Failed a USMLE Step? How retakes work

The attempt rules

• Up to 3 attempts at the same Step within any 12-month period.
• Your 4th attempt must be at least 12 months after your 1st attempt, and at least 6 months after your most recent one.
• 4 attempts at a Step without passing makes you ineligible for every Step in the USMLE.
• Incomplete attempts count. So do attempts at the old Step 2 Clinical Skills.

How to retake

1. Read your score report. A failing Step 1 report marks each content area as below, about the same as, or above a low pass. Step 2 CK and Step 3 reports mark each area as higher, lower or the same as your overall result.
2. Apply again through the organization that registered you, choose a new eligibility period and pay the full fee.
3. Book your new date with Prometric once the scheduling permit arrives.
4. Start with the areas your report marked as weakest, then work through the rest of the content outline, since the retake draws from all of it.

A fail stays on your transcript

Your USMLE transcript shows your full exam history, including failed attempts. Residency programs and licensing boards see it. That’s one more reason not to test before you’re ready. USMLE also prohibits taking a Step just to see what it’s like, and can restrict access if your performance suggests you weren’t ready.

If you passed, you can’t retake

You can’t retake a Step you’ve passed to raise your score. The exceptions are rare, such as meeting a time limit set by a licensing authority. And if you retake a passed Step 1 or Step 2 CK for that reason and fail, you lose eligibility for Step 3.

Time limits matter too. Most licensing authorities want all three Steps passed within seven years of passing your first one. Check the FSMB website for your state’s rule.