# USMLE Step 3 percentiles and passing score: the 2026 table, the 227 average and the 200 standard

_Updated 2026-10-15. Every figure is cited to the numbered sources at the end._

## What are the USMLE Step 3 passing score and percentiles?

Step 3's passing score is 200 for exams taken on or after January 1, 2024; it was 198 before.[1] USMLE's Management Committee is scheduled to review it at its November 2026 meeting, and any change would apply to examinees who take Step 3 on or after January 1, 2027.[9] On USMLE's current table, a 220 is the 31st percentile, 230 the 56th, 240 the 80th and 250 the 93rd among first-time takers from LCME-accredited schools in 2023 to 2025, whose mean was 227 (SD 15).[2]

## Step 3 scoring at a glance

**USMLE Step 3 passing standard, mean and measurement error**

| Item | Value | Detail |
| --- | ---: | --- |
| Minimum passing score | 200 | Effective January 1, 2024; announced December 14, 2023[1] |
| Previous passing score | 198 | January 1, 2020 to December 31, 2023[6][1] |
| Passing score before 2020 | 196 | Through December 31, 2019[6] |
| Score scale | 1 to 300 | Three-digit score with a pass or fail outcome[2] |
| Mean score, first-time takers from LCME-accredited schools | 227 | SD 15 in each of 2023, 2024 and 2025; the 2025 figure excludes Canadian schools[2] |
| Standard error of measurement | 5 | Standard error of difference 7, standard error of estimate 7[2] |
| Percentile norm group | N = 64,576 | First-time takers, January 1, 2023 to December 31, 2025[2] |
| Passing-standard review cycle | approximately every 4 years | USMLE reviews the data for each Step on that cycle and decides whether to change the standard[4] |
| Next scheduled review | November 2026 | USMLE's Management Committee is scheduled to review the Step 3 passing standard at its November 2026 meeting; if it changes the standard, the new one applies to examinees who take Step 3 on or after January 1, 2027[9] |
| Case simulations (CCS) | part of the score | Their weight in the score is no greater than their share of the testing time[5] |

_Each passing-score change applies by test date: 198 to Step 3 examinations beginning on or after January 1, 2020, and 200 to examinees testing on or after January 1, 2024.[6][1]_

## Step 3 percentiles: score to percentile table

**Step 3 three-digit score to percentile rank (USMLE norms, first-time takers 2023 to 2025)**

| Step 3 score | Percentile rank |
| --- | ---: |
| 265 and above | 100 |
| 260 | 99 |
| 255 | 97 |
| 250 | 93 |
| 245 | 88 |
| 240 | 80 |
| 235 | 69 |
| 230 | 56 |
| 225 | 43 |
| 220 | 31 |
| 215 | 20 |
| 210 | 12 |
| 205 | 7 |
| 200 | 4 |
| 195 | 2 |
| 190 | 1 |
| 185 and below | 0 |

_Percentage of first-time takers from LCME-accredited schools (January 2023 to December 2025, N = 64,576) who scored lower. USMLE publishes the table in 5-point steps; read a score in between as sitting between the neighbouring rows.[2]_

A Step 3 score is not comparable with a Step 2 CK score at the same number. The exams have different content, different norm groups and different passing standards, and USMLE warns against reading them side by side.[2] A 230, for instance, is the 56th percentile on Step 3 but the 9th on [Step 2 CK](https://www.stepgenie.app/usmle/step-2-ck-score-percentiles).

> **See where you stand before Step 3** A percentile shows where past examinees landed; practice questions show where you are now. Try a few without an account between shifts. A free account includes 5 Visual QBank questions a day in practice blocks you build by subject and organ system, plus 10 Pattern Mastery questions a day. [Try 3 questions without an account](https://dashboard.stepgenie.app/try?utm_source=stepgenie_site&utm_medium=site&utm_campaign=step-3-passing-score&utm_content=score-page-step) - [Create a free account](https://dashboard.stepgenie.app/sign-up?utm_source=stepgenie_site&utm_medium=site&utm_campaign=step-3-passing-score&utm_content=score-page-step)

## Step 3 percentiles and averages in earlier editions

Step 3 percentiles have barely moved between editions of the USMLE table. The edition updated August 18, 2022 used first-time takers from 2019 to 2021 (N = 58,671) and the edition updated July 24, 2024 used 2021 to 2023 (N = 64,967); both put a 230 at the 55th percentile and a 240 at the 79th, against the 56th and the 80th now.[8][7][2] The mean has been 227 or 228, with a standard deviation of 15, in every year from 2019 to 2025.[8][7][2] An older Step 3 score therefore reads almost the same on any of the three tables.

