The overwhelming majority of resident physicians in the U.S. successfully passed their licensing exams on the first try, but those who selected into several specialties—such as neurosurgery, thoracic surgery and vascular surgery—demonstrated 100% pass rates on Steps 1 and 2 of United States Medical Licensing Examination (USMLE) series of exams, which may indicate a particularly competitive environment for selection.
The data a report from the Association of American Medical Colleges (AAMC) featuring from all first-attempt pass rates for Steps 1 and 2 of the USMLE and levels 1 and 2 of the Comprehensive Osteopathic Medical Licensing Examination of the United States (COMLEX-USA) among 2024–2025 first-year residents in Accreditation Council for Graduate Medical Education-accredited programs. The information in the report was culled from the answers on the GME Track Resident Roster Certification, which the AAMC said has a response rate of roughly 95% each year.
USMLE, a three-step exam administered by the National Board of Medical Examiners, is required for allopathic medical licensing in the U.S., and is required for graduates of MD-granting medical schools. COMLEX-USA is required for graduates of osteopathic medical schools, but most DOs opt to take both the USMLE and COMLEX-USA exams due to the role that the USMLE plays in residency selection.
Step 1 of the USMLE is typically taken in the second year of medical school after the pre-clerkship curriculum. Step 2 is usually taken after core clinical rotations. Step 3 is most often taken after the first year of residency training.
The required score to pass Step 2 CK rose by four points, to 218, in July 2025. Prior to the scoring change, 98% of those from MD-granting medical schools and 96% from DO-granting schools passed Step 2 on their first try. According to USMLE data, the average score on the Step 2 CK was 249 in the 2023–2024 testing cycle.
Primary care specialties such as family medicine and pediatrics also had strong first-attempt pass rates, though they were lower than the specialties previously listed. COMLEX-USA pass rates were similarly high in most physician specialties, with minor variations, depending on specialty.
Internal medicine, which had the highest number of first-year residents in the report who had taken the USMLE, at 9,076, had a first-attempt pass rate of 96.2% for Step 1 and a 97.4% first-attempt pass rate for Step 2. Of the 1,971 first-year residents in internal medicine in the report who had taken the COMLEX-USA exam, 93.5% had passed Level 1 on their first attempt and 94.6% had done so for Level 2.
The next-highest number of first-year residents in the report who had taken the USMLE, 3,667, was seen in family medicine, with 88.4% of them passing Step 1 of the USMLE and 90.6% of them passing Step 2 on their first attempt. For COMLEX-USA, 85.9% of the 1,688 first-year family medicine residents in the report who had taken that exam passed Level 1 on their first attempt, and 86.7% had passed Level 2 on their first attempt.
Dig deeper into the data in the following story to learn:
- Which physician specialties in the report saw 100% of residents pass the USMLE Step 1 on their first attempt.
- The specialties in which all residents in the report passed Step 2 on the first attempt.
- The specialty topics that most often feature in questions on the USMLE.
- Which specialties in the report had the highest average Step 2 scores on the USMLE.
