The USMLE program recommends a minimum passing level for each Step. Medical licensing authorities may accept the recommended pass/fail result, or they may establish their own minimum passing requirements. The recommended requirements to pass USMLE Step 1, Step 2 Clinical Knowledge, and Step 3 were originally identified in the early 1990s, and the Step 2 Clinical Skills standards were first identified in November 2004.

The USMLE Step Committees are responsible for the design and development of the Step examinations, as well as establishing and monitoring standards. These committees are made up of physicians and scientists who bring educational, licensing, and practice perspectives to this process. Every three to four years a Step Committee is asked to complete an in-depth review of standards.

The Step 1 Committee is scheduled to assess the minimum passing score for the USMLE Step 1 examination at its meeting on December 7-8, 2009. In its review of the minimum passing score, the Step 1 Committee will consider information from multiple sources, including: 1) results of content-based standard setting exercises conducted with three independent groups of physicians in 2009; 2) results of surveys of various groups (e.g., state licensing representatives, medical school faculty, samples of examinees) concerning the appropriateness of current pass/fail standards for Step examinations; 3) trends in examinee performance; and 4) score precision and its effect on the pass/fail decision.

The decision of the Step 1 Committee will be posted at the USMLE website. If the Committee determines that a change is appropriate, the new recommended minimum passing score will become effective for all examinees who begin their Step 1 examination on or after January 1, 2010.