USMLE Score Percentiles: 2025 Complete Guide
Understanding your USMLE score percentile rankings is crucial for residency matching success. It could be the key to unlocking top residency spots and paving your path to independent practice. In this comprehensive guide, we'll break down USMLE percentiles for each step — Step 1, Step 2 CK, and Step 3 — showing you exactly where you stand and why your USMLE score matters in today's competitive medical landscape.
What are the USMLE's Minimum Passing Scores?
According to the USMLE.org website, the exam results are reported on a 3-digit score scale.
Here are the latest minimum passing scores for each USMLE exam:
| Exam | Minimum Passing Score | Applies to all exams administered on or after: |
|---|---|---|
| Step 1 | Reported as pass/fail | January 26, 2022 |
| Step 2 CK | 218 | July 1, 2025 |
| Step 3 | 200 | January 1, 2024 |
Passing Rate Performance Data
Current Step 1 performance data reveals concerning trends. Pass rates have declined significantly since the transition: US MD students now pass at 89% (down from 95% pre-2022), DO students at 86%, and international medical graduates at 73%.
Pass rates for Step 2 CK remain high despite the increased standard, with 98% of US MD first-time test-takers and 89% of international medical graduates successfully passing. However, repeat test-takers experience notably reduced pass rates — 74% for US students and 61% for international students — highlighting the increased challenge faced by those retaking the exam.
For Step 3, current pass rates remain strong at 96% for US MD students and 89% for international medical graduates, highlighting the resilience and adaptability of these examinees in the face of evolving standards and increased expectations within the USMLE process.
Current Passing Standards and Recent Changes
The USMLE program has implemented substantial increases to minimum passing standards across multiple examinations within the past few years.
Step 1's minimum passing standard increased from 194 to 196 when the examination transitioned to pass/fail reporting on January 26, 2022, creating a more challenging examination environment despite the elimination of numeric competition. Following a December 2024 review, the USMLE Management Committee voted to maintain the current recommended Step 1 minimum passing standard.
Step 2 CK experienced a four-point increase in its passing standard from 214 to 218, affecting all examinees testing on or after July 1, 2025. Drawing on input from a variety of perspectives, including independent physician panels and diverse sources of expertise, the Management Committee made this change after carefully weighing all available evidence regarding the exam's requirements.
Step 3 saw a two-point increase in its passing standard from 198 to 200, applicable to examinees testing on or after January 1, 2024. After a thorough review, and similar to Step 2 CK, the Management Committee made this change by carefully considering input from various sources, including independent physician panels that participated in content-based standard-setting sessions during September and October 2023.
USMLE Step 2 CK Score Percentiles Guide
Understanding Step 2 CK percentile rankings is crucial for strategic residency planning. Your score directly impacts specialty competitiveness — competitive specialties like dermatology and orthopedic surgery now average at 257, while less competitive fields like family medicine average at 244. With IMG applicants facing additional challenges and geographic preferences affecting competitiveness, knowing USMLE percentiles provides essential context for application strategy.
Step 2 CK Score Percentile Table
Based on official USMLE data from July 2021-June 2024 (N = 69,661 first-time US/Canadian medical school graduates):
| USMLE Score | Percentile | Classification | Strategic Implications |
|---|---|---|---|
| 270+ | 95th+ | Exceptional | Top-tier programs in any specialty |
| 265-269 | 87th-94th | Excellent | Competitive for any specialty/program |
| 260-264 | 76th-86th | Very Strong | Competitive for highly selective specialties |
| 255-259 | 63rd-75th | Good-Strong | Safe for most specialties |
| 250-254 | 50th-62nd | Average-Good | Competitive for mid-tier specialties |
| 245-249 | 37th-49th | Below Average | Adequate for less competitive specialties |
| 240-244 | 26th-36th | Concerning | Limited specialty options |
| 235-239 | 18th-25th | Low | Primary care focus recommended |
| 230-234 | 12th-17th | Very Low | Significant application challenges |
| 225-229 | 7th-11th | Poor | May require remediation |
| 218-224 | 3rd-6th | Minimal Pass | Retaking should be considered |
What is a good USMLE Step 2 CK score?
