USMLE Step 1 and Step 2 CK Pass Rates at the Big Four Caribbean Medical Schools

What actually changed in 2022

For years, applicants and pre-med advisors compared Caribbean medical schools by their USMLE Step 1 first time pass rate, since Step 1 score was a major factor in residency competitiveness. That changed in January 2022, when the National Board of Medical Examiners moved Step 1 to pass or fail grading only. A first time pass is still worth comparing across schools, since a failed attempt costs you time and can delay entry into clinical rotations, but the old habit of comparing Step 1 scores between schools no longer applies. Step 2 Clinical Knowledge remains numerically scored and now carries more weight in how competitive your residency application looks.

Why a clean four school comparison is hard to build

St. George's University, Ross University, the American University of the Caribbean, and Saba University are commonly grouped as the four largest and most established Caribbean medical schools. A full, current, side by side comparison of first time Step 1 and Step 2 CK pass rates across all four was not confirmed for this article. Schools publish these figures on their own admissions or outcomes pages and update them at different times, and third party aggregator sites frequently carry outdated numbers without a visible date attached.

The one dated figure that is confirmed

For the 2019 reporting period, Ross University reported a 96.21% first time pass rate on USMLE Step 1 and 89.23% on Step 2 Clinical Knowledge, against a comparison group of 110 US News ranked medical schools that averaged 96.3% and 96.6% respectively, according to public disclosure data cited through school records . That single data point is six years old at the time of writing and should not be treated as the current rate. Comparable published figures for SGU, AUC, or Saba were not confirmed for this article.

What a pass rate does and does not predict for CaRMS

A strong Step 2 CK pass rate at your school tells you the average graduate is clearing the exam, it does not tell you how competitive your eventual application will look against other Canadians studying abroad in the same match cycle. Canadian residency programs reviewing an IMG application weigh your individual Step 2 CK score, your clinical evaluations, and your specialty choice far more heavily than which specific Caribbean school issued your degree. Use a school's pass rate as one input when choosing where to study, not as a proxy for your own eventual CaRMS outcome.

How to get a real, current comparison yourself

• Go to each school's own admissions or outcomes page and look for a dated first time Step 1 pass rate and Step 2 CK pass rate, not a lifetime average that blends many cohorts together

• Note the cohort year attached to any figure a school publishes, a number without a year attached is not usable for comparison

• Ask an admissions counsellor directly what percentage of the most recent entering cohort actually sat for Step 1 within the program's expected timeline, since a school with a high pass rate among test takers can still lose a large share of its class before anyone sits the exam

• Cross check any number against a second source before treating it as reliable, since marketing pages and independent aggregators sometimes disagree

Watch the denominator, not just the percentage

A pass rate is only as meaningful as the group it is measured against. A school that reports a pass rate among students who sat the exam is answering a different question than a school that reports a pass rate among everyone who entered the program. If a school academically dismisses weaker students before they are allowed to sit Step 1, its test taker pass rate can look strong even while a large share of its entering class never reaches the exam at all. When you compare schools, ask directly what share of a recent entering cohort actually sat Step 1, not just what share of test takers passed it.

What matters more than the headline number

A first time pass rate tells you about the average student in a given cohort. It does not tell you how the school supports a student who struggles, how flexible the retake policy is, or how a failed attempt affects your clinical rotation timeline and total program cost. Ask each school directly about its retake policy and how many attempts it allows before academic dismissal, alongside whatever pass rate figure it publishes. A school with a slightly lower headline pass rate but a genuinely supportive remediation process can be a better fit than one with a higher number built on dismissing struggling students early.