USMLE Step 1 Scoring Guide
How scores are calculated, what they mean, and how to reach your goal score.
Scoring Overview
Step 1 converts to pass/fail since January 26, 2022. The minimum passing standard corresponds to the previous three-digit score of 196. You need approximately 60% of items correct to pass. The exam is not adaptive — all examinees see equivalent test forms. Passing is now the primary goal; residency programs increasingly weight Step 2 CK for objective comparisons.
Score Scale
| Section | Duration | Max Score |
|---|---|---|
| USMLE Step 1 | 480 min | 100 |
Section Breakdown
usmle
Seven 60-minute blocks of up to 40 items each, with 45 min of break time distributed across the day.
Anatomy & embryologyBiochemistry & molecularMicrobiology & immunologyPathology & pathophysiologyPharmacologyPhysiologyBehavioral sciences & biostatsGeneticsNutrition
Key Facts
- Length
- 8 hours (7 × 40-item blocks)
- Items
- Up to 280 MCQs
- Score
- Pass/Fail (since 2022)
- Cost
- $680 USD + Prometric fee
- Pass rate
- ~94% first-time US MD students
- Time per block
- 60 min / 40 items = 1.5 min each
Study Tips
- 1.Start with a dedicated Qbank like UWorld — it's the gold standard.
- 2.Read First Aid 2–3 times, annotating with Qbank insights.
- 3.Do practice questions daily, even during coursework.
- 4.Focus on high-yield topics: pathology, pharmacology, physiology, microbiology.
- 5.Take NBME practice exams every 1–2 weeks in dedicated prep.
- 6.Sleep 7–8 hours — memory consolidation matters more than cramming.