Statistics
USMLE Statistics 2026
Pass rates for Step 1, Step 2 CK and Step 3, this year's residency Match rates, and the 2026 NARQB Missed-Topics Index: which subjects students miss most, measured from 45,879 practice answers by 838 students.
Last updated November 9, 2026. Every figure names its source.
At a glance
Key USMLE statistics for 2026
- 93% of first-time takers from US MD programs passed USMLE Step 1 in 2025, and 75% of first-time takers from non-US schools did (USMLE, 2025).
- 98% of first-time takers from US MD programs passed USMLE Step 2 CK (USMLE, July 2024 to June 2025).
- 93.5% of US MD seniors matched to a first-year residency position in the 2026 Main Residency Match, against 56.4% of non-US citizen international medical graduates (NRMP, March 2026).
- The 2026 NARQB Missed-Topics Index found that students answered 39.5% of Step 1 anatomy questions correctly, the lowest of 11 Step 1 subjects, based on 1,287 answers from 197 students.
- The 2026 NARQB Missed-Topics Index found that gastroenterology & hepatology is the most-missed Step 2 CK specialty, with 53.4% of 1,045 answers correct.
- The 2026 NARQB Missed-Topics Index found that students who were re-tested on a concept they had missed answered correctly 49.1% of the time, based on 7,610 review answers.
Pass rates
USMLE pass rates by exam
- 29,870 examinations of USMLE Step 1 were taken by students and graduates of US MD and DO programs, and 91% were passed (USMLE, 2025).
- 27,746 examinations of USMLE Step 2 CK were taken by students and graduates of US MD and DO programs, and 97% were passed (USMLE, July 2024 to June 2025).
- 22,630 examinations of USMLE Step 3 were taken by students and graduates of US MD and DO programs, and 96% were passed (USMLE, 2025).
- Repeat takers pass far less often: 71% of Step 1 repeat attempts from US MD programs passed in 2025, and 54% of repeat attempts from non-US schools (USMLE).
| Examinees | Number tested | Passed |
|---|---|---|
| US MD, first-time takers | 23,028 | 93% |
| US MD, repeat takers | 2,098 | 71% |
| US DO, first-time takers | 4,623 | 89% |
| US MD and DO, all takers | 29,870 | 91% |
| Non-US schools, first-time takers | 22,066 | 75% |
| Non-US schools, repeat takers | 3,594 | 54% |
| Non-US schools, all takers | 25,660 | 72% |
| Examinees | Number tested | Passed |
|---|---|---|
| US MD, first-time takers | 22,249 | 98% |
| US MD, repeat takers | 440 | 70% |
| US DO, first-time takers | 5,025 | 96% |
| US MD and DO, all takers | 27,746 | 97% |
| Non-US schools, first-time takers | 16,186 | 90% |
| Non-US schools, repeat takers | 1,762 | 64% |
| Non-US schools, all takers | 17,948 | 87% |
| Examinees | Number tested | Passed |
|---|---|---|
| US MD, first-time takers | 21,589 | 96% |
| US MD, repeat takers | 910 | 77% |
| US DO, first-time takers | 129 | 97% |
| US MD and DO, all takers | 22,630 | 96% |
| Non-US schools, first-time takers | 12,480 | 88% |
| Non-US schools, repeat takers | 1,824 | 63% |
| Non-US schools, all takers | 14,304 | 85% |
| Year | US MD programs | Non-US schools |
|---|---|---|
| 2021 | 96% | 82% |
| 2022 | 93% | 74% |
| 2023 | 92% | 72% |
| 2024 | 91% | 73% |
| 2025 | 93% | 75% |
- The Step 1 first-time pass rate for US MD programs fell from 96% in 2021 to 91% in 2024, then rose to 93% in 2025 (USMLE). Step 1 has been reported as pass or fail since January 2022.
Source: USMLE Performance Data, United States Medical Licensing Examination (FSMB and NBME), retrieved November 10, 2026. Repeat-taker counts are examinations given, not people. Through 2024, USMLE counted Canadian schools with US schools; from 2025 it counts them with non-US schools.
Residency
2026 residency Match statistics
- 53,373 applicants registered for the 2026 Main Residency Match, and 48,050 submitted a rank order list (NRMP, March 2026).
