USMLE Gunner

Learn how to get top scores on the USMLE board exams

Category: Step 1

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 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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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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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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