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Of every 4 who apply for a residency, only 3 will make it. Will you be one? Did you know about the 40% failure rate for the USMLE step 1? According to the USMLE, 41% of US citizens who take USMLE step 1 fail. 34 % of foreign citizens who take the step 1 fail. 29% of US citizens who take USMLE Step 2 CK fail , 21% of foreign citizens who take the step 2 CK fail. One in four of NRMP applicants will NOT get a residency position. The Denver Notes are designed to maximize your chances of a top score in the USMLE exams and your residency probability.