Copyright © 1998 by the National Board of Medical Examiners® (NBME ®). All rights reserved.
PERFORMANCE ON 1997 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 sciences, 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 examination includes approximately 720 items, divided into four books administered over a two-day period. A booklet containing the detailed content outline and sample items is published annually and distributed to examinees and to interested medical school faculty, licensing authorities, and other interested individuals.
Examinee Performance on Step 1
The number of examinees tested and the percent passing Step 1 in 1997 are shown in Table 1. The number of examinees registered by the NBME who sat for Step 1 in 1997 decreased by approximately 2% from the 1996 administrations; however, the number of Step 1 examinees registered by the ECFMG® in 1997 increased by approximately 7%. In 1997, the total number of ECFMG examinees sitting for Step 1 exceeded the number of NBME examinees by more than 13,000.
In 1997, 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 US and Canadian medical schools were approximately 212 and 20, respectively, with most scores falling between 165 and 245. The overall pass rate of 90% for NBME-registered examinees in 1997 was higher than that of 1996 (88%). The overall pass rate of 48% for ECFMG-registered examinees in 1997 was higher than that of 1996 (44%).
| Table 1-1997 Step 1 Administrations Number Tested and Percent Passing |
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|---|---|---|---|---|---|---|
| June 1997 | October 1997 | Total 1997 | ||||
| #Tested | %Passing | #Tested | %Passing | #Tested | %Passing | |
| NBME-Registered Examinees | 16,680 | 93% | 1,890 | 69% | 18,570 | 91% |
| First-Time Takers | 15,812 | 95% | 907 | 85% | 16,719 | 95% |
| Repeaters | 868 | 57% | 983 | 55% | 1,851 | 56% |
| Osteopathic Students | 249 | 80% | 58 | 38% | 307 | 72% |
| First-Time Takers | 229 | 84% | 42 | 45% | 271 | 78% |
| Repeaters | 20 | 35% | 16 | 19% | 36 | 28% |
| Total US/Canadian | 16,929 | 93% | 1,948 | 68% | 18,877 | 90% |
| FMG-Registrants | ||||||
| First-Time Takers | 8,245 | 60% | 10,842 | 57% | 19,087 | 58% |
| Repeaters | 6,421 | 36% | 6,664 | 31% | 13,085 | 34% |
| Total FMG | 14,666 | 50% | 17,506 | 47% | 32,172 | 48% |
| Total Step 1 | 31,595 | 73% | 19,454 | 49% | 51,049 | 64% |
USMLE Step 2
The Step 2 examination 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 examination is dictated by a single, integrated content outline that is organized by physician task and disease classification. Step 2 includes approximately 640 items, divided into four books administered over a two-day period. A booklet containing the detailed content outline and sample items is published annually and distributed to examinees and to interested medical school faculty, licensing authorities, and other interested individuals.
Examinee Performance on Step 2
The number of examinees tested and the pass rates for the August 1996, the March 1997, and the August 1997 Step 2 administrations are shown in Table 2; also shown are the August 1996 - March 1997 cohort data. Traditionally, NBME-registered 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 remained fairly consistent over recent years; however, August 1997 showed an increase of approximately 6% for NBME-registrants. ECFMG counts, which had decreased slightly in 1996, increased by approximately 12% for August 1997 when compared to August 1996.
For recent administrations, the mean and standard deviation for first-time takers from US and Canadian medical schools were 207 and 23, respectively, with most scores falling between 140 and 260. The overall pass rate for NBME-registered examinees was slightly higher in 1996-1997 (91%) than in 1995-1996 (90%). However, the overall pass rate for ECFMG-registered examinees decreased in 1996-1997 (43%) when compared to 1995-1996 (47%).
