A good Step 2 CK score depends on your target specialty, but for most U.S. MD graduates, scoring at or above the national mean of 250 puts you in a competitive position. The average matched applicant across all specialties scored a 250 in the most recent match cycle, so hitting that number means you’re performing at the level of peers who successfully matched. Scoring well above it opens doors to the most competitive programs and specialties.
Why Step 2 CK Scores Matter More Now
Since Step 1 switched to pass/fail scoring in January 2022, Step 2 CK has become the only USMLE exam that gives residency programs a numerical score to compare applicants. That shift has made it one of the most heavily weighted standardized metrics in the residency application. Programs that once filtered applicants primarily by Step 1 scores now rely on Step 2 CK to do much of that screening work.
This also means the pressure on a single exam day is higher than it used to be. A strong Step 2 CK score can compensate for a thinner CV or a less well-known medical school, while a weak score is harder to offset without another scored exam to point to.
Score Ranges and What They Mean
The national mean for first-time test takers from U.S. and Canadian medical schools is 250, with a standard deviation of 15. That gives you a rough framework for placing your score:
- 265 and above (one SD above the mean): Highly competitive for any specialty, including the most selective programs in dermatology, plastic surgery, and orthopedic surgery.
- 250 to 264: At or above average. Competitive for the vast majority of specialties and programs.
- 235 to 249: Below average but still within a standard deviation of the mean. Competitive for many primary care and less selective specialties, though it may limit options at top-tier programs.
- 218 to 234: Passing, but below the range where most matched U.S. MD applicants land. This range narrows your options significantly.
- Below 218: Starting July 1, 2025, the minimum passing score increases from 214 to 218. Anything below that threshold is a fail.
Scores by Specialty
The score you need varies significantly depending on where you want to train. Internal medicine and internal medicine-pediatrics had among the highest average Step 2 CK scores for matched primary care applicants, at 251 and 253 respectively. These numbers reflect the overall U.S. MD applicant pool. Surgical subspecialties, dermatology, and other highly competitive fields typically skew even higher, though exact averages shift year to year.
If you’re aiming for a less competitive specialty like family medicine, you have more room below the mean. But even in those fields, scoring well above the minimum passing threshold matters because programs still use Step 2 CK as a screening filter before reading the rest of your application.
Scores for IMGs and DO Students
If you’re an international medical graduate or a DO student, the scoring landscape looks a bit different. DO applicants who matched across all specialties averaged a 248, just slightly below the overall mean. That’s close enough that the same general benchmarks apply, though DO students also have COMLEX scores as part of their application.
For U.S. citizen IMGs, the picture is more variable. Among specialties with enough matched applicants to report data, the highest average Step 2 CK scores were 248, in both general surgery and anesthesiology. The range across reportable specialties stretched from 231 to 248. About half of non-U.S. citizen IMGs who matched placed into internal medicine, where average scores were 244 for non-U.S. IMGs and 238 for U.S. citizen IMGs.
These numbers are generally lower than U.S. MD averages, but that doesn’t mean a lower score is “good enough” for IMGs. Programs often hold IMG applicants to higher score thresholds precisely because the score is one of the few standardized data points they can compare across very different medical education systems. Scoring above 250 as an IMG makes your application considerably stronger.
What Happens if You Score Low or Fail
A score below 235 doesn’t disqualify you from matching, but it limits your options. Many programs set score cutoffs in their screening software, and applications below those thresholds are never read by a human. The lower your score, the fewer interviews you’re likely to receive, especially at academic medical centers.
Failing Step 2 CK is a more serious setback. Many residency programs automatically filter out applicants with any exam failure on their record, regardless of the retake score. That said, a strong retake score paired with a compelling explanation can still lead to a successful match. One applicant who failed by 2 points and then scored in the high 230s on the retake went on to match. The key is demonstrating a clear upward trajectory and addressing the failure directly in communications with programs.
If you’re retaking the exam, aim for a score that’s not just passing but meaningfully above average. A retake score of 230 after a failure still leaves you below the typical matched applicant, while a retake in the 250s tells a program the failure was an anomaly.
How to Think About Your Target Score
Start by identifying the average Step 2 CK score for matched applicants in your target specialty. The NRMP publishes this data annually in its Charting Outcomes report. Your goal should be to meet or exceed that average. If you’re an IMG or have other parts of your application that are less competitive, aim 5 to 10 points above the specialty average to give yourself a cushion.
Practice exam scores from UWorld self-assessments and NBME practice forms tend to predict actual performance reasonably well, typically within 10 to 15 points. If your practice scores are consistently below your target, that’s useful information: you have time to adjust your study plan before sitting for the real exam. Delaying the test to improve your score is almost always a better strategy than taking it underprepared and hoping for the best, especially now that Step 2 CK carries so much weight in the application process.