Is the USMLE Step 1 Pass/Fail?
Yes. Since January 26, 2022, the USMLE Step 1 is reported as pass or fail only, with no three-digit numeric score. To pass, you must meet a minimum standard equivalent to 196 on the retired scale. The change was made to move residency selection away from an overreliance on a single Step 1 number.
Why Did the USMLE Step 1 Switch to Pass/Fail?
For exams taken on or after January 26, 2022, the USMLE stopped reporting a three-digit Step 1 score and now reports only pass or fail. For decades, Step 1 produced a precise number, and residency programs leaned heavily on it to screen and rank applicants - a number could decide who got interviews before anyone read a personal statement. Reporting Step 1 as pass/fail was intended to pull attention away from that single high-stakes figure and toward a fuller picture of each applicant.
The switch does not erase history. If you sat Step 1 before January 26, 2022, your original three-digit result still stands on your USMLE transcript; the pass/fail reporting applies to exams from that date forward. It is also specific to Step 1. As covered further down, Step 2 CK and Step 3 continue to report three-digit numeric scores, which is a key reason attention has shifted onto Step 2 CK.
- •Exams on or after January 26, 2022 are reported as pass or fail, with no three-digit score.
- •Exams taken before that date keep their original three-digit score on the USMLE transcript.
- •The reported outcome is now binary: you either meet the minimum passing standard or you do not.
What Is the Minimum Passing Standard for Step 1?
To pass USMLE Step 1 you must meet a minimum passing standard set by the USMLE program. Even though Step 1 no longer reports a number, that standard is still anchored to the retired three-digit scale: it is equivalent to a 196. The USMLE has said any future review of the standard will not be reported as a three-digit score, so 196 is best understood as the historical anchor rather than a target you will ever see printed on a report. As of 2026, no change to the Step 1 minimum passing standard has been announced.
The USMLE Management Committee reviews the minimum passing standard on a recurring cycle - roughly every four years - and can adjust it. Because the exam is equated across different test forms, there is no fixed number of questions you must answer correctly to pass; the required raw performance shifts slightly from form to form so every candidate is held to the same standard. You may see third-party estimates that you need to answer about 60 percent of questions correctly, but the USMLE does not publish a fixed percent-correct threshold, so treat any such figure as an outside approximation, not an official cutoff.
The table below sums up the scoring facts most Step 1 candidates ask about. Every figure here is anchored to primary USMLE guidance, but rules and fees are updated periodically, so confirm the current details at usmle.org before you rely on them.
USMLE Step 1 scoring and policy at a glance (2026)
| Item | Detail |
|---|
| Score reporting | Pass/fail only, no numeric score, for exams on or after January 26, 2022 |
| Minimum passing standard | Equivalent to 196 on the retired three-digit scale |
| Percent-correct threshold | Not published by the USMLE; equating varies by form |
| Score report timing | About 4 weeks after test day; allow up to 8 weeks |
| Maximum attempts | 4 per Step over a lifetime; no more than 3 in any 12-month period |
| Base registration fee | $695 for US or Canadian LCME- or COCA-accredited students and grads |
Scroll horizontally to view all columns.
What Does Step 1 Pass/Fail Mean for Residency?
With no Step 1 number to sort by, residency program directors have shifted weight onto the parts of an application that still carry a score or a narrative. Step 2 CK, which still reports a three-digit numeric score, has become the most-watched objective metric for many programs, alongside clinical grades, letters of recommendation, research, and the personal statement. The practical takeaway for current students is that passing Step 1 clears a gate rather than winning a race - it is Step 2 CK and the rest of your file that now do the differentiating.
None of this means Step 1 stopped mattering. A fail is still a fail, and every attempt stays on your USMLE transcript, so a clean first-time pass remains the goal. What changed is the upside: there is no longer a high Step 1 number to chase or to lift a borderline application. Program by program, the exact weighting of Step 2 CK against other factors varies and keeps evolving, so confirm what the specialties and programs you are targeting currently prioritize rather than relying on advice written before the switch.
Step 2 CK carries more weight
With Step 1 pass/fail, the three-digit Step 2 CK score is now the leading objective metric many programs screen on.
A pass is a gate, not a ranking
Passing Step 1 clears a requirement; it no longer produces a number that separates you from other applicants.
The rest of your file matters more
Clinical grades, letters, research, and your personal statement fill the gap left by the missing Step 1 number.
A fail still counts
Every attempt, pass or fail, stays on your USMLE transcript, so a clean first-time pass remains the goal.
How Do the Three USMLE Steps Report Scores?
Step 1 is the only USMLE exam reported as pass/fail. Step 2 CK and Step 3 still report a three-digit numeric score, which is a large part of why Step 2 CK has taken on more importance in residency selection. If you are mapping out your whole licensing sequence, it helps to see how the three exams differ in what they report and how their results are used.
