMLEX scores, retakes, course failures), gaps in education/training (unexplained time off, extended med school), professionalism issues (probation, disciplinary actions, poor evaluations, legal trouble), and application inconsistencies (weak LORs, generic statements, mismatched goals, no U.S. clinical experience for IMGs). The key is acknowledging these, explaining them with context (e.g., personal hardship), and demonstrating growth and remediation to show maturity. 

Is Step 1 only pass fail?

As of January 2022, the USMLE Step 1 Exam shifted from being scored to a simple pass/fail grading structure.

What is the lowest score on Step 1?

FAQs. The minimum passing score for Step 1 is 196. However, your exact numerical score for this exam will not be included in your score report. According to the National Board of Medical Examiners (NBME): The USMLE Management Committee establishes the minimum passing score.

Is 250 a good Step 1 score?

250-259 (50th-75th percentile) – Solid score, but you may need other strong application components for highly competitive specialties. 240-249 (25th-50th percentile) – Still a comfortably passing score but could limit options for competitive programs.

How bad is failing Step 1?

Failing USMLE Step 1 can feel like a major setback, but it does not define your future in medicine. Many successful physicians have faced obstacles along the way, and what truly matters is how you respond to adversity.

What is the hardest year of medical school?

Most medical students find the first year hardest due to the overwhelming volume of foundational science and the drastic adjustment to a new academic environment, while others find the third year the most challenging because of the intense, long hours and emotional demands of clinical rotations in the hospital setting, but it often comes down to whether you find academic hurdles or clinical burnout more difficult. 

Can you graduate medical school without passing Step 1?

Therefore, it is a requirement of the School of Medicine that students take and pass all relevant components of United States Medical Licensing Examination (USMLE) during medical school. (1a) All DGSOM students must successfully pass the USMLE Step 1 and Step 2 exams in order to graduate and receive their diploma.