| TABLE 2 - 1996-97 STEP 2 ADMINISTRATIONS Number Tested and Percent Passing |
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|---|---|---|---|---|---|---|---|---|
| August 1996 | March 1997 | 96-97 Cohort Total | August 1997 | |||||
| #Tested | %Passing | #Tested | %Passing | #Tested | %Passing | #Tested | %Passing | |
| NBME-Registrants | ||||||||
| Allopathic Students | 10,756 | 93% | 7,292 | 90% | 18,048 | 92% | 11,421 | 93% |
| First-Time Takers | 10,028 | 95% | 6,413 | 94% | 16,441 | 94% | 10,673 | 95% |
| Repeaters | 728 | 60% | 879 | 61% | 1,607 | 61% | 748 | 64% |
| Osteopathic Students | 26 | 62% | 94 | 82% | 120 | 78% | 56 | 77% |
| First-Time Takers | 21 | 71% | 89 | 85% | 110 | 83% | 48 | 79% |
| Repeaters | 5 | 20% | 5 | 20% | 10 | 20% | 8 | 63% |
| Total US/Canadian | 10,782 | 93% | 7,386 | 90% | 18,168 | 91% | 11,477 | 93% |
| FMG-Registrants | ||||||||
| First-Time Takers | 7,021 | 54% | 7,892 | 50% | 14,913 | 52% | 8,013 | 58% |
| Repeaters | 5,645 | 34% | 6,094 | 32% | 11,739 | 33% | 6,199 | 41% |
| Total FMG | 12,666 | 45% | 13,986 | 42% | 26,652 | 43% | 14,212 | 50% |
| Total Step 2 | 23,448 | 67% | 21,372 | 58% | 44,820 | 63% | 25,689 | 70% |
| * First-Time takers are defined as examinees who had not taken Part I or Step 1 previously; repeaters are defined as examinees who had taken Part I or Step 1 previously. For ECFMG-registered examinees, the first-taker group includes a percentage of examinees who had taken the Foreign Medical Graduate Examination in the Medical Sciences (FMGEMS) prior to its discontinuation in 1993, but had not yet taken Part I or Step 1. | ||||||||
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 before they 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 category, and the test material is presented to examinees organized by clinical setting. Step 3 includes approximately 670 items, divided into four books administered over a two-day period. Materials containing a detailed description of Step 3 content and sample items are published annually and are made available to examinees by state medical licensing authorities or The Federation of State Medical Boards.
Examinee Performance on Step 3
The number of examinees tested and the pass rates for the May 1997 and December 1997 Step 3 administrations are shown in Table 3. The pattern of counts for graduates of US and Canadian schools has indicated a heavier use of the May administration; this pattern has remained consistent over the last few years. The number of graduates of foreign medical schools have climbed steadily, regardless of administration date.
| TABLE 3 - 1997 STEP 3 ADMINISTRATIONS Number Tested and Percent Passing |
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|---|---|---|---|---|---|---|
| May 1997 | December 1997 | Total 1997 | ||||
| #Tested | %Passing | #Tested | %Passing | #Tested | %Passing | |
| Graduates of US or Canadian Schools | ||||||
| Allopathic Graduates | 10,459 | 94% | 7,100 | 90% | 17,559 | 92% |
| First-Time Takers* | 9,991 | 95% | 6,449 | 93% | 16,440 | 94% |
| Repeaters | 468 | 64% | 651 | 59% | 1,119 | 61% |
| Osteopathic Students | 32 | 94% | 18 | 83% | 50 | 90% |
| First-Time Takers | 31 | 94% | 16 | 88% | 47 | 92% |
| Repeaters | 1 | †† | 2 | †† | 3 | †† |
| Total US/Canadian | 10,491 | 94% | 7,118 | 90% | 17,609 | 92% |
| Graduates of Foreign Medical Schools | ||||||
| First-Time Takers | 3,427 | 64% | 3,603 | 62% | 7,030 | 63% |
| Repeaters | 1,511 | 41% | 1,965 | 38% | 3,476 | 39% |
| Total FMG | 4,938 | 57% | 5,568 | 53% | 10,506 | 55% |
| Total Step 3 | 15,429 | 82% | 12,686 | 74% | 28,115 | 78% |
A three-digit score of 176 was required to pass USMLE Step 3 for administrations between June 1994 and December 1996. An in-depth review of the Step 3 standard was completed in April 1997. The review resulted in the decision to raise the minimum passing score from 176 to 177, beginning with the May 1997 administration. For the most recent administration, the mean and standard deviation for first-time takers from US and Canadian medical schools were 207 and 19, respectively, with most scores falling between 140 and 260.