@mom2collegekids The USMLE used to be a factor in getting into residency along with grades etc. I am not sure how important the percentiles are nowadays. I will say this: I firmly believe that there are programs out there in any specialty available if you are willing to go to them.
For example, when I was applying for residency, orthopedics was very competitive. A classmate of mine who didn’t have very good grades managed to get into an ortho program in Detroit. Now I’m sure the neighborhood wasn’t nice, and the work hours were probably long, but you can do anything for five years if you have to…
So in summary, I dont think a substellar USMLE part 1 would be a deal breaker. Passing is the most important thing.
Most people do better on step 2 because it is clinically oriented. He can still make his mark there.