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United States · Licensing exam

How many questions are on the USMLE, and what’s the passing score?

Step 1 has about 280 questions in one 8-hour day and is pass/fail. Step 2 CK has about 316 questions in one 9-hour day, and you need at least 218 to pass. Step 3 is a two-day exam with about 412 questions plus 13 to 14 case simulations, and the minimum pass is 200. These are the figures as of October 2026.

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Updated October 2026 · Written from official sources, listed at the bottom of this page

Each Step at a glance

Step 1Step 2 CKStep 3
QuestionsAbout 280About 316About 232 (Day 1) + 180 (Day 2)
Blocks14 × 30 minutes16 × 30 minutes12 (Day 1) and 9 (Day 2), 30 minutes each
Case simulationsNoneNone13-14 on Day 2
Testing dayAbout 8 hoursAbout 9 hoursAbout 7 hours, then about 9 hours
ResultPass/failScore, minimum 218Score, minimum 200

Each block has up to 20 questions. Step 1 switched to this format on May 14, 2026, and Step 2 CK on May 7, 2026. Before that, both used 60-minute blocks of up to 40 questions.

Passing scores as of October 2026

USMLE says you typically need to get about 60% of questions right to pass, but the exact share changes from Step to Step and form to form. Our practice test uses 70% as a target. That’s our own goal, not a USMLE rule.

  • Step 1: pass or fail only, for exams taken on or after January 26, 2022. You don’t get a three-digit score.
  • Step 2 CK: 218, for exams on or after July 1, 2025.
  • Step 3: 200, for exams on or after January 1, 2024. USMLE is reviewing this standard in November 2026. Any change would apply from January 1, 2027.

What the questions look like

Almost every question is single best answer. You read a short patient story, sometimes with lab results, an image or audio, and pick the one best option. Step 1 asks about the science behind the case. Step 2 CK and Step 3 ask more about diagnosis and what to do next.

Step 3 also has computer-based case simulations (CCS). You manage a simulated patient in real time, ordering tests and treatments as the case unfolds.

USMLE pass rates

First-time takersStep 1 (2025)Step 2 CK (2024-25)Step 3 (2025)
U.S. MD schools93%98%96%
U.S. DO schools89%96%97%
Schools outside the U.S.75%90%88%

These are USMLE’s published figures. Step 2 CK data covers July 1, 2024, to June 30, 2025. Since 2025, students from Canadian schools are counted with schools outside the U.S.

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Everything else, in one place

OverviewUSMLEScoringHow USMLE scoring worksBookingHow to sign up for and schedule the USMLECostHow much does the USMLE cost?What to bringWhat to bring to the USMLEOnline examCan you take the USMLE online?Step 1USMLE Step 1: pass/fail, format and lengthStep 2 CKUSMLE Step 2 CK scores, percentiles and formatStep 3USMLE Step 3: applying, the two days, CCS and scoresResults and transcriptsWhen do USMLE results come out?Free 120 and self-assessmentsFree official USMLE practice: sample questions and NBME self-assessmentsInternational graduatesThe USMLE for international medical graduatesIf you failFailed a USMLE Step? How retakes workContent outline and booksUSMLE study guide: the official content outlinePractice testFree USMLE practice questionsWhere to learnWhere to study for the USMLEStudy plannerUSMLE study planner
Sources: USMLE and 6 more. Checked October 2026.

Rules and fees can change, so check the official site before your test.