USMLE Step 3 Pass Rates: 2025 Results and the 2027 Standard Review
Official 2025 Step 3 pass rates by attempt and medical school group, the current passing score of 200, and the scheduled 2026 review.
The Step 3 pass rate is high: more than nine in ten people who sat the exam in 2025 passed. That headline hides the two numbers that actually matter for your planning. One is how much worse the odds get once you are a repeat taker. The other is that USMLE is reviewing the passing standard this November, and any change applies to everyone who tests from 1 January 2027.
This page gives you the official figures straight from USMLE's performance data, explains what the passing score does and doesn't tell you, and covers what to do if you want to be well clear of the line.
The Step 3 pass rate in 2025, by group
These are USMLE's published figures for everyone who tested in calendar year 2025.
| Group | Examinees | Pass rate |
|---|---|---|
| US MD, first attempt | 21,589 | 96% |
| US MD, repeat attempt | 910 | 77% |
| US DO, first attempt | 129 | 97% |
| Non-US graduates (IMGs), first attempt | 12,480 | 88% |
| Non-US graduates (IMGs), repeat attempt | 1,824 | 63% |
Source: USMLE Performance Data, 2025. USMLE suppressed the DO repeater category because it contained fewer than five examinees. Beginning in 2025, Canadian graduates were included in the non-US group rather than the US group.
Across all 36,934 examinees, that works out to roughly 92% passing, or about 3,100 people who didn't pass. That figure is our calculation from USMLE's rounded percentages, so treat it as approximate.
Notice the DO row. Only 129 DO graduates sat Step 3 in 2025, because most DO graduates take COMLEX Level 3 instead. A 97% pass rate in a group that small moves several points from one year to the next, so don't read much into it.
How 2025 compares with 2024
| Group | 2024 | 2025 |
|---|---|---|
| US MD, first attempt | 97% | 96% |
| US MD, repeat attempt | 73% | 77% |
| IMG, first attempt | 89% | 88% |
| IMG, repeat attempt | 64% | 63% |
The rates changed little, but the group definitions differ: Canadian graduates moved from the US group in 2024 to the non-US group in 2025. Both years used a passing score of 200.
Watch out for stale figures
Several widely read prep pages still quote older data, including first-attempt IMG pass rates in the mid-70s. The official 2024 and 2025 figures are 89% and 88%. If a page doesn't say which year its numbers come from, check them against USMLE's performance data page before you let them worry you.
Step 3 pass rate vs Step 3 passing score
These are different things, and people often mix them up.
The passing score is a threshold. For Step 3 it is 200 on USMLE's three-digit scale. It has applied to every exam taken on or after 1 January 2024, when it went up from 198.
The pass rate is an outcome. It is the share of examinees who scored 200 or more.
Why does the difference matter? The passing score is set by standard-setting panels, not by curving. There's no quota, so you're competing against the standard rather than against the people in your testing center. If everyone in your cohort is well prepared, everyone can pass.
How your score is reported
Step 3 results come as a three-digit score plus a pass or fail outcome. USMLE says results are typically available within four weeks, but advises allowing at least eight weeks before you rely on having one. If your score gates something, like a visa petition, a license application or a fellowship start date, plan around eight weeks.
The passing standard review: what's happening in November
On 2 September 2026, USMLE announced a scheduled review of the Step 3 passing standard. What we know:
- The USMLE Management Committee will review it at its November 2026 meeting.
- It will consider standard-setting panels, surveys of stakeholders such as licensing boards and program directors, trends in examinee performance, and score precision.
- If the Committee decides a change is appropriate, the new standard applies to everyone who tests on or after 1 January 2027.
- USMLE has said it will give advance notice of any change on its website and in the Bulletin of Information.
What we don't know is the outcome. The review could raise the standard, lower it or leave it alone. The last review, in late 2023, raised it by two points.
What should you do about it? If you test before the end of 2026, nothing changes. If you test in 2027 and your practice scores sit right at the line, the review is a reason to build a margin rather than aim at 200. That was sensible advice anyway.
Why repeat takers pass so much less often
The first-attempt and repeater rates differ:
- US MD graduates fell from 96% on a first attempt to 77% on a repeat.
