<P> Step 1 is designed to test the knowledge learned during the basic science years of medical school as applied in the form of clinical vignettes . This includes anatomy, behavioral sciences, biochemistry, microbiology, pathology, pharmacology, and physiology, as well as to interdisciplinary areas including genetics, aging, immunology, nutrition, and molecular and cell biology . Epidemiology, medical ethics and questions on empathy are also emphasized . Each exam is dynamically generated for each test taker; while the general proportion of questions derived from a particular subject is the same, some test takers report that certain subjects are either emphasized or deemphasized . </P> <P> Currently, students receive a three - digit score following sitting for the Step 1 examination . In 1999, the USMLE phased out the use of a percentile - based system in favor of a three - digit and two - digit scaled scoring system . In October 2011, two - digit scaled scores were no longer reported to any parties besides the examinees . In April 2013, the two - digit score was eliminated completely from the score report . </P> <P> While the USMLE program does not disclose how the three - digit score is calculated, Step 1 scores theoretically range from 1 to 300, most examinees score in the range of 140 to 260, the passing score is 194 and the national mean and standard deviation are approximately 229 and 20, respectively . Rise in the national mean Step 1 score has been observed with time, as shown in the table below . According to the National Resident Matching Program, the mean score for U.S. allopathic seniors who matched to residency programs in 2016 was 233.2 (sd = 17.4). </P> <Table> National Step 1 means among US and Canadian first time test - takers by year <Tr> <Th> Year </Th> <Th> Mean Score </Th> <Th> Standard Deviation </Th> </Tr> <Tr> <Th> 2016 </Th> <Td> 228 </Td> <Td> 21 </Td> </Tr> <Tr> <Th> 2015 </Th> <Td> 228 </Td> <Td> 20 </Td> </Tr> <Tr> <Th> 2014 </Th> <Td> 227 </Td> <Td> 20 </Td> </Tr> <Tr> <Th> 2013 </Th> <Td> 226 </Td> <Td> 21 </Td> </Tr> <Tr> <Th> 2012 </Th> <Td> 224 </Td> <Td> 21 </Td> </Tr> <Tr> <Th> 2011 </Th> <Td> 224 </Td> <Td> 22 </Td> </Tr> <Tr> <Th> </Th> <Td> 222 </Td> <Td> 24 </Td> </Tr> <Tr> <Th> 2009 </Th> <Td> 221 </Td> <Td> 24 </Td> </Tr> <Tr> <Th> 2008 </Th> <Td> 221 </Td> <Td> 23 </Td> </Tr> </Table>

What is the pass mark for usmle step 1