A "good" Step 2 CK score percentile depends entirely on your specialty goals and career objectives. For most medical students, a score above the national median of 250 is considered good, while scores above 260 (75th USMLE percentile) are considered very good to excellent.
How does your Step 2 CK score affect your residency match outcome?
USMLE Step 2 CK score percentile rankings have become the fourth most important factor in residency interviews, fundamentally shaping match outcomes across all specialties. According to the 2024 NRMP Program Director Survey, 83% of program directors consider Step 2 CK scores when evaluating applicant competitiveness, and approximately 30% of programs now use target scores for interview screening.
Direct impact on match probability: The correlation between a high percentile and match success varies by specialty, but clear patterns emerge. Residency applicants scoring above the 75th percentile (260+) have significantly higher chances of matching to their preferred specialty and programs. Those scoring below specialty averages face increased challenges, often requiring broader application strategies or consideration of alternative specialties.
Specialty-specific effects: For competitive specialties like dermatology, orthopedic surgery, and diagnostic radiology, Step 2 CK scores often serve as an initial screening tool. Programs receiving hundreds of applications use USMLE score percentile thresholds to manage volume, making the difference between a 250 and a 260 potentially decisive for interview invitations. In contrast, less competitive specialties emphasize holistic review, though scores below 240 still raise concerns about academic preparation.
Strategic considerations: Match outcomes depend on the interaction between USMLE percentile and other application components. A high score can compensate for weaker research experience or clinical grades, while exceptional research may offset lower scores. However, this compensation has limits — scores below the 25th Step 2 CK score percentile for a specialty typically require extraordinary strength in other areas to achieve successful matches.
What are the recommended Step 2 CK scores for common and top residency programs?
Specialty-specific score recommendations based on 2024 match data:
Highly Competitive Specialties (Top Programs: 260+, Competitive Programs: 255+)
Dermatology: 257
Orthopedic Surgery: 257
Diagnostic Radiology: 256
Plastic Surgery: 256
Otolaryngology: 256
Neurological Surgery: 255
Moderately Competitive Specialties (Top Programs: 255+, Competitive Programs: 250+)
Vascular Surgery: 253
General Surgery: 253
Internal Medicine-Pediatrics: 253
Interventional Radiology: 253
Radiation Oncology: 252
Obstetrics & Gynecology: 252
Anesthesiology: 252
Internal Medicine: 251
Less Competitive Specialties (Top Programs: 250+, Competitive Programs: 245+)
Neurology: 250
Child Neurology: 248
Pathology: 247
Pediatrics: 247
Physical Medicine & Rehabilitation: 248
Emergency Medicine: 248
Psychiatry: 246
Family Medicine: 244
Program type considerations: Academic/University Programs typically require Step 2 CK scores that are 5-10 points above specialty averages, while Community Programs often accept scores at or slightly below averages. Top-tier academic programs (Mayo Clinic, Massachusetts General Hospital, Johns Hopkins) generally expect scores in the upper 250s to 260s regardless of specialty competitiveness.
Geographic factors significantly affect requirements. Programs in highly desirable locations like New York, California, or major metropolitan areas often have score requirements that are 10-15 points above published averages due to increased competition.
International medical graduate adjustments: IMGs should target scores that are 5-15 points above the listed recommendations. US citizen IMGs typically need scores in the 245-250 range for less competitive specialties, while non-US citizen IMGs require 250+ for similar competitiveness.
USMLE Step 3 Score Percentiles Guide
USMLE Step 3 represents the final examination in the USMLE sequence and serves as the gateway to independent medical practice. Unlike Steps 1 and 2 CK, Step 3 is typically taken during or after residency training, making it unique in timing and strategic importance. While a student’s Step 3 score carries the lowest weight among USMLE examinations for most career decisions, passing Step 3 is essential for medical licensure, and can impact fellowship applications and demonstrate clinical competency for international medical graduates.
