USMLE Pass Rate by Country 2024

The USMLE, better known as the United States Medical Licensing Examination, is a test that is used to award licenses to future physicians. Applicants must complete three steps in this examination before they are able to earn a medical licensure. The test measures a potential physician's ability to apply and demonstrate all the skills they have learned throughout the course of their education journey. Naturally, it is a complex exam process, and not everyone passes. This article explores the pass rates of USMLE examinees and which countries tend to be more successful with this test.

Overall, the percentage of passing exams often depends on the examinees’ education levels as well as how many times they have taken the test. The test is taken in three steps, and the stats associated with each of those steps vary. For example, in 2023, 90% of MD degree graduates from US and Canadian schools passed Step 1 of the USMLE exam. This was a decrease, however, from the previous year’s rate of 91%. The same year, only 86% of those with a DO degree passed this portion of the exam, as compared to 89% in 2022.

As far as Step 2: CK Administrations, the MD degree recipients who took this part for the 1st time had the highest pass rate. 98% of MD degree graduates from US and Canadian schools passed on the first try in 2023, which was the same rate as in 2022. 96% of those with a DO degree passed on the first try as compared to 97% in 2022.

The final step in the USMLE exam is Step 3: Administrations. Overall, 97% of those with an MD Degree from a US or Canadian school passed the exam. 97% also passed on the first try. Those who took this step again were only successful 77% of the time. Out of those with a DO degree, 95% overall and first-time testers successfully passed. 96% of testers from US and Canadian schools passed the year before.

Test takers from non-US and Canadian Schools typically do not do as well on this test, especially on Step 1. Only 72% of non-US and non-Canadian examinees passed Step 1 on the first try in 2023. That number dropped to 47% for those who took the test a second time.

Of the examinees from Non-US/Canadian schools who took Step 2 in 2023, 88% passed on the first try and only 60% of repeaters passed. And as for Step 3, the rate was 92% among the first timers and only 64% for repeat examinees.

Curiously, given the normally lower passing rates among non-US and non-Canadian examinees, the country of Nepal produced the highest pass rates of all the countries in the world in 2021-23. For Step 1 in 2022, for example, the average score of examinees testing in the Nepal test center was 240 while no other test center in the world had an average examinee score above 227. Unfortunately, these results had an unconventional explanation.

In early 2023, the National Board of Medical Examiners discovered organized cheating related to USMLE testing in Nepal, where many examinees had access to live exam questions via such online platforms as Telegram. The NBME conducted a statistical analysis which revealed irregular score patterns, with Nepal's test center showing highly improbable answer similarities. Consequently, the NBME invalidated the scores of 832 people associated with Nepal from 2021 to 2023 to maintain the exam’s integrity. The USMLE test center in Nepal was closed in early 2024.

China appears to produce the greatest number of examinees who pass the test, largely due to the sheer numbers of test takers internationally. It is reasonable that China would have the greatest number of people passing the test. One study revealed that, in 2017, out of 547 participants, 65% passed Step 1, in just one province of Hainan. China has 12 other provinces conducting the USMLE, so the large number of passers makes sense due to the multitude of examinees from this country.