**Step 3 percentile rank in three editions of the USMLE norm table**

| Step 3 score | Takers 2019-2021 (August 2022 edition) | Takers 2021-2023 (July 2024 edition) | Takers 2023-2025 (current) |
| --- | ---: | ---: | ---: |
| 265 and above | 100 | 100 | 100 |
| 260 | 99 | 99 | 99 |
| 255 | 97 | 97 | 97 |
| 250 | 93 | 93 | 93 |
| 245 | 88 | 87 | 88 |
| 240 | 79 | 79 | 80 |
| 235 | 68 | 68 | 69 |
| 230 | 55 | 55 | 56 |
| 225 | 42 | 42 | 43 |
| 220 | 30 | 30 | 31 |
| 215 | 20 | 19 | 20 |
| 210 | 12 | 12 | 12 |
| 205 | 7 | 7 | 7 |
| 200 | 3 | 3 | 4 |
| 195 | 2 | 2 | 2 |
| 190 | 1 | 1 | 1 |
| 185 and below | 0 | 0 | 0 |

_First-time takers from LCME-accredited schools in each edition's calendar-year window: US and Canadian schools in the 2022 and 2024 editions, with Canadian schools removed from 2025 in the current one. Editions updated August 18, 2022,[8] July 24, 2024[7] and August 17, 2026.[2]_

**Step 3 mean and standard deviation by calendar year, first-time takers from LCME-accredited schools**

| Year | Mean | SD |
| --- | ---: | ---: |
| 2019 | 227 | 15 |
| 2020 | 228 | 15 |
| 2021 | 227 | 15 |
| 2022 | 228 | 15 |
| 2023 | 227 | 15 |
| 2024 | 227 | 15 |
| 2025 | 227 | 15 |

_2019 to 2021 from the August 2022 edition,[8] 2022 from the July 2024 edition[7] and 2023 to 2025 from the current edition, whose 2025 figure excludes Canadian schools.[2]_

## Step 3 pass rates

**USMLE Step 3 percent passing by examinee group and calendar year**

| Group | 2023 | 2024 | 2025 |
| --- | ---: | ---: | ---: |
| US MD schools, first-time takers | 97% (n = 21,703) | 97% (n = 21,213) | 96% (n = 21,589) |
| US MD schools, repeat examinees | 77% (n = 702) | 73% (n = 775) | 77% (n = 910) |
| US DO schools, first-time takers | 95% (n = 100) | 93% (n = 110) | 97% (n = 129) |
| Non-US schools, first-time takers | 92% (n = 11,500) | 89% (n = 12,134) | 88% (n = 12,480) |
| Non-US schools, repeat examinees | 64% (n = 1,264) | 64% (n = 1,835) | 63% (n = 1,824) |

_USMLE Performance Data. Through 2024 the US group includes Canadian schools; from 2025 they are counted with non-US schools. The US DO count is small because most DO residents take COMLEX Level 3 instead, so read that 97 percent with care.[3] Step 1 and Step 2 CK rates are on the [USMLE pass rate page](https://www.stepgenie.app/usmle/step-1-pass-rate)._

## Format, and when people take it

Step 3 is the last of the three examinations and the only one aimed at unsupervised practice. It runs over two test days. The first day (Foundations of Independent Practice) is multiple-choice questions; the second (Advanced Clinical Medicine) combines multiple-choice questions with computer-based case simulations, in which you manage a patient over simulated time. The exact item counts and timing for each day are set out in the current USMLE bulletin.

Most examinees are residents. Step 3 is required for an unrestricted medical license in the United States, so it is usually taken during or after the first year of residency, once the program's own requirements and the state licensing board's timing rules are known. Because it is a US-licensure examination, nearly all examinees are already in US training.

## Frequently asked questions

### What is the passing score for USMLE Step 3?

200 on the three-digit scale, for any examination taken on or after January 1, 2024. USMLE announced the change on December 14, 2023; the previous standard was 198. USMLE has also announced that its Management Committee is scheduled to review the Step 3 passing standard at its November 2026 meeting; if the Committee decides a change is appropriate, the new standard will apply to everyone who takes Step 3 on or after January 1, 2027, and USMLE will post the decision on its website.

### What was the Step 3 passing score before 2024?

198, for Step 3 examinations that began on or after January 1, 2020, until the standard rose to 200 for examinees testing on or after January 1, 2024. Before 2020 it was 196.

### What are the Step 3 percentiles?

On USMLE's current norm table, based on first-time takers from LCME-accredited schools who tested from January 1, 2023 to December 31, 2025 (N = 64,576), a 210 is the 12th percentile, 220 the 31st, 230 the 56th, 240 the 80th, 250 the 93rd and 260 the 99th. Every score of 265 or above is at the 100th percentile. Canadian schools were removed from the group starting with 2025.

