Average USMLE Step 1 Scores by Residency Program

Average USMLE Step 1 Scores By Residency Program

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Among the factors that will affect residency matches is the USMLE Step 1 scores. Some even say that this examination has the most significant impact on your medical journey. In this article, we will talk about USMLE Step 1 scores by residency program.

Step 1 is an essential milestone in medical school that you should look forward to. USMLE Step 1 is taken at the end of your last semester in the second year. During this time of your education, you probably saw many things that made you think about what specialty you want to pursue.

Whether you are still yet to make a decision or have your eyes completely fixed on one field, you might want to check the competitiveness of each program.

[Update – Since January of 2022, Step 1 is now pass/fail and this change has taken effect. The weight carried previously by Step 1 scores as a factor for deciding which residency application to pursue will now be passed to Step 2 Clinical Knowledge (CK) score.]

Program Competitiveness

Yes, each specialty has different levels of competitiveness based on the previous average scores, and they are classified into three tiers:

  • Competitive
  • Moderately competitive
  • Less Competitive

The first tier, competitive programs, comprises the most challenging areas to match. This includes:

  • Cardiac and Thoracic Surgery
  • Dermatology
  • General Surgery
  • Neurosurgery
  • Orthopedic Surgery
  • Ophthalmology
  • Otolaryngology
  • Plastic Surgery
  • Urology
  • Radiation Oncology

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The second tier is the moderately competitive programs, including:

  • Anesthesiology
  • Emergency Medicine
  • Medicine/Pediatrics (combined)
  • Radiology (Diagnostic)
  • Obstetrics and Gynecology

Lastly, the less competitive specialties receive the most matches, and this includes the following programs:

  • Family Medicine
  • Internal Medicine
  • Pathology
  • Pediatrics
  • Physical Medicine and Rehabilitation
  • Psychiatry

Although these categories may induce intimidation, know that these are only general guidelines, and some boundaries between each tier are not entirely fixed. Other factors may influence the level of a specialty’s competitiveness, such as prestige, location, and more.

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USMLE Step 1 Scores

Next to that, let us also understand the USMLE Step 1 scores and their corresponding explanations:

215 to Passing Score

A score of 215 is considered low, but it is still a passing grade. The lowest passing score is 194, equating to at least 55% to 65% correct answers to the 350 questions. However, students with this score range are more likely limited to match lesser competitive specialties. 

215 to 230

This scoring range is considered all right. It is still on the lower side, and some limitations may still occur in the matching process. Fortunately, students in this score range can keep opportunities open for them if paired with solid performances on the other criteria and match up with more competitive categories. 

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230 to 245

This is a good score range if you aim for more competitive specialties. Usually, students who score 230 and higher have all things open for them, especially when paired with excellent clinical grades and good performances on Step 2

245 to 255

245 to 255 scores are outstanding and are highly preferred by program directors. When you get a score this high, there is a big chance that all specialties will remain available for you to match.

However, it is essential to remember that Step 1 scores alone are not the only requirement for you to match a particular specialty. Having strong data to support your Step 1 scores, such as good gradespersonal statements, and quality recommendation letters, can be of big help. 

250 and above

Scores 250 and above are considered excellent and perhaps guaranteed to match the applicant to all specialties. Program directors very positively view this, and it can be a significant factor when it comes to matching prestigious training programs across the country. 

There is still a cutoff series, an interview screening strategy employed most especially in competitive fields of study. These programs only offer these interviews to applicants with scores this high and above their predetermined cutoff level. 

Be informed that there are programs that publish cutoff scores on their respectable sites, while some do not. It is best not to believe any cutoff rumors, as most are unreliable. If you really want to know the cutoff score of a specific program, you should check their sites for the information.

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Average USMLE Step 1 Scores By Residency Program

Throughout your medical school career, USMLE Step 1 scores are used as an objective metric to see whether you are able to reach the cutoff of specific specialties and programs. However, it is reported that the Step 1 examination will shift from a numerical scoring to a pass/fail outcome system.

