How to read a Caribbean school's Step 1 pass rate
Since Step 1 moved to pass/fail in 2022, schools no longer publish average scores, and pass rate has become the primary quantitative outcome for basic sciences. Not every reported rate is comparable, though. Ask specifically for the first-time pass rate for eligible test-takers among students who matriculated four years earlier, not the all-time or eligible-attempts rate. Some schools quote only students who cleared an internal Comp exam before being certified to sit Step 1 — that filter can inflate the pass rate by 10–15 percentage points versus a cohort-based measure.
2024–2026 benchmarks for context
The NBME's most recent published data (2024 testing year) provides the anchoring benchmarks Caribbean schools compare themselves against.
- US MD schools: 96% first-time pass rate
- US DO schools: 94% first-time pass rate
- US IMGs (US citizens at foreign medical schools): 84%
- Non-US IMGs: 82%
- Repeat test-takers (all categories): 60–68%
Top-tier Caribbean schools and published pass rates
St. George's University has publicly reported first-time pass rates of 95–97% in recent years for students who complete the basic-sciences program. Ross University reports 96% (2023 cohort) among first-time takers. American University of the Caribbean and Saba University publish rates in the mid-90s, and Medical University of the Americas has historically reported 96–99% among certified test-takers. These four schools consistently outperform the non-US IMG benchmark.
Mid-tier and emerging schools — read the fine print
Mid-tier schools often publish strong numbers too, but check whether the figure is for the entire matriculating cohort or only for students who cleared internal benchmarks. A school reporting a 92% first-time pass rate that only allows 60% of a class to sit the exam is producing a very different outcome from one reporting the same 92% across the full matriculating cohort. Ask for the completion rate (matriculants who ever sit Step 1) alongside the pass rate.
What actually drives Step 1 pass rate differences
Curriculum integration (integrated systems vs. discipline-based), the presence of a formal NBME Comp Assessment before certification, dedicated Step 1 preparation time (typically 8–12 weeks), and access to UWorld, NBME self-assessments, and Kaplan or Amboss subscriptions are the biggest institutional factors. Individual factors — MCAT score, undergrad GPA, and total hours in dedicated prep — remain the strongest predictors of individual outcomes.
