USMLE Step 1 is not curved. Your result is based on whether you meet a fixed standard of proficiency, not on how you perform relative to other test-takers. No predetermined percentage of examinees will pass or fail on any given administration. This is true both before and after the exam’s transition to pass/fail-only reporting in January 2022.
How Step 1 Scoring Actually Works
A curved exam ranks test-takers against each other, so your score depends partly on everyone else’s performance that day. Step 1 doesn’t do this. Instead, it uses a criterion-referenced approach: your performance is measured against a fixed benchmark of medical knowledge. If every single person taking the exam on a given day meets that benchmark, every single person passes.
Behind the scenes, the exam uses a statistical framework called Item Response Theory to calibrate each question. Every question on Step 1 has parameters for difficulty, how well it distinguishes between stronger and weaker examinees, and the probability of a correct guess. These parameters ensure that your outcome reflects what you actually know rather than how hard or easy your particular set of questions happened to be. Since different test-takers receive different question sets on different days, this calibration process (called equating) makes results comparable across all versions of the exam without pitting you against other examinees.
The Pass/Fail Transition
For exams taken on or after January 26, 2022, Step 1 reports only a pass or fail outcome. Before that date, examinees received a three-digit numeric score alongside their pass/fail result. If you took the exam before the cutoff, your transcript still shows your numeric score. If you took it after, residency programs see only pass or fail.
The passing standard sits at 196 on the old three-digit scale. The USMLE Management Committee reviewed this threshold most recently in December 2024 and voted to keep it unchanged. Notably, the organization has said that future reviews of the passing standard will no longer be reported in terms of a three-digit score, signaling a full departure from numeric scoring for Step 1.
Current Pass Rates
Because the exam is criterion-referenced, pass rates can shift from year to year depending on how well-prepared the test-taking population is. For 2025, 93% of first-time takers from U.S. MD programs passed Step 1, and 89% of first-time takers from U.S. DO programs passed. These numbers are high, but they’re not guaranteed by design. They simply reflect how many examinees cleared the fixed standard.
Why This Matters for Residency Applications
The distinction between a curve and a fixed standard became far more consequential after the pass/fail switch. When Step 1 reported numeric scores, residency programs used those numbers to rank and filter applicants, even though the exam was never technically curved. It functioned in practice as a competitive sorting tool because the three-digit score gave programs a way to compare candidates on a standardized scale.
With that number gone, Step 2 CK has absorbed much of that role. Step 2 CK still reports a numeric score on a 1 to 300 scale, giving residency programs a standardized data point for screening applicants. If you’re a medical student planning your board prep timeline, the practical takeaway is that passing Step 1 is now a binary checkpoint. The exam where your score still visibly matters for competitive differentiation is Step 2 CK.
What “Not Curved” Means for Your Prep
Knowing Step 1 isn’t curved changes how you should think about studying. You’re not competing against the person sitting next to you in the testing center. You need to clear a defined level of competency, and the difficulty of your particular exam form is already accounted for by the scoring model. A harder set of questions doesn’t penalize you, because the equating process adjusts for that variation.
This also means that practice exam scores from question banks, which often rank you in percentiles against other users, don’t perfectly mirror the real exam’s scoring logic. Those percentile rankings are norm-referenced by nature. The actual Step 1 doesn’t care where you fall in a distribution. It only cares whether your estimated ability meets the threshold.