Since January of 2022, this change has taken effect, and we are yet to see how this works for the medical school examinations. The weight carried previously by Step 1 scores as a factor for deciding which residency application to pursue will now be passed to Step 2 Clinical Knowledge (CK) score.

However, Step 1 will remain important as it is still a requirement to pass it in order to take Step 2. Until we fully understand how the new changes work, let’s stick to the original scoring system and understand the average scores by residency program to give you an idea of the score you should aim for. 

As mentioned, the lowest passing score for Step 1 is 194, but you should aim for at least 238 to 251 to ensure you get into the program you desire. Based on the 2020 Match report for U.S. MD Seniors, the top-matched specialties are the following:

SpecialtyUSMLE Step 1 score rangePercentage of applicants matched in 2020
Internal medicine220–24957.70%
Family medicine200–22963.20%

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For these specialties, the Step 1 score ranges from 220 to 249, with a matching percentage of 60% to 66% for first-year residents. 

Moving on, let’s look at the average results for the 2020 match for USMLE Step 1 from the NRMP. Note that some data that have inadequate sample size has been withheld by the NRMP, thus the N/A results:

 US MD/DO SeniorsNon-US IMGs (International Medical Graduates)
Child Neurology232207228220
Diagnostic Radiology241222240231
Emergency Medicine231221231224
Family Medicine220208215210
General Surgery234221240229
Internal Medicine231217232217
Internal Med/Peds233222238218
Interventional Radiology250236239243
Obstetrics and Gynecology231222233221
Orthopedic Surgery245239245237
Otolaryngology (ENT)244239
Physical Med and Rehabilitation226221223220
Plastic Surgery249238246239
Radiation Oncology243256224209
Vascular Surgery241256224209


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What Are The Most Competitive Residencies And Their Average Step 1 Scores?

According to the National Residency Matching Program (NRMP), the following are the specialties with the highest level of competition based on the filled positions by MD Seniors:

SpecialtyAverage USMLE® Step 1 Score (U.S. Seniors Matched)Average USMLE Step 1 Score (IMGs Matched)
Orthopaedic surgery248241
Neurological surgery248239
Plastic surgery249246

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What Are The Least Competitive Residencies And Their Average Step 1 Scores?

On the other hand, these are the specialties with the least matching competition:

SpecialtyAverage USMLE® Step 1 Scores (U.S. Seniors Matched)Average USMLE® Step 1 Scores (IMGs Matched)
Internal medicine235226
Family medicine221211
General surgery237237

What Is A Good USMLE Step 1 Score?

With the number of specialty options, each has a specific score range requirement to match. While studying for Step 1, it would be best to do your research and find the score range your desired specialty falls into.

However, if you want to have several specialty options to pursue in your residency, be sure to aim for a score between 230 to 245 for a good chance and 245 and above to guarantee excellent results.

Scores lower than 230 are still acceptable, but you will be more likely to have difficulty matching your preferred specialty.

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Step 1 is a huge milestone for medical students. If you get a good score on this examination, then congratulations because you will have a high chance of getting accepted to your chosen program.

If you did not pass or score below 230, there are still some things that you can do. You can retake USMLE Step 1 up to six times with a maximum of three tries within a year.

Other factors may increase your chance of getting into the program you liked, such as strong recommendation letters, clinical experience, and an impressive curriculum vitae (CV) that highlights relevant extracurricular activities.

In the end, remember that your score is not a reflection of who you are and what you can do. There is always room for development, and you have to believe that you can.

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If you are about to take USMLE Step 1, then check out the Step 1 Academy.

The Step 1 Academy is designed for students who are looking to crush their Step 1 exams but who may not know the approach or tools to help get them there. Click here if you want to get a high Step 1 score.

That’s all for now! I hope this post was able to help you in any way. If you learned from this article, check out our other content:

Until the next one my friend…

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