Score Reports

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1. Why have the Step examination score reports changed and how was the new format developed?

The new score report format reflects both advances in the underlying science of assessment and changes to the USMLE examinations over time. USMLE score reports were virtually unchanged for nearly two decades. During that time, the USMLE exams experienced incremental changes, including changes to content sampling, item types, and review and modification of minimum passing scores. Simultaneously, measurement researchers, including those who support the USMLE program, continued to advance the science of subscore computational methods, data visualization, and score reporting.

The process used to design a new score report format included:

  • The development of prototype score reports that better supported the intended inferences
  • Approval of the prototypes by USMLE governance committees (composed of medical school faculty, members of state medical boards, and public members)
  • Focus group studies with USMLE test-takers to identify preferences among prototypes and to evaluate their ability to make correct inferences (and not make incorrect inferences) from the prototype score reports

The examinee focus group results clearly demonstrated that the new score report format was viewed as a substantial improvement by USMLE test-takers. Results also showed that USMLE examinees were both able to interpret the information provided in the new score report format appropriately and were less likely to make incorrect inferences.

The Step 1 examinee score report underwent further modifications to account for the transition to reporting only a pass/fail outcome, which began for examinees taking Step 1 exams on or after January 26, 2022. The new Step 1 examinee score report format supports the transition to Step 1 pass/fail reporting while continuing to provide candidates who receive a failing outcome feedback on content areas requiring further study before they retake the exam.

Please view the sample score reports:

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2. How do I interpret my score?

Your score reflects your relative mastery of the concepts and principles that constitute the basis of safe and effective patient care specific to each Step examination.

The average score and standard deviation for recent administrations are included on your score report. Detailed information about interpreting USMLE scores is available in the Score Interpretation Guidelines.

Please see additional information about score reports here.

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3. What is the minimum passing standard, and is it always the same?

The USMLE Management Committee establishes a passing standard for each individual Step examination. This standard reflects the level of performance an examinee must achieve to pass. The USMLE Management Committee reviews data for each Step examination approximately once every three to four years and decides whether to change the recommended passing standard.

Information on passing standards for USMLE examinations is posted here.

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4. How are scores from different forms of a Step examination made comparable?

Within each Step examination, USMLE creates various forms that are similar in difficulty and content. Scores on individual examination forms are made comparable through equating, a psychometric process that adjusts scores based on the difficulty of the questions. This can be thought of as small score increases applied to examinees who see somewhat more difficult sets of test questions, and small score decreases applied to test takers who see somewhat less difficult sets of test questions. This process ensures examinees who take different forms are held to the same passing standard. 

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5. How is my performance compared to others?

Step 1 before pass/fail transition, Step 2 CK, and Step 3: Your performance is compared to other examinees by comparing your three-digit score to that of a recent group of examinees (students from US and Canadian medical schools taking the examination for the first time). The blue bars represent the distribution of this group’s scores, with higher bars indicating more individuals with scores in that range. Your overall performance (three-digit score) is marked with an orange rectangle and solid line. The black rectangle and dashed line indicate the minimum passing score.

If your overall performance (indicated by the orange rectangle and solid line on page 1) is toward the right side of the chart and to the right of the tallest blue bar, your performance was higher than others. If your overall performance is toward the left side of the chart, or to the left of the tallest blue bar, your performance was lower than others.

Additional information about how your performance compares to others (including norm tables and summary data from recent administrations) is available in the Score Interpretation Guidelines. Performance data by group for each Step  examination is available each year based on the performance of examinees in that year.

Step 1 after pass/fail transition: After Step 1 transitions to pass/fail score reporting, passing examinees will not see performance feedback on their score report. Examinees who fail will receive the visual described above to help assess how close they scored in relation to the passing standard.

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6. What is the standard error of the estimate (SEE), and what does it tell me about my performance?

Step 1 before pass/fail transition, Step 2 CK, and Step 3: The standard error of the estimate (SEE) indicates how you might perform if you were to retest repeatedly under the same conditions (without learning or forgetting). Approximately two-thirds (or 68%) of the time your score would fall within one SEE of your reported score (your score +/- 1 SEE); 95% of the time your score would fall within two SEEs of your reported score. This information may be useful if you are planning to retake the examination.

Step 1 after pass/fail transition:  The SEE will not be provided on Step 1 score reports for examinations administered on or after January 26, 2022.

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7. How do I interpret my Relative Strengths and Weaknesses?

Step 1 before pass/fail transition, Step 2 CK, and Step 3: Your score report shows both your overall performance (your three-digit score and pass/fail outcome) and an indication of whether your performance in each content area within the examination was higher, lower, or the same as your overall performance. For example, if your overall performance was strong and most of the content areas indicate that your performance fell in the “same” category, your performance across the examination was strong.

Step 1 after pass/fail transition: The Step 1 examinee score report for failing candidates who test on or after January 26, 2022 indicates whether the examinee scored below, about the same, or above a low-pass on each content area. A low-pass corresponds to performance that is above but near the passing standard. In other words, the low-pass represents performance that is sufficient to pass by a small margin. Examinees can use this information to identify areas of both strength and weakness.

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8. In the relative strengths and weakness section of my score report, all the boxes for every content area are the same as my overall performance. What does this mean?

Step 1 before pass/fail transition, Step 2 CK, and Step 3: This indicates that your performance was consistent across the examination. Your performance in each content area was neither stronger nor weaker than your overall performance.

To interpret the boxes, you can use the chart and your three-digit score from the first page to determine your performance. You can then use the boxes next to each content area to determine whether your performance in each content area is the same as or different from your overall performance. If each box indicates that your performance was the same, you had no areas of performance that were meaningfully stronger or weaker than your overall performance on the examination.

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9. What is the best remediation strategy if I did not pass a Step examination? Should I focus only on content areas in the lower or same categories?

The Step examinations are highly integrative, and you should plan to review all content areas. In prioritizing which areas to review, you should take into account both the representation of that content area on the examination (based on the % items per exam next to the content area label) and your relative performance in that content area. Remediation strategies focused solely on relatively weak areas of performance are unlikely to be the most effective for failing examinees. In most cases, failing scores are best remediated through attention to all content areas.

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10. How much of each content area appears on the examination?

The "% Items Per Test" describes the breakdown of test questions on a typical examination by content area. For example, 30%–40% of each Step 3 test includes items within the Patient Care: Diagnosis content area. Though the amount of content in each area varies on each test, these percentages provide a guideline about how much content in each area is on the examination.

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11. Who else sees my score report?

Your score report is provided only for your personal use. When you want a third party (e.g., residency programs) to receive an official record of your USMLE scores, request that your registration entity send the transcript (see Requesting a Transcript of USMLE Scores). Under some circumstances, medical schools may receive scores and pass/fail outcomes for their students.