The USMLE Step exams are one of the most important and anxiety-inducing aspects of medical training. Step 1 is an exam that most medical students take in their second or third year of school, which tests basic science knowledge relevant to the practice of medicine. Students generally take Step 2 during the third or fourth year of medical school. Step 2 focuses more on clinical science applicants. Step 3 is the final exam of the USMLE series. It is usually taken during residency training and tests an examinee’s application of clinical knowledge for the unsupervised practice of medicine. Each of these exams is important; ultimately, you must pass all three to become a licensed physician. A common question for many medical students is which of these three exams is the hardest. Unfortunately, the answer to this question may be different depending on whom you ask.
Is USMLE Step 1 the Hardest Even Though it is Pass/Fail?
Traditionally, Step 1 has been thought of as both the most difficult and most important USMLE Step exam. There are several reasons for this. Firstly, this exam is the first in the series, and students taking it will have had less experience with the types of questions that the USMLE asks. They also may have less test-taking stamina, which is important for the 8-hour examination. Another reason is that this exam tests basic science knowledge, including subjects like biochemistry which many students struggle with. Scoring well on Step 1 also previously held great importance for many students, as it was a significant consideration of residency programs when evaluating applicants. Achieving a top score on Step 1 was one way to distinguish your application for competitive residency spots.
However, this is no longer the case with Step 1 becoming pass/fail in January 2022. Step 2 may become more important in the residency application process with this shift. (see our article “How Will the USMLE Step 1 Pass Fail System Affect your Step 2 Score?” for more on this topic). It is important to keep in mind that this switch to pass/fail could be a double-edged sword. On the one hand, it has taken the pressure off young medical school students to achieve a high score on their first pass of USMLE Step 1 so early in their medical careers. On the other hand, it may have led to a more lax attitude around Step 1 studying, which may put more students in danger of failing the exam.
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Many students think of Step 2 as an easier exam than Step 1. This may be because they have already had experience with USMLE testing. Maybe they have identified successful study methods and know how to create an ideal study schedule for their dedicated study time. It could also be that this exam tests clinical knowledge, which doctors often learn through experiences on the wards and thus may be easier to recall during the stress of test day. While Step 3 also tests clinical knowledge, the majority of doctors take it during residency training. Examinees often do not have the same kind of dedicated time for preparation that they have for Step 1 and Step 2. This can lead to this exam being perceived as more difficult. Additionally, USMLE Step 3 is a two-day exam, meaning it is almost twice as long as both Step 1 and 2. Test-taking fatigue can be a huge factor in an examinee’s performance.
Which USMLE Exam is Hardest?
So which USMLE step exam is hardest? While many factors might influence the answer to this question, we can look to the data to give us some insight. According to the 2021 Performance Data from the USMLE, Step 1 had the lowest passing rate, with 95% of US/Canadian students passing and 77% of examinees from non-US/Canadian schools passing. Step 3 had a slightly better pass rate, with 97% of US/Canadian examinees and 87% of non-US/Canadian examinees passing. Step 2 had the highest passing rates for both US/Canadian students (98%) and non-US/Canadian test takers (88%). This data suggests that Step 1 was the hardest exam to pass.
No matter which step you are preparing for, the USMLE exams are challenging. It is important to plan your study schedule, start early, and do lots of practice questions and exams. If you are struggling with any aspect of your preparation, a tutor can help get you on track to succeed. Contact Elite Medical Prep to schedule a complimentary consultation today!
FAQs
The difficulty level of each step of the USMLE exam is subjective and varies from person to person. However, many students consider Step 1 to be the hardest due to the wide range of topics covered and the depth of knowledge required.
Is Step 2 or Step 3 harder? ›
Step 3 is easier because the questions are similar to the stuff you do all day at work already. also, less emphasis on primary level factoid questions - more emphasis on broad mgmt plans. also, most people finish day 1 in 5-6 hours and day 2 in 4-5 hours.
