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How Many People Fail the USMLE Step 1 and Step 2 CK Each Year?

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by Alec Palmerton, MD in Plan

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 Degree22,14696%88620,34397%610
1st Takers21,30897%63919,77298%395
Repeaters83866%28557167%188
DO Degree4,83796%1935,27495%264
1st Takers4,79496%1925,23596%209
Repeaters4367%143974%10
IMGs16,06578%353413,11783%2,230
1st Takers14,04682%252811,74287%1,526
Repeaters2,01945%11101,37550%688
Total Step 1 Exams43,04838,734
Total Step 1 Repeaters2,9001,985
Total Step 1 Fails4,6143,104

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 Rates2017201820192020
MD Degree Examinations21,38221,61122,14620,343
MD Degree Passing %94%95%96%97%
MD Fails*1,2831,081886610
DO Degree Examinations3,8354,1364,8375,274
DO Degree Passing %95%96%96%95%
DO Fails*192165193264
IMGs Examinations17,20316,44316,06513,117
IMGs Passing %73%75%78%83%
IMG Fails*4,6454,1113,5342,230
Total Step 1 Exams42,42042,19043,04838,734
Overall Step 1 Pass Rate86%87%89%92%
Total Step 1 Fails6,1195,3574,6143,104

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 Degree21,72197%65218,57498%371
1st Takers21,09398%42218,13898%363
Repeaters**62872%17643676%105
DO Degree3,47697%1043,36297%101
1st Takers3,44597%1033,34197%100
Repeaters**3174%82171%6
IMGs12,94182%232910,29587%1,338
1st Takers11,08287%14419,12390%912
Repeaters**1,85957%7991,17259%481
Total Step 2 CK Exams38,13832,231
Total Step 2 CK Repeaters2,5181,629
Total Step 2 CK Fails3,0851,811

And the same data for Step 2 CK fails from 2017-2020:

Step 2 CK Passing Rates:2016-20172017-20182018-20192019-2020
MD Degree Examinations21,07122,36721,72118,574
MD Degree Passing %95%96%97%98%
MD Fails*931836628436
DO Degree Examinations2,5813,0763,4763,362
DO Degree Passing %94%94%97%97%
DO Fails*34383121
IMGs Examinations14,29113,61312,94110,295
IMGs Passing %76%78%82%87%
IMG Fails*2,3422,1441,8591,172
Total Step 2 CK Exams37,94339,05638,13832,231
Overall Step 2 CK Pass Rate88%90%92%94%
Total Step 2 CK Fails4,6384,0743,0851,811

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.

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Want FREE Cardiology Flashcards?

Cardiology is key for impressive USMLE scores. Master cardiology from a Harvard-trained anesthesiologist who scored USMLE 270 with these 130+ high-yield flash cards. You’ll be begging for cardio questions - even if vitals make you queasy.

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