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The Score You Should Aim For on the USMLE Step 1

One of the first things that crosses a medical student’s mind who is beginning study preparations for a board examination, is what is my goal score? What score do I want? What score do I need, and what score is attainable? Determining a goal score is the first step in study preparation. If you don’t know the score you want, how can you start to study? Here’s what I’ve learned about determining a goal score:

A goal score should not be thought of as a single number, rather it is a range between the score that you need in order to remain competitive in your chosen specialty, and the highest score that you can attain.

When I settled on my goal USMLE Step 1 score in late 2013, I knew I wanted to be an orthopaedic surgeon, and in order to maximize my potential of matching, I knew I needed to at least match the score of the averaged matched orthopaedic applicant (245 per NRMP’s Charting Outcomes in the Match). So 245 became the lower limit of my range. Anything less than that, and I would not only be upset, but also be at a disadvantage compared to the rest of the prospective orthopaedic applicants. The lower limit is the easy part – this is the score that you need, but any lower and you’ll wish you never took the exam.

I knew that I needed at least a 245 on the USMLE Step 1, but what would be the upper limit of my goal range — what would be my highest attainable score?

When you think about this number, think of the score that will you make you pop bottles of champagne on rounds with your attending, cause  you to jump and down with joy, and sing “We Are the Champions” at the top of your lungs. Sounds great, right? This is the score you truly want. Your high score depends on two things:

  1. how able you are to cram a fire hose of information into your head in a short amount of time


  1. how motivated you are to do it.

For me, this was easy. My girlfriend (now fiancée) bet me that if I scored at least a 265 on Step 1, she would clean my house for a month. A whole month! Are you kidding me? So my high score was set and my goal score range was 245-265. With a 245, I would be happy and confident in my abilities to match. With a 265, I knew I would match (>99% of orthopaedic applicants with a Step 1 score greater than 260 matched in 2014), and have a clean house to boot.

I know not everyone reading this blog has the luxury of a significant other willing to clean his or her house for blowing Step 1 out of the water, but every specialty has a 99% match rate with a certain Step 1 score. This is your upper goal score. Although this goal score range will likely fluctuate throughout your dedicated USMLE study period as motivation dwindles and confidence falls with the shear amount of material you’ll find you don’t know or forgot, if you can stick to a firm goal score range, you’ll find success. As a wise man once said, “Nothing stills an inquiring mind more than the conviction that it knows.” Set your goal score range, stick with it, and find success.