Copyright © 1996 by the National Board of Medical Examiners® (NBME ®). All rights reserved.
PERFORMANCE ON 1995 USMLE EXAMINATIONS

USMLE Step 1

The USMLE Step 1 examination assesses whether an examinee can apply the knowledge and understanding of key concepts of basic biomedical science, with an emphasis on principles and mechanisms of health, disease, and modes of therapy. The inclusion of Step 1 in the USMLE sequence is intended to ensure mastery of not only the basic medical sciences undergirding the safe and competent practice of medicine in the present, but also the scientific principles required for maintenance of competence through lifelong learning. Content coverage is dictated by a single, integrated content outline that is organized by organ system and process. The exam includes approximately 720 items divided into four books. A booklet containing the detailed content outline and sample items is published annually and sent to medical schools for distribution to examinees and to interested faculty.

Examinee Performance on Step 1

The number of examinees tested and the percent passing Step 1 in 1995 are shown in Table 1; the NBME figures include examinees from osteopathic schools. The number of examinees registered by the NBME who sat for Step 1 in 1995 was almost equal to the number who sat in 1994; however, the number of Step 1 examinees registered by ECFMG® in 1995 increased by approximately 25%.

In 1995, a three-digit score of 176 was required to pass USMLE Step 1. For recent administrations, the mean and standard deviation for first-time takers from U.S. and Canadian medical schools were approximately 205 and 20, respectively, with most scores falling between 165 and 245. The overall pass rate of 88% for NBME-registered examinees was slightly higher than in 1994 (86%). For ECFMG-registered examinees in 1995 the overall pass rate (45%) was slightly higher than in 1994 (44%).

USMLE Step 2

Step 2 assesses whether an examinee can apply the medical knowledge and understanding of clinical science considered essential for provision of patient care under supervision, including emphasis on health promotion and disease prevention. The inclusion of Step 2 in the USMLE sequence of licensing examinations ensures that due attention is devoted to principles of clinical science that undergird the safe and competent practice of medicine. Content coverage for this exam is dictated by a single, integrated content outline that is organized by physician task and disease classification. Step 2 includes approximately 720 items divided into four books. A booklet containing the detailed content outline and sample items is published annually and sent to medical schools for distribution to examinees and to interested faculty.

Examinee Performance on Step 2

The number of examinees tested and pass rates for the August 1994 and the March and August 1995 Step 2 administrations are shown in Table 2. Traditionally, examinee counts for the Fall Step 2 have been larger than those for the Spring examination and this continues to be true for recent administrations. Overall, counts for NBME-registered examinees have been slightly higher than in recent years; ECFMG counts, however, have increased significantly.

In 1995, a three-digit score of 167 was required to pass USMLE Step 2. For recent administrations, the mean and standard deviation for first-time takers from U.S. and Canadian medical schools were 202 and 22, respectively, with most scores falling between 140 and 260.

USMLE Step 3

Step 3 assesses whether an examinee can apply the medical knowledge and understanding of biomedical and clinical science considered essential for the unsupervised practice of medicine, with emphasis on patient management in ambulatory settings. The inclusion of Step 3 in the USMLE sequence of licensing examinations reflects the importance of adequately assessing the level of such knowledge and understanding in physicians who are about to assume independent responsibility for the delivery of general medical care to patients. The content of this examination is organized along two principal dimensions: physician tasks and clinical encounter and the test material is presented to examinees organized by clinical setting. Step 3 includes approximately 730 items divided into four books. Materials containing a detailed description of Step 3 content and sample items are published annually and are available to examinees from state medical licensing authorities or from the Federation of State Medical Boards.

Examinee Performance on Step 3

The number of examinees tested and the pass rates for the June and December 1995 Step 3 administrations are shown in Table 3. During the initial administrations of Step 3 in 1994 it was noted that relatively few examinees sat for examinations. The small group of 1994 examinees was attributed to the continued availability in that year of NBME Part III, the impact of the specific requirements of the individual state licensing authorities, and the general novelty of Step 3 procedures and programs to potential examinees, training program directors and the state authorities. However, in 1995, there was a dramatic increase in the numbers of examinees taking Step 3. Although the potential size of the Step 3 population may not yet be realized, data from the 1995 administrations should provide a reasonably stable base for assessing the impact of the final segment of the USMLE sequence.

In 1995, a three-digit score of 176 was recommended as the passing score for USMLE Step 3. For recent administrations, the mean and standard deviation for first-time takers from LCME- accredited U.S. and Canadian medical schools were 205 and 18, respectively, with most scores falling between 150 and 260.