### What is the average Step 3 score?

227, with a standard deviation of 15, for first-time takers from LCME-accredited medical schools in each of 2023, 2024 and 2025. On the current percentile table a 230 is the 56th percentile and a 240 the 80th.

### Have the Step 3 percentiles changed over time?

Very little. On the editions of the USMLE table updated August 18, 2022 (first-time takers 2019 to 2021) and July 24, 2024 (2021 to 2023), a 230 was the 55th percentile and a 240 the 79th; on the current table (2023 to 2025) they are the 56th and the 80th. The mean has been 227 or 228, with a standard deviation of 15, in every year from 2019 to 2025.

### How much do the case simulations count on Step 3?

USMLE's bulletin gives an upper bound rather than a fixed weight. It says your performance on the case simulations will affect your Step 3 score and could affect whether you pass or fail, and that their proportional contribution to the score is no greater than the proportion of testing time allotted to them.

### What percentage of people pass Step 3?

In 2025, 96 percent of first-time takers from US MD schools passed (21,589 tested), 88 percent of first-time takers from non-US schools (12,480 tested) and 77 percent of US MD repeat examinees. The US MD first-attempt rate was 97 percent in both 2023 and 2024.

### When do you take Step 3?

Usually during or after the first year of residency. It is the examination required for an unrestricted medical license in the United States, and program and state licensing rules decide the earliest sensible date.

### Is a Step 3 score comparable to a Step 2 CK score?

No. The two examinations have different content, norm groups and passing standards (200 for Step 3, 218 for Step 2 CK), and USMLE says the scores should not be compared at the same number. Step 3 percentiles run higher at a given score: a 230 is about the 56th percentile on Step 3 but the 9th on Step 2 CK.

## Related

- [Step 2 CK score percentiles](https://www.stepgenie.app/usmle/step-2-ck-score-percentiles) -- The August 2026 percentile table, the 251 average, the 218 passing score, earlier editions, and Step 1 and Step 3 percentiles.
- [USMLE Step 1 passing score](https://www.stepgenie.app/usmle/step-1-passing-score) -- 196 on a scale you never see, what the pass/fail report shows, the last Step 1 percentile table and what to do after a fail.
- [USMLE Step 1 pass rate](https://www.stepgenie.app/usmle/step-1-pass-rate) -- Pass rates for every year since 2019 by school type, repeat examinees, and the latest Step 2 CK and Step 3 rates.
- [Free USMLE self-assessment](https://www.stepgenie.app/self-assessment) -- A timed, exam-format form for Step 1 or Step 2 with a system-by-system readout.

## Sources

1. USMLE, Change to the Step 3 passing standard begins January 1, 2024 (announced December 14, 2023): https://www.usmle.org/change-step-3-passing-standard-begins-january-1-2024
2. USMLE Step Examination Score Interpretation Guidelines (PDF) (updated August 17, 2026): https://www.usmle.org/sites/default/files/2022-05/USMLE%20Step%20Examination%20Score%20Interpretation%20Guidelines_5_24_22_0.pdf
3. USMLE Performance Data (accessed October 14, 2026): https://www.usmle.org/performance-data
4. USMLE, Examination Results and Scoring (accessed October 14, 2026): https://www.usmle.org/scores-transcripts/examination-results-and-scoring
5. USMLE Bulletin of Information, Scoring and Score Reporting (accessed October 14, 2026): https://www.usmle.org/bulletin-information/scoring-and-score-reporting
6. USMLE, Change in minimum passing score for Step 3: 196 to 198 from January 1, 2020 (archived copy) (posted December 9, 2019; captured January 2, 2020): https://web.archive.org/web/20200102201004/https://www.usmle.org/announcements/?ContentId=259
7. USMLE Score Interpretation Guidelines, edition updated July 24, 2024 (archived copy) (captured September 14, 2024): https://web.archive.org/web/20240914130423/https://www.usmle.org/sites/default/files/2022-05/USMLE%20Step%20Examination%20Score%20Interpretation%20Guidelines_5_24_22_0.pdf
8. USMLE Score Interpretation Guidelines, edition updated August 18, 2022, the last with a Step 1 norm table (archived copy) (captured October 8, 2022): https://web.archive.org/web/20221008032229/https://www.usmle.org/sites/default/files/2022-05/USMLE%20Step%20Examination%20Score%20Interpretation%20Guidelines_5_24_22_0.pdf
9. USMLE, Scheduled Review of USMLE Step 3 Passing Standard (posted September 2, 2026): https://www.usmle.org/scheduled-review-usmle-step-3-passing-standard-0

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