USMLE Score Percentiles
Understanding USMLE score percentile rankings is crucial for residency matching success. Knowing where a score lands can be the key to unlocking top residency spots and paving the path to independent practice. This comprehensive guide breaks down USMLE percentiles for each step (Step 1, Step 2 CK, and Step 3), covering exactly what each score means and why it matters in the current competitive medical landscape.
DO students taking COMLEX-USA can also check out the COMLEX score percentiles guide for equivalent Level 1, Level 2-CE, and Level 3 breakdowns.
What are the USMLE's Minimum Passing Scores?
According to the USMLE.org website, exam results are reported on a 3-digit score scale (except Step 1, which is pass/fail). Here are the current minimum passing scores for each exam:
| Exam | Minimum Passing Score | Effective Date |
|---|---|---|
| Step 1 | Pass / Fail | January 26, 2022 |
| Step 2 CK | 218 | July 1, 2025 |
| Step 3 | 200 | January 1, 2024 |
Passing Rate Performance Data
According to the USMLE 2025 performance data, first-time pass rates vary significantly by examinee type. The chart below reflects the most recent official figures across all three steps.
First-Time Pass Rates by Examinee Group (2025 Data)
Repeat test-takers see markedly lower rates: 70% for US MD and 64% for international students on Step 2 CK, highlighting the challenge faced by those retaking the exam. Choosing the best USMLE Step 1 study resources from the start matters more than ever. For Step 3, first-time pass rates remain strong at 96% for US MD students and 88% for international medical graduates. Note: beginning in 2025, USMLE groups examinees from Canadian schools with non-US examinees in its reporting.
Current Passing Standards and Recent Changes
The USMLE program has implemented substantial increases in minimum passing standards across multiple examinations in recent years.
January 2022
Step 1 — Transition to Pass/Fail
The minimum passing standard increased from 194 to 196 when the examination transitioned to pass/fail reporting, creating a more challenging environment despite the elimination of numeric competition. Following a December 2024 review, the USMLE Management Committee voted to maintain the current recommended minimum passing standard.
January 2024
Step 3 — Passing Standard Raised to 200
A two-point increase from 198 to 200, applicable to examinees testing on or after January 1, 2024, following content-based standard-setting sessions in late 2023.
July 2025
Step 2 CK — Passing Standard Raised to 218
A four-point increase from 214 to 218, affecting all examinees testing on or after July 1, 2025. The Management Committee made this change after carefully weighing all available evidence regarding examination requirements.
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
ⓘ USMLE Score Interpretation Guidelines — updated April 2026Score Explorer — Drag to Explore Percentiles
74th–84th percentile
Based on official USMLE data from July 2021-June 2024 (N = 69,661 first-time US/Canadian medical school graduates):
| Score | Percentile | Tier | Band | Strategic Implications |
|---|---|---|---|---|
| 270+ | 94th+ | Exceptional | Top-tier programs in any specialty | |
| 265–269 | 85th–93rd | Excellent | Competitive for any specialty/program | |
| 260–264 | 74th–84th | Very Strong | Competitive for highly selective specialties | |
| 255–259 | 60th–73rd | Good-Strong | Safe for most specialties | |
| 250–254 | 47th–59th | Average-Good | Competitive for mid-tier specialties | |
| 245–249 | 34th–46th | Below Avg | Adequate for less competitive specialties | |
| 240–244 | 24th–33rd | Concerning | Limited specialty options | |
| 235–239 | 16th–23rd | Low | Primary care focus recommended | |
| 230–234 | 10th–15th | Very Low | Significant application challenges | |
| 225–229 | 6th–9th | Poor | May require remediation | |
| 218–224 | 3rd–5th | Min 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?
Understanding how the residency match process works puts this in context: 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. If that is your target, building a study plan to score 260 on Step 2 CK early in your dedicated period is critical. 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.
Recommended Step 2 CK Scores by Specialty
Specialty-specific score recommendations based on the latest available NRMP data (2024 Main Residency Match, Charting Outcomes):
Highly Competitive — Top Programs: 260+ · Competitive: 255+
Moderately Competitive — Top Programs: 255+ · Competitive: 250+
Less Competitive — Top Programs: 250+ · Competitive: 245+
Program type and geography matter
Academic/University Programs typically require scores 5–10 points above specialty averages. Programs in highly competitive markets (New York, California, major metropolitan areas) often require scores 10–15 points above published averages. IMGs should target scores 5–15 points above listed recommendations.
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 | Percentile | Tier | Band | Strategic Implications |
|---|---|---|---|---|
| 260+ | 99th+ | Exceptional | Highly competitive for any fellowship | |
| 255–259 | 97th–98th | Excellent | Advantageous for highly competitive fellowships | |
| 250–254 | 93rd–96th | Excellent | Competitive for most fellowships | |
| 245–249 | 88th–92nd | Very Good | Suitable for competitive fellowship applications | |
| 240–244 | 80th–87th | Very Good | Meets most fellowship requirements | |
| 235–239 | 69th–79th | Good | Adequate for fellowship applications | |
| 230–234 | 56th–68th | Good | Sufficient for most purposes | |
| 225–229 | 43rd–55th | Average | Adequate for licensing; may need strengthening | |
| 220–224 | 31st–42nd | Below Avg | May limit fellowship options | |
| 215–219 | 20th–30th | Below Avg | May indicate need for additional preparation | |
| 210–214 | 12th–19th | Low | Suggests significant knowledge gaps | |
| 205–209 | 7th–11th | Low | Indicates substantial clinical deficiencies | |
| 200–204 | 4th–7th | Min Pass | Significant remediation recommended | |
| Below 200 | <4th | Fail | Requires remediation and retesting |
What Is a Good Step 3 Score?
Passing Step 3 on the initial attempt is crucial. A failed attempt means waiting for the next eligibility period, paying $955 to reapply, and potentially delaying licensure and board certification. The guide on what to do after failing Step 3 walks through the retake timeline, study adjustments, and how to communicate the setback to a program.
Recent data shows that the mean score for Step 3 is around 227. Performance above 240 demonstrates strong competency (80th+ USMLE percentile), while a Step 3 score exceeding 250 indicates exceptional ability (93rd+ percentile).
For fellowship applications, a Step 3 score serves as one evaluation component among many. While programs do not 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 a Step 3 Score Affect 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 the following breakdown among fellowship programs:
Fellowship Programs & Step 3
Final Thoughts
Here is the hard truth about USMLE score percentiles in the current match environment: the number matters less than knowing exactly what it means for the specific specialty and program list a student is targeting. A 252 is a competitive score for family medicine and a liability for neurosurgery. Treating the mean as a benchmark without that context is how applicants end up blindsided on match day.
Step 1 is pass/fail now, which means Step 2 CK has absorbed almost all the numeric weight programs used to spread across both exams. The raising of the Step 2 CK passing standard to 218 in July 2025 signals the direction the USMLE program is moving. Programs are not relaxing their thresholds in response — many have raised them. A score at or above the ~75th percentile (260+) does not guarantee a match, but it removes the score as a liability and lets the rest of the application do the work it is supposed to do.
The students who use percentile data well treat it as a planning tool, not a report card. They identify the target range for their specialty early, build a study plan backward from that number, and leave enough time to retake if needed. Once the target is clear, pairing preparation with the right Step 2 CK resources is what closes the gap between where a score is and where it needs to be.