Step 3 Score Percentiles and Strategic Implications
The following table provides comprehensive Step 3 score ranges, USMLE percentile rankings, and strategic implications based on official USMLE data from 2022-2024:
| Score Range | Percentile | Performance Level | Strategic Implications |
|---|---|---|---|
| 260+ | 99th+ | Exceptional | Highly competitive for any fellowship; demonstrates mastery across all clinical domains |
| 255-259 | 97-99th | Excellent | Advantageous for highly competitive fellowships; may compensate for weaker prior USMLE scores |
| 250-254 | 93-97th | Excellent | Competitive for most fellowships; well above average clinical competency demonstration |
| 245-249 | 87-93rd | Very Good | Suitable for competitive fellowship applications; demonstrates solid clinical knowledge |
| 240-244 | 79-87th | Very Good | Meets most fellowship requirements; comfortable margin above average |
| 235-239 | 68-79th | Good | Adequate for fellowship applications; demonstrates competent clinical reasoning |
| 230-234 | 55-68th | Good | Sufficient for most purposes; meets typical fellowship screening thresholds |
| 225-229 | 42-55th | Average | Adequate for licensing; may need strengthening for competitive fellowships |
| 220-224 | 30-42nd | Below Average | Sufficient for licensing; may limit fellowship options in competitive specialties |
| 215-219 | 19-30th | Below Average | Adequate for licensing, but may indicate a need for additional clinical preparation |
| 210-214 | 12-19th | Low | Meets licensing requirements but suggests significant knowledge gaps |
| 205-209 | 7-12th | Low | Meets minimum requirements but indicates substantial clinical deficiencies |
| 200-204 | 3-7th | Minimum Pass | Adequate for licensing only; significant remediation recommended for fellowship pursuit |
| Below 200 | <3rd | Fail | Requires remediation and retesting; delays licensure and career progression |
What is a good Step 3 score?
Passing Step 3 on your initial attempt is crucial. A failed attempt means waiting for your next eligibility period, paying $925 to reapply, and potentially delaying licensure and board certification.
Recent data shows that the mean score for Step 3 hovers around 230. Performance above 240 demonstrates strong competency (79th+ USMLE percentile), while a Step 3 score exceeding 250 indicates exceptional ability.
For fellowship applications, a student’s Step 3 score serves as one evaluation component among many. While programs don't admit candidates based solely on a high Step 3 score, they do establish minimum thresholds. Achieving 240+ creates a more favorable impression than barely meeting the 200+ passing requirement.
How does your Step 3 score affect your residency or fellowship?
A Step 3 score does not affect residency applications since most medical students take the examination during or after their intern year. Residency programs typically require a passing Step 3 score during training (usually by PGY-2 year), but do not use scores for resident evaluation or advancement decisions. The primary impact is ensuring progression through training — failure can delay advancement and create licensing complications.
In terms of fellowship applications, Step 3 scores carry moderate importance, though they remain less critical than Step 2 CK scores, clinical performance, and research productivity. Research shows:
70% of fellowship programs require a passing Step 3 score for interview consideration
20% have specific target Step 3 scores (typically 220-240 range)
12% do not consider a student’s Step 3 score in selection decisions
The key strategic insight is that your Step 3 score serves primarily as a screening tool rather than a major decision factor for fellowship applications. While a strong Step 3 score (220+) helps avoid initial cuts, fellowship success depends much more heavily on clinical performance during residency, research productivity, and strong letters of recommendation from specialty faculty.
Final Thoughts
Understanding your USMLE score percentile is no longer optional in today's competitive medical landscape. With Step 1 now pass/fail, your Step 2 CK score directly determines residency opportunities, while your Step 3 score influences fellowship prospects and licensing timelines. The data shows clear patterns — scores above the 75th USMLE percentile significantly improve match outcomes, while those below specialty averages require strategic application adjustments.
The recent increases in passing standards across all steps reflect medicine's evolving expectations. To succeed, it's important to know not only the minimum passing scores but also what scores are considered competitive for your chosen specialty and preferred locations. Whether aiming for dermatology residency or family medicine, knowing where your USMLE score percentile stands provides the foundation for realistic goal-setting and effective preparation strategies.
Ready to achieve your target USMLE score percentile? MedBoardTutors specializes in helping students pass USMLE exams and reach competitive USMLE percentile thresholds. Our expert USMLE tutors provide personalized strategies to boost your scores and overall performance across all steps. Schedule a free USMLE tutoring consultation to learn how we can help you succeed.