SI MedExams is an independent, unofficial hub for the exams that shape a medical career: the three USMLE Steps, the NBME shelf exams taken during clerkships, how they fit across the years, and the general prep principles that carry over from one to the next.
Unofficial site. SI MedExams is independent and is not affiliated with, endorsed by, or connected to the NBME, USMLE, LCME, NRMP, or AAMC. National pass-rate figures below are from USMLE Performance Data (via NBME), with authoritative tables at usmle.org → Performance Data. Always confirm current policies at the official sources.
The exams
From the first licensing hurdle to the final one, and the subject exams in between. Each card below is a doorway — the deep-dive sites go further.
The first national licensing exam, covering the basic sciences of the preclinical years. It has been pass/fail since January 2022, and the passing standard rose from 194 to 196. The pass/fail change roughly doubled the failure rate: US MD first-time pass went from 95% in 2021 to 89% in 2024. A fail still carries weight — 77% of residency program directors consider failed Step attempts when choosing whom to interview (2024 NRMP survey).
Step 1 deep-dive →Clinical Knowledge — the scored exam that carries the most weight in residency selection since Step 1 went pass/fail. National first-time pass rates are high (98% US MD, 2022–2024) with a mean score of 249 (2023–24), but the passing standard rose to 218 in July 2025, and repeat-taker pass rates fall to roughly 74% MD / 72% DO.
Step 2 CK deep-dive →The final licensing exam, taken during residency, testing the ability to apply clinical knowledge and manage patients independently. US MD first-time pass runs about 97% (2023). Most residents sit it early in training, when the knowledge from the earlier Steps is freshest.
All three Steps →Subject exams taken at the end of core clerkships — internal medicine, surgery, pediatrics, OB/GYN, psychiatry, family medicine, and neurology. They count toward clinical grades and double as the most realistic rehearsal for Step 2 CK, since each one drills the clinical reasoning of its specialty.
About shelf exams →Preclinical, clinical, residency: the usual sequence and the planning principles that matter — leaving time for a retake, getting Step 2 CK in before residency applications, and confirming current eligibility rules at usmle.org and with school advisors.
Exam timing →Twelve plain-English answers to the questions every medical student asks: pass/fail vs scored, what the national numbers mean, retakes, and where the official answers live.
Read the FAQs →The network
SI MedExams focuses on exam prep. The sibling sites go deeper on the surrounding topics — all independent, all unofficial.
The USMLE overview hub — the program as a whole, eligibility, score reporting, and how the three Steps fit together.
Visit SI USMLE →A deep-dive on Step 1: the pass/fail era, what the exam covers, and what changed when the passing standard rose to 196.
Visit SI Step 1 →A deep-dive on Step 2 CK: the scored centerpiece of residency applications and the 218 passing standard.
Visit SI Step 2 CK →The flagship portal for the whole network — every site, organized by who you are and what you need.
Visit the portal →Medical school itself — the curriculum, the years, and where the exams fit into the journey.
Visit SI Med School →Accreditation, tracked — the standards, the toolkit, and how exam outcomes fit into a school's continuous quality improvement.
Visit the LCME Hub →Start here
The usual sequence from preclinical to residency, plus the planning mistakes worth avoiding.
Plan your sequence →Spaced repetition, active recall, question banks as learning tools, self-assessments as readiness gauges, and burnout recognition. No brand endorsements, no magic.
Learn the principles →