USMLE Gunner

Learn how to get top scores on the USMLE board exams

Author: Cam Medlin

Analysis of the USMLE Percentile Rankings

The USMLE recently released the percentile rankings (PDF) for scores on all three board exams taken between 2017 through 2019 (updated May 19, 2022). The USMLE does not publish percentile rankings with individual scores and only provides this kind of data to the public every 1-2 years.

In the tables below we have kept the data from previous reports, but the graphs and analysis are updated to reflect the latest data.

This information is very interesting because we can see the actual distribution of scores compared to a normalized distribution, or standard bell curve, that we typically assume when calculating a percentile rank for USMLE scores.

USMLE Step 1

Let us get right into the data. The following is the table showing the mean and standard deviation on USMLE Step 1 for US and Canadian students.

USMLE Step 1
Calendar Year Mean Standard Deviation
2011 226 22
2012 227 22
2013 228 21
2014 229 20
2015 229 20
2016 228 21
2017 229 20
2018 230 19
2019 232 19
2020 235 18
2021 231 19

The are some questions that we will try to answer with this information:

  1. What is the actual distribution of scores? Is it close to a normalized distribution or is it skewed?
  2. What do the different distributions really tell us?
  3. How accurate is our percentile calculator?
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Best Review Books for Step 2 & 3

The following review books and resources are the ones I found most helpful throughout medical school and are kept up to date (last revision January 2020). Reading these can help you learn the topics most likely to be tested on the USMLE Step 2 and 3 exams.
If you are looking for review books for Step 1 you can find them here.

Third and Fourth Years of Medical School – Clinicals and USMLE Step 2 and 3 Prep

After you have completed USMLE Step 1 successfully, Step 2 and 3 are not as difficult and do not typically require as much preparation. As always, I would focus primarily on practice questions in your preparation for the second and final USMLE exams. But, you will need something to study as you go through your clinicals, and the following books are great for that purpose.
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Best Review Books for USMLE Step 1

The following review books and resources are the ones I found most helpful throughout medical school and are kept up to date (last revision January 2020). Reading these can help you learn the topics most likely to be tested on the USMLE Step 1 exam.
If you are looking for USMLE Step 2 or 3 books you can find them here.
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How to Save Money During Medical School

The importance of borrowing the least amount of money possible for medical school cannot be overstated. With student loan interest rates over 6% and tuition for medical school increasing every year, it is not unrealistic to estimate that you will be paying back more than two times what you initially borrowed. Unfortunately, it appears that this trend of increasing debt will continue for the foreseeable future even though physician salaries have remained flat or even decreased in recent years. The last time the AAMC published data (PDF) on medical school debt was in 2017:

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Amazon Prime For Medical Students – Get 2 Day Shipping Free

I should have posted this a long time ago as it is so useful for medical students. Get an Amazon Prime membership and you will get free 2 day shipping – order something today and it is on your doorstep the day after tomorrow! I went ahead and signed up when I was in medical school since I was ordering books every couple months and Amazon was always much cheaper than the University book store.
I was reminded today by a friend that you can try out an Amazon Student account first and get the 2 day shipping on anything Amazon sells totally free for 6 months. After 6 months if you do not cancel your membership you will be charged $49/year for up to 4 years instead of the normal $99/year for the full membership.  I believe all you need is a .edu email address, and if you are looking at this blog you probably have at least 1 or 2 of those 😉 right?
The only major downside to the Student Membership is that Prime streaming videos and the Kindle loaning library are only available with a paid membership (not during the 6 month free period). Anyway, I thought many of you might like to try it out.

Example of a 4 Week Study Schedule for USMLE Step 1

Here is an example of a 4 week study schedule for USMLE Step 1. This is the study schedule I used to review for Step 1 and ended up doing very well. This study schedule uses First Aid and UWorld Step 1 Qbank. I recommend these review books to supplement your First Aid reading.
Notice that the primary focus in this example is doing practice questions, as they are the most effective study tool. The reading material is less important and you will be moving very quickly through First Aid.
This is assuming that all the First Aid content is a review for you as you should have already learned it in medical school. If you did not do well in your first two years of medical school, especially in pathology and physiology, you may need to spend some extra time in First Aid and the review books.
If you feel that 4 weeks is not enough time to prepare, anywhere from 4-6 weeks may be better for you. Simply adjust the number of questions and reading accordingly, but keep this basic schedule, doing at least 3-4 full practice tests using UWorld questions prior to your exam.
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Test Taking Strategies for the USMLE Board Exams

This is written specifically for the board exams (Step 1, 2, and 3) but you can apply these tips to most exams. Remember to get in the habit of applying these tips when using practice questions so that when you are taking the real exam all of these strategies come naturally.
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How to Best Use UWorld Qbank to Study

UWorld is a very good resource in studying for USMLE Step 1. The most powerful way to remember content is to be tested, to answer questions. The Q-bank enables you to do this with thousands of questions that are similar to those on the actual exam.
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Preparing for the USMLE Step 1 Board Exam

Preparing for USMLE Step 1 is daunting. You know it is the one of the most important test you will ever take, and it will determine what type of residency you will be able to get in to. All that is true, but do not worry too much – with the correct preparation you can do well on Step 1.
As I mentioned before, the most important part of preparing for Step 1 is learning as much as possible and doing well in the first 2 years of medical school. You should give yourself about 4-6 weeks of intense preparation. Any shorter will probably not be enough, and too much longer will make you burn out. Set up a reasonable study schedule before you start and try to stick to it. Here is an example of a good study schedule that I used when preparing for Step 1.
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The First Two Years of Medical School

The best way to ensure that you do well on Step 1 is to do well in your classes the first 2 years in medical school. Easier said than done, right? The following methods that I learned helped improve my performance considerably throughout the first 2 years of medical school, but you must find what works for you, and don’t get stuck in a rut studying a certain way if it is not working for you.
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