- 38,354 applicants matched to a first-year (PGY-1) position in the 2026 Main Residency Match (NRMP, March 2026).
- Programs offered 44,344 positions in the 2026 Main Residency Match, and 93.5% (41,482) were filled when the algorithm ran (NRMP, March 2026).
| Applicants | Active applicants | Matched to PGY-1 |
|---|---|---|
| US MD seniors | 20,934 | 93.5% |
| US DO seniors | 8,503 | 93.2% |
| US citizen international medical graduates | 4,210 | 70% |
| Non-US citizen international medical graduates | 11,944 | 56.4% |
Source: Results of the 2026 Main Residency Match, National Resident Matching Program (NRMP), March 2026, retrieved November 10, 2026.
Original research
The 2026 NARQB Missed-Topics Index
NARQB is a question bank for the USMLE and ABIM exams. The index reports how often students answer its board-style questions correctly, so it shows where students struggle, not how they score on test day.
- The 2026 NARQB Missed-Topics Index covers 45,879 answers from 838 students, recorded between July 6, 2026 and November 9, 2026.
- The 2026 NARQB Missed-Topics Index found that students answered 57.4% of USMLE Step 2 CK practice questions correctly, based on 20,388 answers from 268 students.
- The 2026 NARQB Missed-Topics Index found that students answered 47.1% of USMLE Step 1 practice questions correctly, based on 17,537 answers from 423 students.
- The 2026 NARQB Missed-Topics Index found that students answered 58.2% of USMLE Step 3 practice questions correctly, based on 6,863 answers from 120 students.
- The 2026 NARQB Missed-Topics Index found that students answered 62.8% of ABIM Internal Medicine practice questions correctly, based on 1,091 answers from 36 students.
Hardest USMLE Step 1 subjects
- The 2026 NARQB Missed-Topics Index found that anatomy, genetics and biochemistry are the three most-missed Step 1 subjects, at 39.5%, 41.3% and 43.0% of answers correct.
- The 2026 NARQB Missed-Topics Index found that behavioral science is the least-missed Step 1 subject, at 62.1% of answers correct.
| Subject | Answered correctly | Answers | Students |
|---|---|---|---|
| Anatomy | 39.5% | 1,287 | 197 |
| Genetics | 41.3% | 455 | 99 |
| Biochemistry | 43.0% | 1,754 | 220 |
| Physiology | 44.5% | 1,829 | 246 |
| Pharmacology | 45.8% | 2,960 | 281 |
| Microbiology | 46.8% | 1,148 | 185 |
| Pathology | 47.7% | 4,063 | 342 |
| Immunology | 47.8% | 939 | 162 |
| Embryology | 49.2% | 531 | 114 |
| Biostatistics, epidemiology & evidence-based medicine | 53.8% | 1,345 | 159 |
| Behavioral Science | 62.1% | 1,128 | 157 |
USMLE Step 1 by organ system
- The 2026 NARQB Missed-Topics Index found that renal & urinary is the most-missed Step 1 organ system, at 43.4% of 959 answers correct.
| Organ system | Answered correctly | Answers | Students |
|---|---|---|---|
| Renal & urinary | 43.4% | 959 | 191 |
| General principles | 44.3% | 2,331 | 255 |
| Nervous system & special senses | 44.3% | 2,294 | 268 |
| Blood & lymphoreticular | 44.4% | 1,058 | 181 |
| Respiratory | 45.2% | 1,077 | 167 |
| Endocrine | 45.4% | 871 | 160 |
| Gastrointestinal | 46.2% | 1,491 | 222 |
| Immune system | 46.3% | 920 | 165 |
| Skin & subcutaneous tissue | 46.4% | 442 | 104 |
| Cardiovascular | 46.8% | 1,503 | 232 |
| Reproductive & breast | 46.8% | 1,105 | 193 |
| Musculoskeletal | 48.3% | 648 | 133 |
Hardest USMLE Step 2 CK specialties
- The 2026 NARQB Missed-Topics Index found that gastroenterology & hepatology, pediatrics & adolescent medicine and emergency medicine are the three most-missed Step 2 CK specialties, at 53.4%, 53.7% and 54.7% of answers correct.