- IMGs fell from 88% to 63%.
Selection likely contributes: people who fail once tend to be under more pressure the second time, often with less protected study time. But the gap is big enough to change how you should think about your first attempt. Sitting early "to see how it goes" is a poor plan when the repeater group has a lower observed pass rate; this comparison does not predict an individual outcome.
A failed attempt also costs you in ways that don't show up in the pass rate:
- Attempt limits. USMLE doesn't allow more than three attempts at the same Step within 12 months. After four unsuccessful attempts at any Step, you're ineligible for the whole USMLE sequence.
- State limits. Many state medical boards set their own cap on Step 3 attempts, often three, along with a deadline for completing all three Steps (commonly seven or ten years). Check FSMB's state-by-state table for the state where you plan to be licensed.
- Time. Another fee ($955 for Step 3 in 2026–27), another eligibility period, and possibly a delayed license or visa.
Where Step 3 points are lost
USMLE does not publish a section-by-section breakdown of failures, so be sceptical of anyone who claims to know the exact split. What we can say from the structure of the exam:
- Day 2 is long and comes after Day 1. Day 2 is 180 multiple-choice questions and then 13–14 computer-based case simulations (CCS), about nine hours in total.
- CCS is the one section you can't train with a question bank. A question bank shows you the answer choices. CCS gives you a blank order box, a running clock and a patient who may change as simulated time advances.
- CCS scores restraint as well as action. USMLE says you will be scored lower for an aggressive approach when observation is the standard of care. Habits from multiple-choice questions, such as ordering every test, cost points here.
How to stay well clear of 200
- Take a baseline before you start. Do USMLE's free sample questions and the six official CCS cases first, so you know where you stand rather than guessing.
- Aim for a margin, not the line. If your practice-test scores are close to passing, plan more study time, especially if you test in 2027.
- Give CCS its own block of practice. Do enough full, timed cases that your opening orders, monitoring and disposition become automatic, and review every domain you dropped.
- practice Day 2 when you're tired. Run cases in a row at the end of a shift, because that's what the CCS section feels like after hours of questions.
- Read how CCS is scored so you know what the six domains reward before you practice.
Practice the CCS portion
CCS Orbit brings 120+ interactive cases to iPhone at launch, with Learn and Exam modes, six-domain debriefs and review tools for recurring mistakes. Cases and debriefs work offline. Three cases are free; Orbit Plus offers a one-time US$34.99 60-day Exam Pass or US$59.99 lifetime access. Explore the app and get its launch email.
Key takeaways
The 2025 Step 3 pass rate was high on a first attempt (96% for US MD graduates and 88% for IMGs in 2025) and much less so on a second, where it drops to 77% and 63%. The passing score is 200 until at least the end of 2026, and a review in November could change it for anyone testing from 1 January 2027. The best response to both facts is the same: sit once, with a margin, and with real practice on CCS rather than just question banks.
Frequently asked questions
What is the Step 3 pass rate?
In 2025, 96% of US MD graduates passed Step 3 on their first attempt, as did 97% of DO graduates and 88% of international medical graduates. Across all examinees, including repeaters, about 92% passed, according to USMLE's published performance data.
What is the passing score for Step 3?
The Step 3 passing score is 200 on USMLE's three-digit scale. It has applied to all exams taken on or after 1 January 2024, when it went up from 198. USMLE reviews the standard at its November 2026 meeting, and any change would apply to exams taken from 1 January 2027.
Is the Step 3 pass rate lower for IMGs?
Yes, somewhat. In 2025, 88% of first-attempt international medical graduates passed, compared with 96% of first-attempt US MD graduates. For repeat takers the gap widens: 63% of IMG repeaters passed, compared with 77% of US MD repeaters.
How many times can you take Step 3?
USMLE allows no more than three attempts at the same Step within 12 months. A fourth attempt must be at least 12 months after the first and six months after the most recent. After four unsuccessful attempts at any Step, you're ineligible for further USMLE exams. Many state medical boards also set lower limits for Step 3 specifically.
How long does it take to get Step 3 results?
USMLE says Step 3 results are usually available within four weeks of your exam. It recommends allowing at least eight weeks if a deadline such as a license, visa or fellowship start depends on your result.