.png)
.png&w=1920&q=70)
Scoring
How Many Times Can You Take USMLE Step 1, Step 2 CK and Step 3? Attempt Limits Explained
USMLE attempt limits explained: four attempts per Step, three in 12 months, the wait before a fourth attempt, what counts, and state board rules.
By MedPrep Institute Editorial Team · Published · 5 min read
Fear of running out of attempts drives a lot of searches. The good news is that the rules are simple. This guide sets them out as we last checked them, and points to where to confirm each one.
The short answer
You can take each Step up to four times. You cannot take the same exam more than three times in any 12-month period, and a fourth attempt has a longer waiting period. After four unsuccessful attempts at a Step, you are ineligible to apply for any Step.
The USMLE attempt rules
- Four attempts per Step (Step 1, Step 2 CK and Step 3 each).
- Three attempts in 12 months at the same exam, at most.
- Fourth attempt timing: ECFMG's booklet lists at least 12 months after your first attempt at that exam and at least six months after your most recent attempt.
- No retake after a pass: USMLE generally does not allow you to retake a Step you have passed.
What counts as an attempt
Incomplete attempts count toward the limit, and attempts at the formerly administered Step 2 CS count too. Treat any test appointment where you begin the exam as an attempt.
State board and ECFMG rules
For licensure, state medical boards may limit the number of attempts allowed to pass each Step, sometimes more strictly than USMLE. The FSMB site lists state-specific details. If you are an international graduate, also check ECFMG's requirements and timelines.
If you are near the limit
If you have already failed once, the most useful move is a diagnosis, not a date. Find the cause, rebuild with timed, mixed practice, and schedule only when assessments show a clear margin. Our failed Step retake guide walks through it, and the passing scores page lists current standards, including the Step 2 CK 218 standard that applies to retakers.
Why older guides say six attempts
The four-attempt limit took effect in 2021. Older material, including a 2018 USMLE bulletin, lists a six-attempt limit. If a guide mentions six, it is out of date.
Frequently asked questions
How many times can you take USMLE Step 1?
Up to four times. Incomplete attempts count, and after four unsuccessful attempts you are ineligible to apply for any Step.
How many times can you take Step 2 CK?
Up to four times, with the same limits on spacing and the same rules about incomplete attempts.
How many times can you take Step 3?
Also four attempts, though state boards can set their own limits on attempts for licensure.
Can you take a USMLE Step more than three times in a year?
No. You may not take the same exam more than three times within a 12-month period.
How long must you wait for a fourth attempt?
ECFMG lists at least 12 months after your first attempt and at least six months after your most recent one. Confirm on USMLE.org.
Can you retake a Step you passed to raise your score?
Generally no. USMLE does not allow retaking a Step you have already passed.
Sources and disclaimers
Figures in this guide come from the USMLE program's published notices and from third-party summaries that we could not check against the primary source, and we say so where that applies. Standards, policies and score data change, so confirm current details on USMLE.org, ECFMG and NRMP before you plan around them. MedPrep Institute is our own product, and is not affiliated with or endorsed by NBME, FSMB, USMLE, ECFMG, NRMP, UWorld or any other company named here. All trademarks belong to their owners.