USMLE Step 1 and Step 2 CK Pass Rates and Difficulty (2026)

How hard is the USMLE, and what are the odds of passing? This guide lays out the current Step 1 and Step 2 CK pass rates, the passing standards, and what the numbers mean for your preparation in 2026. Figures are drawn from official USMLE reporting through the most recent testing year; standards are confirmed as of mid-2026.

Step 1: now pass/fail

Since January 2022, Step 1 has been reported as pass or fail, with no numeric score released. Behind the scenes the passing standard is a three-digit 196 — raised from 194 at the transition and held at 196 after a December 2024 review, with no change for 2025 or 2026. Examinees typically need to answer roughly 60% of questions correctly to pass. The shift to pass/fail was meant to ease the pressure of chasing a high Step 1 number, but in practice it moved that pressure to Step 2 CK rather than removing it.

First-attempt pass rates dipped after the switch to pass/fail — the so-called "pass/fail effect" — though they recovered somewhat in 2025. In the most recent data, US MD students pass at around 91%, US DO students at around 89%, and international medical graduates at around 72% on a first attempt, with repeat takers markedly lower, near 54%. The roughly 19-point gap between US graduates and IMGs reflects structural factors — curriculum, clinical exposure, language and resource access — rather than ability. A failed attempt is recorded on the transcript that programs see, which is why passing first time matters so much; there is no partial credit for a near miss.

Step 2 CK: the new focus

Step 2 CK is still reported as a three-digit score, and with Step 1 pass/fail, it has become the primary objective measure residency programs use to compare applicants. Its passing standard rose from 214 to 218 on July 1, 2025. First-attempt pass rates are very high for US and Canadian graduates — roughly 96% or above — while IMGs pass at around 68%, a figure that has declined in recent years and represents the widest gap of any Step. That IMG figure has fallen from around 83% in 2020, a decline attributed to a larger, more varied applicant pool rather than an easier-to-fail exam.

Crucially, for Step 2 CK passing is not the goal — scoring well is. The mean score for first-time US and Canadian MD examinees is around 249 (with a standard deviation near 15), and a competitive score for most specialties falls roughly between 240 and 260. The 218 passing standard sits well below the mean, so adequately prepared candidates clear it comfortably; the real work is maximizing your score. Because the same clinical material underlies both exams, strong Step 1 preparation pays off directly on Step 2 CK.

Why the standards keep rising

The passing thresholds are periodically adjusted upward as mean scores rise, which is why Step 2 CK moved to 218. Pass rates for US graduates stay remarkably stable despite these increases, because the bar is recalibrated rather than the cohort changing. Expect further upward adjustments in future reviews if scores continue to climb. For test-takers, this means practice-exam targets should be read against the current standard, not figures quoted in older study guides.

What the numbers mean for you

Three practical takeaways follow from the data. First, prioritize passing Step 1 on a first attempt — a fail appears on your transcript and weighs against you, even though a pass reveals nothing about how comfortably you cleared it. Second, treat Step 2 CK as the score that matters: start early, especially as it now carries more weight, and benchmark relentlessly with official NBME self-assessments. Third, if you are an IMG, plan for the structural gap with more study hours, an earlier start, and rigorous practice-exam benchmarking before you sit. None of these figures should be discouraging: the large majority of well-prepared candidates pass, and the gap is closed by preparation, not talent.

How to give yourself the best odds

High performers tend to share habits: working through thousands of practice questions, using spaced repetition for high-yield facts, taking regular full-length practice exams, and focusing on clinical reasoning over rote memorization. A good question bank that coaches reasoning and exposes gaps — used consistently, with full review of right and wrong answers — does more for your odds than sheer volume skimmed quickly. Quality of review beats quantity of questions every time.

How much study time it takes

There is no single right answer, but a common pattern is a dedicated study period of roughly six to eight weeks for Step 1 after a foundation built during preclinical years, and for Step 2 CK a mix of clerkship-long practice plus several focused weeks before the exam. IMGs often plan for longer, given the structural gap. What matters more than the calendar is consistent daily question practice with thorough review.

Common questions

What is the USMLE Step 1 pass rate? On a first attempt in the most recent data, roughly 91% for US MD students, 89% for US DO students and 72% for international medical graduates.

What score do you need to pass Step 1? Step 1 is pass/fail; the behind-the-scenes passing standard is a three-digit 196, and examinees typically need about 60% correct.

What is the Step 2 CK pass rate and passing score? US and Canadian graduates pass at roughly 96% or above and IMGs at around 68%; the passing standard rose to 218 on July 1, 2025.

What is a good Step 2 CK score? Roughly 240 to 260 is competitive for most specialties; the mean for first-time US and Canadian MD examinees is around 249. Targets vary by specialty, with the most competitive fields expecting higher.

Why is Step 2 CK more important now? Step 2 CK is more important now because Step 1 is pass/fail, making it the main numeric score residency programs use to evaluate applicants, so a strong score is a priority. A strong Step 2 CK score can also help offset weaker parts of an application.

Try iatroX's free USMLE sample questions →