- The 2026 NARQB Missed-Topics Index found that psychiatry & behavioral health is the least-missed Step 2 CK specialty, at 64.1% of answers correct.
| Specialty | Answered correctly | Answers | Students |
|---|---|---|---|
| Gastroenterology & hepatology | 53.4% | 1,045 | 99 |
| Pediatrics & adolescent medicine | 53.7% | 2,110 | 123 |
| Emergency medicine | 54.7% | 483 | 62 |
| OB/GYN | 55.1% | 1,790 | 128 |
| Cardiology & vascular medicine | 55.2% | 1,868 | 137 |
| Dermatology | 56.1% | 481 | 69 |
| Endocrinology, diabetes & metabolism | 56.5% | 1,245 | 118 |
| Preventive medicine, public health & occupational/environmental medicine | 56.6% | 316 | 61 |
| Infectious diseases | 56.8% | 1,945 | 131 |
| Pulmonology | 57.0% | 700 | 81 |
| Rheumatology, allergy & immunology | 57.1% | 562 | 72 |
| Oncology | 57.9% | 430 | 69 |
| Ethics, law, communication, patient safety & health systems | 58.1% | 453 | 60 |
| Surgery / trauma / perioperative care | 58.4% | 746 | 93 |
| Neurology | 60.0% | 1,021 | 90 |
| Hematology | 60.8% | 487 | 76 |
| Nephrology | 60.9% | 585 | 88 |
| Musculoskeletal / orthopedics / sports medicine | 61.7% | 626 | 76 |
| Biostatistics, epidemiology & evidence-based medicine | 62.2% | 886 | 75 |
| Psychiatry & behavioral health | 64.1% | 1,358 | 116 |
Hardest USMLE Step 3 specialties
- The 2026 NARQB Missed-Topics Index found that endocrinology, diabetes & metabolism is the most-missed Step 3 specialty, at 53.3% of 458 answers correct.
| Specialty | Answered correctly | Answers | Students |
|---|---|---|---|
| Endocrinology, diabetes & metabolism | 53.3% | 458 | 57 |
| Infectious diseases | 55.3% | 438 | 58 |
| Gastroenterology & hepatology | 56.5% | 549 | 42 |
| Pediatrics & adolescent medicine | 57.1% | 308 | 53 |
| OB/GYN | 57.7% | 532 | 51 |
| Cardiology & vascular medicine | 57.9% | 722 | 54 |
| Biostatistics, epidemiology & evidence-based medicine | 58.6% | 671 | 55 |
| Ethics, law, communication, patient safety & health systems | 72.4% | 555 | 45 |
How students score on practice questions
- The 2026 NARQB Missed-Topics Index found that the median student answered 53.2% of practice questions correctly, and the middle half of students scored between 47.0% and 58.8%, among 183 students with at least 50 answers.
- The 2026 NARQB Missed-Topics Index found that students answered 55.1% of questions with an image correctly and 53.6% of questions without one, based on 3,574 and 42,305 answers.
- The 2026 NARQB Missed-Topics Index found that students re-tested on a concept they had missed answered 49.1% of those review questions correctly, based on 7,610 answers from 247 students.
Methodology
How the index is measured
- Every figure is the share of answered questions that were answered correctly. Each student answers a question once, in practice sets on the NARQB website and apps, between July 6, 2026 and November 9, 2026.
- NARQB is adaptive: it chooses each student's next questions from their earlier answers. Students do not all see the same questions, so these percentages are not comparable to scores on a fixed set of questions and should not be read as predicted exam scores.
- Students are people who chose to practice on NARQB. They are not a random sample of USMLE examinees.
- A subject or organ system is listed only with at least 300 answers from at least 40 students. ABIM subjects and several Step 3 specialties fall below that and are left out.
- 4 accounts that answered more than 1,000 questions in one day were treated as automated and excluded.
- Review questions are counted separately from first answers. Only totals are published; no individual's answers are.
Citation
How to cite these statistics
You may quote any figure on this page with credit. For NARQB's own figures, cite:
NARQB. 2026 NARQB Missed-Topics Index. Updated November 9, 2026. https://www.narqb.com/usmle-statistics
For pass rates and Match rates, cite USMLE and NRMP, who published them. Questions about the data: contact us.
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