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United States · Licensing exam

USMLE Step 1: pass/fail, format and length

As of October 2026, Step 1 is reported only as pass or fail. There’s no three-digit score, so there’s also no Step 1 percentile, average or score by specialty to look up. It’s one 8-hour day of about 280 multiple-choice questions, split into fourteen 30-minute blocks.

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

Why there’s no Step 1 score anymore

Step 1 exams taken on or after January 26, 2022, get a pass or fail and nothing else. Older Step 1 exams still show their three-digit score on your transcript, next to the pass or fail.

Behind the scenes, the passing standard is 196 on the three-digit scale. You just don’t see a number. USMLE says future reviews of that standard won’t bring a reported score back.

What your Step 1 report shows

NBME also reports results to LCME- and COCA-accredited schools for their students. To stop your result going to your school, email webmail@nbme.org from your account of record at least 10 business days before your test.

  • If you pass: your result, with no breakdown by topic.
  • If you fail: each content area marked as below, about the same as, or above a low pass, so you can see where to focus.
  • No standard error or comparison chart, which Step 2 CK and Step 3 reports still have.

Format and length

Since May 14, 2026Before
Testing dayOne 8-hour sessionOne 8-hour session
QuestionsAbout 280Up to 280
BlocksFourteen 30-minute blocks of up to 20Seven 60-minute blocks of up to 40
Minimum break time55 minutes45 minutes
Optional tutorial5 minutes15 minutes

Finishing a block or the tutorial early adds the spare time to your breaks.

Can you predict a Step 1 result?

There’s no official score predictor, since there’s no score to predict. The closest thing is NBME’s Comprehensive Basic Science Self-Assessment. It has 200 questions, starts at $62, and reports your estimated probability of passing Step 1. NBME says that estimate isn’t a guarantee.

When to take it, and how many pass

You can take Step 1 and Step 2 CK in either order, once you’re enrolled in or have graduated from an eligible medical school. You need to be eligible both when you apply and on test day.

In USMLE’s 2025 data, 93% of first-time takers from U.S. MD schools passed, 89% from U.S. DO schools, and 75% from schools outside the U.S.

Explore

Everything else, in one place

OverviewUSMLEQuestions and passingHow many questions are on the USMLE, and what’s the passing score?ScoringHow 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 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, NBME and 5 more. Checked October 2026.

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