2005 USMLE Performance Data
As published in the 2005 NBME Annual Report,
Copyright 2006 by the National Board of Medical Examiners®

USMLE Administration, Minimum Passing Scores, and Performance

Continuous test administration of the USMLE is available to all examinees. For Step 1, Step 2 Clinical Knowledge (CK), and Step 3, which are the computer-based testing (CBT) components of the USMLE program, test scheduling and delivery are provided by Prometric, Inc.®, part of The Thomson Corporation™. These CBT examinations are currently administered at more than 150 US/Canadian Prometric test centers and more than 200 international Prometric test centers. Additional test centers are located at eight medical schools in the United States. The Step 1 and Step 2 CK examinations are administered worldwide; the Step 3 examination is administered only in the United States. Step 2 Clinical Skills (CS) is a standardized patient (SP) examination. Scheduling and test delivery for Step 2 CS are provided by the Clinical Skills Evaluation Collaboration (CSEC). There are five CSEC centers.

For each of the Step examinations, once the registration process is completed, applicants make their own appointment to take the examination at a location and time most convenient to their schedule. Examination results are processed continuously, and scores are reported weekly. Most Step 1 and Step 2 CK examinees receive their scores approximately three to four weeks after their test date and most Step 3 examinees, four to six weeks. For Step 2 CS, most examinees receive their results by approximately eight weeks, but this length of time may vary for some individuals because of the scoring and quality assurance steps associated with this component of USMLE. For all Step examinations, individual score reports are mailed to examinees; medical schools and state licensing authorities can receive score information by using a secure website.

A pass or fail result is provided, as a USMLE recommendation, for each examinee. Passing results are based on achievement of specified levels of proficiency established prior to administration of examinations. Statistical procedures are employed to ensure that for each Step, the level of proficiency required to pass remains uniform across forms of the examination. As noted in the USMLE Bulletin of Information and at the USMLE website, the score required to meet the recommended level of proficiency is reviewed periodically and may be adjusted without prior notice. Notice of adjustments is posted on the Internet. In reviewing standards for USMLE examinations, the USMLE Step Committees employ information gathered from a number of sources including standard setting surveys. These surveys, which seek opinions on the appropriateness of current USMLE pass/fail standards for each of the Steps, are sent to random samples of examinees, directors of basic and clinical science courses and clinical clerkships, associate deans for academic and student affairs, directors and chief residents from residency programs, members of USMLE test material development committees, executive directors and presidents of all state medical boards, and members of the NBME Board and the FSMB Board of Directors.

In addition to surveys, USMLE Step Committees consider the results of content review by standard setting panels. These panels are typically made of individuals who are not otherwise involved in the USMLE program. These panels review the content of the Step examinations and, through a series of exercises, provide data that reflect their opinions on minimally acceptable levels of performance.

Step 1

Details on the performance of examinees taking Step 1 in 2004 and 2005 are provided in Table 1. Data for 2005 are based upon examinees whose results were reported through February 8, 2006. Approximately 16,700 and 16,800 first-time takers from US and Canadian medical schools that grant the MD degree were tested in 2004 and 2005, respectively. First-time takers from non-US/Canadian medical schools numbered approximately 12,300 and 13,500 for the same years. The pass rates for first-time takers from MD-granting US and Canadian medical schools were 93% in 2004 and 94% in 2005. Because failing examinees generally retake Step 1, the ultimate passing rate across test administrations is expected to increase to approximately 99% for this same group.

TABLE 1 - 2004-2005 STEP 1 ADMINISTRATIONS Number Tested and Percent Passing
	2004		2005*
	#Tested	%Passing	#Tested	%Passing
Examinees from US/Canadian Schools that Grant
MD Degree	18,355	91%	18,290	92%
1st Takers	16,703	93%	16,799	94%
Repeaters**	1,652	64%	1,491	65%
DO Degree	1,192	69%	1,331	72%
1st Takers	1,131	70%	1,265	73%
Repeaters**	61	53%	66	53%
Total US/Canadian	19,547	89%	19,621	90%
Examinees from Non-US/Canadian Schools
1st Takers	12,251	67%	13,488	68%
Repeaters**	5,964	40%	5,911	39%
Total non-US/Canadian	18,215	58%	19,399	59%
* Represents data for examinees tested in 2005 and reported through February 8, 2006. ** ‘Repeaters’ represents examinations given, not number of different examinees.

