What Is a Good USMLE Step 1 and USMLE Step 2 Score?

FAQ Section

1. Is Step 1 still scored?

No, Pass/Fail since Jan 2022.

Passing is essential, but more importantly, Step 1 builds the foundation for Step 2.

2. So which score matters now?

Step 2 CK. Scored 1-300; Pass = 218; Average = 245-247

As part of their holistic review, programs now look closely at Step 2 CK when comparing applicants.

3. What’s a “good” Step 2 CK score?

Depends on specialty:

– Primary care: 220–235

– Mid-competitive (IM, OB, EM, gen surg): 235-245

– Competitive (derm, ortho, plastics, ENT, neurosurg): 250+

Score expectations rise with specialty competitiveness. Knowing your target helps guide prep.

4. Can I retake Step 2 CK to improve my score?

No! If you achieve any passing score, you cannot retake the exam.

A passing score locks in forever. Programs see every attempt, so make the first one your best.

5. Do scores matter as much as they used to?

Probably not but it’s hard to say.

Scores are just one piece of the puzzle. Letters, rotations, and interviews carry huge weight too.

Step Scores Have Changed, But Strategy Still Matters

For years, Step 1 was the gatekeeper of residency competitiveness. But now that it’s pass/fail, students are asking:

• “What score matters now?”
• “How do I stand out without a Step 1 number?”
• “What Step 2 score do I need for my specialty?”

Let’s break it down with clarity: what counts as a good score on Step 1 (pass), what Step 2 CK targets you should aim for, and why your first attempt matters.

Step 1: Pass/Fail, But Still Crucial

As of January 2022, Step 1 is reported only as pass/fail. This means that residency programs no longer use it as a numerical filter. But don’t think that this means doing well on Step 1 isn’t important. Step 1 still covers the basic foundational sciences so mastering Step 1 content makes Step 2 CK easier. Even further, a lot of Step 2 questions sneak in some Step 1 material that you thought you were going to leave behind forever. 

Bottom line: Step 1 matters for passing, doing well on clerkship rotations, and building your Step 2 CK knowledge.

Step 2 CK: The Score That Counts Now

Step 2 CK is scored numerically from 1-300 with a passing score of 218 (recently raised from 214) and an average score among U.S. MD examinees typically being 245-247. 

Now it’s time to address the elephant in the room. Does your Step 2 CK score matter as much as Step 1 scores used to before Step 1 went pass/fail? The answer is it’s hard to say. Step 1 went pass/fail largely in an effort to alleviate the pressure that students felt with this exam being the “end all be all” for their future in medicine. Now that Step 2 is the scored exam, the pressure has somewhat shifted. However, it is important to note that residency programs are performing holistic reviews of applications, with clerkship evaluations and recommendation letters being weighed very heavily. Your Step 2 score is far from the deciding factor or the only thing that matters on your application, but it’s certainly still a component that is seriously considered.

It’s also important to note that the type of program may inform how heavy an emphasis they put on Step 2 scores. If your dream program is a highly academic or research oriented program, they will probably care more about high Step 2 scores. On the other hand, community-based or rural programs may tend to de-emphasize Step 2 scores and place more weight on your experience with their patient populations, recommendation letters, and interview skills. 

What’s a “Good” Step 2 Score by Specialty?

What makes a “good” or “competitive” Step 2 score really depends on the specialty you’re applying into. Let’s look at general ranges:

• Primary care (family med, pediatrics, psych):
  Competitive scores are 220–235.
• Moderately competitive (IM, OB/GYN, EM, general surgery):
  Aim for 235–245 to stand out.
• Highly competitive (derm, plastics, ortho, ENT, neurosurgery):
  You’ll want 250+, with many successful applicants scoring 255–260+.

These aren’t hard cutoffs, but they reflect trends in match data and program director surveys. Remember that residency programs are doing more holistic reviews of applications now but Step 2 scores do still matter quite a bit and a great score can help you stand out. 

For IMG and DO students applying to competitive specialties or programs that historically have prioritized MD candidates, it is especially important to show that you can score within or even better, above the average score range for that specialty. This will reassure programs that you’re able to excel academically and pass challenging board exams, which are qualities that are highly valued by many programs across the United States. 

Why Your First Attempt Is Critical

Unlike the MCAT, if you pass Step 2 CK, you cannot retake it for a better score. Programs see all attempts, and a failure is a red flag. So, your first attempt is your only shot if you pass, so it needs to be your best shot.

So it probably goes without saying that it is extremely important to start preparing early (even during your core rotations). Use UWorld and NBME practice exams. Simulate test conditions and pace yourself so that you can get realistic practice for the real deal.

Tutor Tips for Step Success

1. Treat Step 1 seriously even though it’s pass/fail. It builds your Step 2 foundation.
2. Start Step 2 prep during rotations. Learn actively as you go.
3. Use UWorld questions daily. Don’t wait until the end.
4. Take NBME practice tests seriously. They’re your best predictors.
5. Know your specialty’s score expectations. Dermatology ≠ Family Medicine.

Takeaway

• Step 1: Pass/fail, but use it to learn deeply for Step 2.
• Step 2 CK: Aim for at least 245, but target 250+ if you’re going for competitive specialties.

Unlike the MCAT, there are no do-overs on Step 2 if you pass, so make that first attempt count.

Residency programs still care about your scores, but they also care about your letters, your story, and your fit. Play the long game, prep smart, and you’ll put yourself in a strong position to match into the specialty you love. 

If you’re looking for expert advice on preparing for USMLE exams or putting together the optimal residency application, feel free to reach out to EMP to be strategically paired with an expert tutor to help you reach your test score and residency matching goals!

The post What Is a Good USMLE Step 1 and USMLE Step 2 Score? appeared first on Elite Medical Prep.