How many people fail Step 1 and Step 2 CK every year? How has this changed over time? These are the questions I looked at, as I considered whether Step 1 being pass-fail would help/hurt IMGs and/or DOs.
Table of Contents
How Many People Fail Step 1 Every Year?
First, the data on the number of people who fail Step 1 (source: USMLE):
| Step 1 | # Tested (2019) | % Passing (2019) | # Failed* (2019) | # Tested (2020) | % Passing (2020) | # Failed* (2020) |
|---|---|---|---|---|---|---|
| MD Degree | 22,146 | 96% | 886 | 20,343 | 97% | 610 |
| 1st Takers | 21,308 | 97% | 639 | 19,772 | 98% | 395 |
| Repeaters | 838 | 66% | 285 | 571 | 67% | 188 |
| DO Degree | 4,837 | 96% | 193 | 5,274 | 95% | 264 |
| 1st Takers | 4,794 | 96% | 192 | 5,235 | 96% | 209 |
| Repeaters | 43 | 67% | 14 | 39 | 74% | 10 |
| IMGs | 16,065 | 78% | 3534 | 13,117 | 83% | 2,230 |
| 1st Takers | 14,046 | 82% | 2528 | 11,742 | 87% | 1,526 |
| Repeaters | 2,019 | 45% | 1110 | 1,375 | 50% | 688 |
| Total Step 1 Exams | 43,048 | 38,734 | ||||
| Total Step 1 Repeaters | 2,900 | 1,985 | ||||
| Total Step 1 Fails | 4,614 | 3,104 |
For perspective, 2020 was an odd year. (To say the least). For some perspective, here is a similar look at Step 1 fails from 2017-2020:
| Step 1 Passing Rates | 2017 | 2018 | 2019 | 2020 |
|---|---|---|---|---|
| MD Degree Examinations | 21,382 | 21,611 | 22,146 | 20,343 |
| MD Degree Passing % | 94% | 95% | 96% | 97% |
| MD Fails* | 1,283 | 1,081 | 886 | 610 |
| DO Degree Examinations | 3,835 | 4,136 | 4,837 | 5,274 |
| DO Degree Passing % | 95% | 96% | 96% | 95% |
| DO Fails* | 192 | 165 | 193 | 264 |
| IMGs Examinations | 17,203 | 16,443 | 16,065 | 13,117 |
| IMGs Passing % | 73% | 75% | 78% | 83% |
| IMG Fails* | 4,645 | 4,111 | 3,534 | 2,230 |
| Total Step 1 Exams | 42,420 | 42,190 | 43,048 | 38,734 |
| Overall Step 1 Pass Rate | 86% | 87% | 89% | 92% |
| Total Step 1 Fails | 6,119 | 5,357 | 4,614 | 3,104 |
How Many People Fail Step 2 CK Every Year?
Next, the same for the number of people who fail Step 2 CK:
| Step 2 CK | # Tested (2018-2019) | % Passing (2018-2019) | # Failed (2018-2019) | # Tested (2019-2020) | % Passing (2019-2020) | # Failed (2019-2020) |
|---|---|---|---|---|---|---|
| MD Degree | 21,721 | 97% | 652 | 18,574 | 98% | 371 |
| 1st Takers | 21,093 | 98% | 422 | 18,138 | 98% | 363 |
| Repeaters** | 628 | 72% | 176 | 436 | 76% | 105 |
| DO Degree | 3,476 | 97% | 104 | 3,362 | 97% | 101 |
| 1st Takers | 3,445 | 97% | 103 | 3,341 | 97% | 100 |
| Repeaters** | 31 | 74% | 8 | 21 | 71% | 6 |
| IMGs | 12,941 | 82% | 2329 | 10,295 | 87% | 1,338 |
| 1st Takers | 11,082 | 87% | 1441 | 9,123 | 90% | 912 |
| Repeaters** | 1,859 | 57% | 799 | 1,172 | 59% | 481 |
| Total Step 2 CK Exams | 38,138 | 32,231 | ||||
| Total Step 2 CK Repeaters | 2,518 | 1,629 | ||||
| Total Step 2 CK Fails | 3,085 | 1,811 |
And the same data for Step 2 CK fails from 2017-2020:
| Step 2 CK Passing Rates: | 2016-2017 | 2017-2018 | 2018-2019 | 2019-2020 |
|---|---|---|---|---|
| MD Degree Examinations | 21,071 | 22,367 | 21,721 | 18,574 |
| MD Degree Passing % | 95% | 96% | 97% | 98% |
| MD Fails* | 931 | 836 | 628 | 436 |
| DO Degree Examinations | 2,581 | 3,076 | 3,476 | 3,362 |
| DO Degree Passing % | 94% | 94% | 97% | 97% |
| DO Fails* | 34 | 38 | 31 | 21 |
| IMGs Examinations | 14,291 | 13,613 | 12,941 | 10,295 |
| IMGs Passing % | 76% | 78% | 82% | 87% |
| IMG Fails* | 2,342 | 2,144 | 1,859 | 1,172 |
| Total Step 2 CK Exams | 37,943 | 39,056 | 38,138 | 32,231 |
| Overall Step 2 CK Pass Rate | 88% | 90% | 92% | 94% |
| Total Step 2 CK Fails | 4,638 | 4,074 | 3,085 | 1,811 |
A Few Observations of the USMLE Failure Rate Data
Pass Rates for DOs and MDs are Virtually Identical
One thing you’ll notice is that DOs and MDs pass Step 1 and Step 2 CK at very similar rates.
IMGs Pass Step 1 and Step 2 CK at a Much Lower Rate
Conversely, we can see clearly that IMGs pass Step 1 and Step 2 CK at a much lower rate. In working with IMGs, and hearing about the additional barriers they face when preparing for the USMLEs, this makes sense. Not only is the content emphasis different, oftentimes it has been years since they learned it. (Or they may not have learned some of those topics at all, like a lot of basic science topics).
Whatever the reason, IMGs pass both Step 1 and Step 2 CK at a lower rate.
Pass Rates for Step 1 and Step 2 CK Are Increasing, Especially for IMGs
The overall pass rates have been improving overall, driven largely by the increasing pass rates from IMGs. This is encouraging and would be a welcome trend to see continue.
Have You Failed Step 1 or Step 2 CK?
Maybe you failed Step 1 or Step 2 CK. Or perhaps you are struggling to improve your score and are worried you might not pass your USMLE. If so, you may be feeling like there is no hope. We invest so much into these exams, and for many of us, this is the first time we’ve struggled this much with anything. It can be one of the most emotionally draining and isolating experiences of our lives.
There is, however, hope. As you can see, every year thousands of examinees don’t pass their USMLE Step 1 or Step 2 CK. If you are not passing your exams, read this article to see what you can do to turn your USMLE fail into a new trajectory.
