USMLE Step 1 Pass Rate 2026: Latest Figures for MD, DO and IMG Examinees
Written by Dr Zartasha Ali, MBBS, FCPS (Medicine). Reviewed by Dr Ammar Hussain, MBBS, FCPS (Pediatrics), MRCPCH.
The USMLE Step 1 pass rate in 2025 was 91% for examinees from US medical schools and 72% for examinees from non-US schools, according to the performance data published on usmle.org. Among first-time takers the figures were 93% for US MD students, 89% for US DO students and 75% for examinees from non-US schools.
The 2025 data is the latest full year available. USMLE publishes each calendar year’s results early in the following year, so figures for exams taken in 2026 are not out yet. We read the numbers on this page from usmle.org on 14 October 2026.
USMLE Step 1 pass rate in 2025
| Examinee group | Number tested | Percent passing |
|---|---|---|
| US schools, MD degree: all | 25,126 | 91% |
| MD first-time takers | 23,028 | 93% |
| MD repeaters | 2,098 | 71% |
| US schools, DO degree: all | 4,744 | 89% |
| DO first-time takers | 4,623 | 89% |
| DO repeaters | 121 | 79% |
| US schools: total | 29,870 | 91% |
| Non-US schools: all | 25,660 | 72% |
| Non-US first-time takers | 22,066 | 75% |
| Non-US repeaters | 3,594 | 54% |
Source: USMLE Performance Data, 2025 table, usmle.org.
Three notes from the source help you read the table:
- “Repeaters” counts exams, not people. In its tables for earlier years, USMLE states that “Repeaters” represents examinations given, not the number of examinees. One person who sat the exam twice in a year is counted twice.
- Canadian schools moved groups in 2025. USMLE notes that from 2025, examinees from Canadian schools are grouped with non-US examinees. Before 2025 they were grouped with US examinees.
- There is no single overall figure. USMLE reports the US and non-US groups separately and does not publish one combined pass rate.
USMLE Step 1 fail rate
USMLE publishes the percent passing. The fail rate is the remainder, so the figures below are our subtraction from the 2025 table.
| Examinee group, 2025 | Pass rate | Fail rate |
|---|---|---|
| US MD first-time takers | 93% | 7% |
| US DO first-time takers | 89% | 11% |
| Non-US first-time takers | 75% | 25% |
| US MD repeaters | 71% | 29% |
| US DO repeaters | 79% | 21% |
| Non-US repeaters | 54% | 46% |
Put in plain numbers: about 1 in 14 US MD students failed on the first attempt in 2025. Among first-time takers from non-US schools, 1 in 4 failed.
Step 1 pass rate for IMGs compared with US MD and DO students
USMLE does not use the term “IMG” in its performance tables. The nearest group is “examinees from non-US schools”, which covers students and graduates of medical schools outside the United States.
On the first attempt in 2025:
- US MD students: 93%
- US DO students: 89%
- Non-US schools: 75%
The gap between US MD students and non-US examinees was 18 percentage points. USMLE’s tables report the numbers and do not explain the gap.
We will not guess at causes here. Note that the non-US group is very large and mixed: 22,066 first-time takers in 2025, from many countries, schools and stages of training.
A group figure is not a prediction for one person. It tells you how the whole group did, not how you will do.
First-time and repeat takers
Repeat takers pass less often than first-time takers in every group.
| Group, 2025 | First-time takers | Repeaters | Difference |
|---|---|---|---|
| US MD | 93% | 71% | 22 points |
| US DO | 89% | 79% | 10 points |
| Non-US schools | 75% | 54% | 21 points |
The DO repeater figure rests on only 121 exams, so it moves a lot from year to year. It was 60% in 2023 and 79% in 2025.
For non-US repeaters, 54% in 2025 is the highest figure in the five years shown on usmle.org. It was 45% in 2021 and 2022.
How the Step 1 pass rate has changed since 2021
Step 1 changed to pass/fail reporting for exams taken on or after 26 January 2022. The table shows the last year before that change and the four years since.
| Year | US MD first-time | US DO first-time | US total | Non-US first-time | Non-US total |
|---|---|---|---|---|---|
| 2021 | 96% | 94% | 95% | 82% | 77% |
| 2022 | 93% | 89% | 91% | 74% | 71% |
| 2023 | 92% | 87% | 90% | 72% | 68% |
| 2024 | 91% | 86% | 88% | 73% | 70% |
| 2025 | 93% | 89% | 91% | 75% | 72% |
Source: USMLE Performance Data tables for 2021 to 2025, usmle.org. For 2021 to 2024 the “US” columns are USMLE’s “US/Canadian schools” group. For 2025 they are US schools only.
