The USMLE Step 1 exam: questions, score, pass rate and test dates

How many questions are on USMLE Step 1?

The total number of items on Step 1 does not exceed 280. Since 14 May 2026 the exam runs in fourteen 30-minute blocks, and the number of questions per block may vary but does not exceed 20. Before that date it was seven 60-minute blocks of up to 40 questions.

USMLE states that the total number of items and the length of the exam day did not change with the new blocks. So the answer to how many questions on USMLE Step 1 is the same as before: up to 280, in an 8-hour session with at least 55 minutes of break time and a 5-minute optional tutorial.

Source: USMLE — Step 1 Exam Content. Checked 18 October 2026.

USMLE Step 1 passing score

Step 1 results are reported as pass or fail for every exam since 26 January 2022, so you will not see a number. The passing score for USMLE Step 1 still exists in the background: on the three-digit score scale the passing standard is 196.

USMLE explains that examinees typically must answer approximately 60 percent of items correctly to pass, and that no predetermined percentage of examinees will pass or fail. You are measured against the standard, not against the other candidates.

Source: USMLE — Examination Results and Scoring. Checked 18 October 2026.

USMLE scores across the Steps

USMLE scores are reported on a three-digit scale, except Step 1, which is pass/fail. For comparison, the minimum passing score for Step 2 CK is 218 for exams on or after 1 July 2025, and the USMLE 3 passing score is 200 for exams on or after 1 January 2024.

Step 1 exams taken before 26 January 2022 received a three-digit score. For any newer USMLE Step One score, only the pass or fail outcome is reported.

Source: USMLE — Examination Results and Scoring. Checked 18 October 2026.

USMLE Step 1 pass rate

USMLE publishes the USMLE Step 1 pass rate by group each year. For 2025 administrations:

• First-takers from U.S. schools granting the MD: 93% of 23,028 (2024: 91%)
• First-takers from U.S. schools granting the DO: 89% of 4,623
• Repeaters from U.S. MD schools: 71% of 2,098
• First-takers from schools outside the U.S.: 75% of 22,066 (2024: 73%)
• Repeaters from schools outside the U.S.: 54% of 3,594

Source: USMLE — Performance Data. Checked 18 October 2026.

What the USMLE Step 1 passing rate means for you

The USMLE Step 1 passing rate is much lower for repeaters than for first-takers in every group, so the first attempt is the one to prepare for. From 2025, USMLE groups examinees from Canadian schools with non-U.S. examinees, so compare years with that change in mind.

Source: USMLE — Performance Data. Checked 18 October 2026.

USMLE Step 1 test dates and eligibility periods

There are no fixed USMLE Step 1 test dates. When you register you choose an eligibility period; NBME uses three-month periods, for example 1 November 2026 to 31 January 2027. You then book an appointment at a Prometric center within that period.

USMLE Step 1 exam dates are offered first-come, first-served, and scheduling may not be available more than six months ahead. You can reschedule within your eligibility period, but a fee applies to changes made in the 45 calendar days before your appointment. If you cannot test in time, you can request a one-time extension of the eligibility period; NBME lists $70 for this.

Source: USMLE — Bulletin of Information: Applying and Scheduling. Checked 18 October 2026.

USMLE Step 1 score report and release

Results are typically available within four weeks of your test date, and USMLE scores are released on Wednesdays. The organization that registered you sends an email when your USMLE score report is ready; allow at least eight weeks before you follow up.

The USMLE Step 1 score report shows pass or fail. Passing examinees do not see performance feedback. If you fail, the report shows whether you scored below, about the same as, or above a low pass in each content area, which is your starting point for a retake plan.

Source: USMLE — Common Questions: Score Reports. Checked 18 October 2026.

Is there a USMLE Step 1 score predictor?

USMLE itself offers no USMLE Step 1 score predictor. The nearest official tool is NBME’s Comprehensive Basic Science Self-Assessment: its score report gives your estimated probability of passing the USMLE Step 1, which NBME says is not a guarantee of your future performance.

Certsqill shows a readiness score per content area based on expert-developed practice questions, with an explanation for every answer option. Treat any readiness number, ours included, as a guide to where to study next.

Source: NBME — Comprehensive Basic Science Self-Assessment (CBSSA). Checked 18 October 2026.

USMLE Step 1 exam: questions people ask

How many questions are on the USMLE Step 1?

No more than 280, in fourteen 30-minute blocks of up to 20 questions. Source: USMLE Step 1 Exam Content, checked 18 October 2026.

What is the USMLE Step 1 passing score?

Step 1 is reported as pass/fail; the passing standard is 196 on the three-digit scale. Source: USMLE Examination Results and Scoring, checked 18 October 2026.

What is the USMLE Step 1 pass rate?

In 2025, 93% for first-takers from U.S. MD schools, 89% for U.S. DO first-takers and 75% for first-takers from non-U.S. schools. Source: USMLE Performance Data, checked 18 October 2026.

When are the USMLE Step 1 exam dates?

There are no fixed dates. You pick an eligibility period and book a Prometric appointment, up to six months ahead, first-come, first-served. Source: USMLE Bulletin of Information, checked 18 October 2026.

When will I get my USMLE Step 1 score?

Typically within four weeks of your test date; scores are released on Wednesdays. Source: USMLE, checked 18 October 2026.

What is the USMLE 3 passing score?

200 for Step 3 exams on or after 1 January 2024. Source: USMLE Examination Results and Scoring, checked 18 October 2026.