I have met numerous medical students who have struggled with USMLE Step 1. This is a very difficult exam to pass. Don't be discouraged. If you didn't pass, ask yourself these critical questions:
1. Do you know why you didn't pass? Do you really know the reason(s)?
2. What can you do differently?
3. How much time will it take to get you to the point where you can be 100% confident that you'll pass?
Whether you're attending a U.S. medical school or a medical school in another country, the root causes for not passing are often very similar. In some cases, medical students may have learning disabilities that have not been diagnosed. In other cases, the student may lack motivation and feel very discouraged. Regardless of the root causes, there is room for improvement.
Don't give up.