Is Step 2 much harder than Step 1? ›
Step 1 tests a broad range of basic science knowledge and Step 2 focuses on a smaller range of content that directly applies to practicing medicine. For some, passing Step 1 may take longer than Step 2, and vice versa.
What is the most difficult exam in the US? ›
California Bar Exam (USA)
The California Bar Exam is among the state bar tests that any individual, who wants to practice law in California state, must take. The exam is familiar to all by now, especially its high level of difficulty in which only 50% of the candidates would pass.
Which USMLE step is the easiest? ›
USMLE Step 1, which focuses on the basic sciences and medical knowledge, is generally perceived as more difficult than Step 2. But if you did well in your classes during your first two years of medical school, you are likely to pass Step 1 without a problem.
Is it common to fail Step 1? ›
So, what happens if you fail USMLE Step 1? In 2022, 91% of students passed Step 1, leaving nearly 10%, 1489 students, to retake the test. While failing Step 1 certainly isn't ideal, it could happen, but it doesn't have to kill your hopes of becoming a doctor or matching into your ideal residency program.
Do most people pass Step 2? ›
The Step 2 pass rate has been well over 90% for test-takers from MD and DO schools in recent years, according to the USMLE. But if you fail, USMLE policy allows up to four total attempts to pass any of the Step exams. As far as the impact of that failure on your residency prospects, a Step 2 fail is not a deal-breaker.
Does Step 2 matter for residency? ›
To ensure you secure residency interviews, aim for a Step 2 CK score above 255. Similarly, for Step 3, target a score above 235. While Step 1 is now pass/fail, scoring in or above the 75th percentile on Step 2 CK and Step 3 can boost your chances of landing your preferred residency spot.
Is Step 1 harder than MCAT? ›
In terms of exam difficulty, the MCAT is considered easier compared to the USMLE Step 1. It is because the MCAT only tests the basic science principles and skills of the individual if one fits the requirement to proceed or enter med school.
Which is the 1 toughest exam? ›
This article will take you through the list of the world's toughest exams.
- Union Public Service Commission (UPSC) ...
- Mensa. ...
- Graduate Record Examination (GRE) ...
- CFA (Chartered Financial Analyst) ...
- GATE. ...
- CCIE (Cisco Certified Internetworking Expert) ...
- Exam for the Master Sommelier Diploma. ...
- All Souls Prize Fellowship Exam.
2. IIT-JEE. The IIT-JEE or JEE Advanced exam is ranked 2nd toughest exam in the world and the first most difficult exam in India. IIT-JEE is the national-level exam and the only entrance exam for Engineering programs at the Indian Institutes of Technology (IITs).
What is the hardest medical exam to pass? ›
The United States Medical Licensing Examination (USMLE) takes the top spot as the most challenging exam in the US, with an average preparation time ranging from 200 to 400 hours for each of its three steps.
Is Step 1 harder or easier than UWorld? ›
The frequently updated content ensures you learn and master the most relevant material that helps confront your individual USMLE Step 1 strengths and weaknesses. UWorld may be harder than Step 1, with some questions above the actual test's difficulty level.
Which step is the hardest? ›
The first step is always the hardest. It takes guts, determination, and confidence to make that move, and most people don't have the right stuff. The good news is, once you have taken that first step and built up your confidence, the second and third steps become so much easier.
Is Step 3 tough? ›
Is the USMLE Step 3 Hard? Yes, Step 3 of the USMLE is longer than both previous exams (two days in length) and consists of 412 multiple-choice questions as well as 13 case simulation questions. However, you shouldn't have a hard time with the exam if you are well-prepared.
Are they making Step 1 harder? ›
The Step 1 pass rate is decreasing. Don't become part of this unwelcome trend! Committing to a study plan will be key to passing this exam. Start with a quality question bank, layer in supplemental resources like textbooks and videos, and finally take and pass multiple practice tests before sitting for the real exam.
