USMLE Step 1 - Scoring

Scoring

The USMLE phased out the use of a percentile based system in 1999. Examinees receive a three-digit score and a two-digit score; the latter of which is not a percentile. The three-digit score is a scaled score with a mean of 225 and a standard deviation of approximately 21. The three-digit score is calculated using a statistical percentile that ensures that scores from different years are read on a common scale, since the exam is known to get progressively more difficult as the years go on. The two digit score is a scaled score that defines 75 as the minimum passing score, which is equivalent to a 188 on the three-digit scale. The three-digit score is more commonly used. As of October 3, 2011, USMLE began the process of eliminating the reporting of results on the two-digit score scale to any parties, including residency programs, other than the examinee and any state licensing authority to which the examinee sends results.

A score of 188 is needed to pass the test. At present, the national mean score is 225, with a standard deviation of approximately 20; an increase from the previous three means, which were 221 (standard deviation of 23), 218 (standard deviation of 23) and 215 (standard deviation 20). Many top residency programs use a "cutoff" score for Step 1, below which applicants are unlikely to be considered. Most other residency programs follow a similar "cutoff," but will allow consideration of applicants with significantly higher Step 2 scores.

"A 2008 study compared USMLE scores across multiple medical schools. Overall USMLE scores did vary among institutions, as would be expected. However, the majority of these differences could be accounted for by differences in incoming students, particularly MCAT scores. In other words, schools admitting students who are better test-takers tended to have higher average USMLE scores. Approximately 85% of the variation between schools can be traced to this variation among incoming students.

Only about 15% of the variation in USMLE score across different medical schools could be traced to factors related to the school itself. Little of this difference could be traced to differences in curriculum or school level-educational policies. Private school students tended to perform better on Step 1 but worse on Step 3. The geographic location of the school also impacted scores. This study did not directly address the quality of teaching that students receive, in part because this is difficult to assess and quantify. Overall these findings suggest that the majority of variation in USMLE performance among different schools is likely secondary to traits that the students bring into the medical school environment, rather than differences between medical schools themselves."