The table below summarizes reporting for each Step. Minimum passing standards for Step 2 CK and Step 3 are set by the USMLE and can change, so confirm the current values at usmle.org rather than memorizing a number here. For a deeper look at the other two exams, see our Step 2 CK guide and Step 3 guide; if you are still preparing for Step 1 itself, the Step 1 study guide walks through a full prep plan.
How each USMLE Step reports its result
| Exam | Score reporting | Notes |
|---|
| Step 1 | Pass/fail only | No three-digit score since January 26, 2022; minimum standard equivalent to 196 |
| Step 2 CK | Three-digit numeric score | Now a leading objective metric for many residency programs; confirm the current minimum at usmle.org |
| Step 3 | Three-digit numeric score | Confirm the current minimum passing standard at usmle.org |
Scroll horizontally to view all columns.
The Step 1 pass/fail policy is not changing in 2026, but the shape of test day is. For exams on or after May 14, 2026, the USMLE is restructuring the session from 7 blocks of 60 minutes into 14 shorter blocks of 30 minutes, with up to 20 items per block instead of up to 40. The minimum break time increases from 45 to 55 minutes, and the optional tutorial shrinks from 15 minutes to 5. What does not change is the important part: the exam is still a single 8-hour session with up to 280 single-best-answer multiple-choice items, and the pass/fail scoring and 196-equivalent minimum standard are unaffected.
Practically, the new structure means more, shorter sprints and slightly more total break time to manage across the day. If your test date falls near the changeover, confirm which format applies to your specific appointment, because this update is new and the block and break specifics are worth re-checking close to your date at usmle.org. Your prep content does not change - Step 1 still covers the integrated basic sciences organized by system and process - only the on-screen pacing does.
USMLE Step 1 format before and after May 14, 2026
| Feature | Before May 14, 2026 | On or after May 14, 2026 |
|---|
| Blocks | 7 blocks of 60 minutes | 14 blocks of 30 minutes |
| Items per block | Up to 40 | Up to 20 |
| Minimum break time | 45 minutes | 55 minutes |
| Optional tutorial | 15 minutes | 5 minutes |
| Total items | Up to 280 (unchanged) | Up to 280 (unchanged) |
| Session length | About 8 hours (unchanged) | About 8 hours (unchanged) |
Scroll horizontally to view all columns.
How Many Times Can You Retake Step 1, and What Does It Cost?
If you do not pass, USMLE retake rules are strict. You are allowed a maximum of four attempts at Step 1 over your lifetime, and no more than three attempts within any 12-month period. A fourth attempt must come at least 12 months after your first attempt and at least six months after your most recent one. And because Step 1 is pass/fail, a passing result cannot be retaken to improve it - once you pass, you are done with Step 1 for good.
On cost, the 2026-2027 base registration fee for Step 1 is $695 for students and graduates of US or Canadian LCME- or COCA-accredited schools registering through the NBME or FSMB. Testing outside the US or Canada adds a $210 international region fee on top of the base. International medical graduates registering through the ECFMG pay $1,020 per exam, a rate effective January 1, 2025. Fees change annually and vary by registration pathway, so confirm the current figures with your registering organization before you pay, and date-check anything you read, including this page.
- •Maximum of 4 Step 1 attempts in your lifetime.
- •No more than 3 attempts in any 12-month period.
- •A 4th attempt must be at least 12 months after your 1st and at least 6 months after your most recent attempt.
- •A passing score cannot be retaken to improve it.
What If You Fail USMLE Step 1?
A failed Step 1 is a setback, not the end of a medical career - plenty of practicing physicians passed on a later attempt. The first move is diagnostic honesty: work out whether you missed by a little or a lot, and whether the gap is content knowledge, test-taking stamina across an 8-hour day, or exam-day logistics. Your score report, available about four weeks after test day, groups your performance by content area, so you can see where the weak spots are before you commit to a retake and its 12-month and 6-month spacing rules.
Build the retake around those weak areas rather than re-reading everything, and give yourself a realistic runway - the report can take up to eight weeks in some cases, so plan your timeline with margin. If Step 2 CK is coming up too, remember that its three-digit score now carries extra weight, which makes a focused, well-paced study plan across both exams worth the effort. Detailed timing is covered in our USMLE score release timeline.
When the stakes are high and time is short, Exam Assist supports USMLE candidates on pay-after-pass terms: you pay only after you reach your goal, not upfront for hours of tutoring. Message us with your test date, which Step you are sitting, and where your practice scores are landing, and we will lay out your options confidentially. Exam Assist is independent and is not affiliated with the USMLE program, the NBME, the FSMB, or the ECFMG.
Whichever path you choose, anchor it to current, primary-source rules: verify the passing standard, retake spacing, fees, and the May 2026 format details at usmle.org before you rebook. The requirements move, and the most expensive mistake is planning a retake around outdated information.