What the table shows:
- Pass rates fell in every group in 2022, the first year of pass/fail reporting.
- They continued to fall or stayed level through 2023 and 2024.
- They rose in every group in 2025. US MD first-time takers returned to 93%, the 2022 level.
- No group has returned to its 2021 figure.
The table shows when the changes happened. It does not show why.
USMLE publishes a separate note about reading the 2022 Step 1 data, linked from its performance data page. The change in how Canadian schools are grouped also means 2025 is not a perfect like-for-like comparison with earlier years.
USMLE pass rate for Step 2 CK and Step 3
For comparison, here are the latest figures USMLE has published for the other two Steps.
| Exam and period | US MD first-time | US DO first-time | US total | Non-US first-time | Non-US total |
|---|---|---|---|---|---|
| Step 2 CK, 2024-2025 | 98% | 96% | 97% | 90% | 87% |
| Step 3, 2025 | 96% | 97% | 96% | 88% | 85% |
Source: USMLE Performance Data, usmle.org.
The USMLE Step 3 pass rate in 2025 was 96% for examinees from US schools, with 22,630 tested. For examinees from non-US schools it was 85%, with 14,304 tested. Repeaters passed Step 3 at 77% for US MD graduates and 63% for non-US graduates.
Step 1 has the lowest pass rate of the three exams for every group. For first-time takers from non-US schools, the pass rate was 75% on Step 1, 90% on Step 2 CK and 88% on Step 3.
What the pass rate does and does not tell you
It is not a quota. The USMLE Bulletin of Information states that no predetermined percentage of examinees passes or fails. The pass rate is a result, not a target. Everyone who meets the passing standard passes.
It does not show the standard. The standard is set separately. Our page on the USMLE Step 1 passing score explains where the line is and how it is reported.
It does show the cost of going in early. A fail uses one of the four attempts USMLE allows per Step, and repeaters pass at lower rates than first-time takers. A retake also means a new application and a new fee. See USMLE exam fees for the amounts.
A sensible use of these numbers is to check your readiness with timed practice before you book. USMLE provides free sample questions on usmle.org. RecallsGuru’s USMLE Step 1 recalls are written by our own authors and mapped to the official content outline.
Questions people ask
Is Step 1 harder than the MCAT?
They test different things, so there is no official comparison. The MCAT is an admission test taken before medical school. Step 1 tests two years of medical school science applied to patients, so it covers far more material.
Is there a Step 1 pass rate by school?
The USMLE publishes pass rates by type of school (US MD, US DO and non-US), not by individual school. Some schools publish their own rate, so check the school’s website.
What is the USMLE Step 1 pass rate for first-time takers?
In 2025 it was 93% for US MD students, 89% for US DO students and 75% for examinees from non-US schools. The source is the USMLE performance data page.
What is the USMLE Step 1 pass rate for IMGs?
USMLE reports “examinees from non-US schools”. In 2025 that group passed at 75% on the first attempt and 72% overall, with 25,660 exams taken.
What percentage of people fail Step 1?
In 2025, 7% of US MD first-time takers, 11% of US DO first-time takers and 25% of non-US first-time takers did not pass. These are our subtractions from USMLE’s published pass rates.
Did the pass rate drop after Step 1 became pass/fail?
Yes, in the published figures. US MD first-time takers went from 96% in 2021 to 93% in 2022 and 91% in 2024, then back to 93% in 2025. The data does not prove the cause.
How many people take Step 1 each year?
In 2025 USMLE recorded 29,870 Step 1 exams for US schools and 25,660 for non-US schools. That is 55,530 exams in total, by our addition. Some people are counted more than once because repeat attempts are counted as exams.
Is the Step 1 pass rate the same every year?
No. Since 2021 the US total has ranged from 88% to 95%, and the non-US total from 68% to 77%.
When will the 2026 pass rates be published?
USMLE has not announced a date. Its tables for 2021 to 2024 used results reported through dates between late January and mid-March of the following year. We will update this page when the 2026 table appears.
Sources
Pages opened on 14 October 2026:
- USMLE, Performance Data (tables for 2021 to 2025): https://www.usmle.org/performance-data
- USMLE, Bulletin of Information 2027, Scoring and Score Reporting: https://www.usmle.org/bulletin-information/scoring-and-score-reporting
- USMLE, Examination Results and Scoring: https://www.usmle.org/scores-transcripts/examination-results-and-scoring
- USMLE, Common Questions, Attempt Limit: https://www.usmle.org/common-questions/attempt-limit