Step 2 CK

Details on the performance of examinees taking Step 2 CK in the 2003–2004 and 2004–2005 academic years are provided in Table 2A. First-time takers from US and Canadian medical schools granting the MD degree numbered approximately 16,400 for both the 2003–2004 and 2004–2005 periods. First-time takers from non-US/Canadian medical schools numbered approximately 9,900 and 10,400, respectively. The pass rate for first-time takers from MD-granting US and Canadian medical schools was 94% for both periods. As noted with Step 1, given the opportunity for this same group to repeat the examination, the ultimate Step 2 CK passing rate across test administrations is expected to increase to approximately 99%.

TABLE 2A - 2003-2005 STEP 2 CK ADMINISTRATIONS Number Tested and Percent Passing
	2003-2004*		2004-2005*
	#Tested	%Passing	#Tested	%Passing
Examinees from US/Canadian Schools that Grant
MD Degree	17,772	92%	17,803	93%
1st Takers	16,431	94%	16,447	94%
Repeaters**	1,341	67%	1,356	69%
DO Degree	439	76%	399	85%
1st Takers	413	80%	386	85%
Repeaters**	26	23%	13	62%
Total US/Canadian	18,211	92%	18,202	92%
Examinees from Non-US/Canadian Schools
1st Takers	9,862	75%	10,355	77%
Repeaters**	3,178	46%	3,470	50%
Total non-US/Canadian	13,040	68%	13,825	71%
* Data for Step 2 CK are provided for examinees tested during the period from July 1 to June 30. ** ‘Repeaters’ represents examinations given, not number of different examinees.

Step 2 CS

Details on the performance of examinees taking Step 2 CS in the 2004-2005 academic year (from first day of administration on June 14, 2004 through June 30, 2005) are provided in Table 2B. During this period there were approximately 15,800 first-time takers from US and Canadian medical schools that grant the MD degree and 12,700 first-time takers from non-US/Canadian medical schools.

Examinees taking Step 2 CS must pass three separate subcomponents in order to receive an overall pass on Step 2 CS. The three subcomponents are: Integrated Clinical Encounter (ICE), Communication and Interpersonal Skills (CIS), and Spoken English Proficiency (SEP). The overall Step 2 CS pass rate for first-time takers from US and Canadian medical schools that grant the MD degree was 96% and the pass rate for first-time takers from non-US/Canadian medical schools was 83%.

TABLE 2B - 2004-2005 STEP 2 CS ADMINISTRATIONS Number Tested and Percent Passing
	2004-2005*
	#Tested	%Passing
Examinees from US/Canadian Schools that Grant
MD Degree	16,124	96%
1st Takers	15,814	96%
Repeaters**	310	96%
DO Degree	31	87%
1st Takers	31	87%
Repeaters**	0	N/A
Total US/Canadian	16,155	96%
Examinees from Non-US/Canadian Schools
1st Takers	12,708	83%
Repeaters**	973	83%
Total non-US/Canadian	13,681	83%
* Data for Step 2 CS are provided for examinees tested during the period from June 14, 2004 to June 30, 2005. ** ‘Repeaters’ represents examinations given, not number of different examinees. N/A - not applicable.

Step 3

Details on the performance of examinees taking Step 3 in 2004 and 2005 are provided in Table 3. Data for 2005 are based upon examinees whose results were reported through February 8, 2006. First-time takers who were graduates of MD-granting schools in the US and Canada numbered approximately 16,400 in 2004 and 15,900 in 2005. First-time takers who were graduates of non-US/Canadian medical schools numbered approximately 7,700 and 8,300, respectively, for the same years. For 2004 and 2005, the pass rate for first-time takers who were graduates of MD-granting US and Canadian medical schools was 96% for both years. Like Step 1 and Step 2 CK, the ultimate Step 3 passing rate, accounting for repeat attempts, is expected to increase to approximately 99% for this same group.