USMLE Step 2 CK Percentiles: How to Interpret and Score in the Top Ranges

The USMLE Step 2 CK percentiles provide a benchmark to evaluate your performance compared to other test-takers. With Step 1 now pass/fail, Step 2 CK scores play an increasingly important role in residency applications, making a high percentile score critical for competitive specialties. This guide breaks down the latest percentile data and provides actionable tips to help you achieve your Step 2 CK goals.

USMLE Step 2 CK Score Ranges and Percentiles: Shift to Pass/Fail for Step 1 and Effects on Residency Applications

Given the NBME/FSMB decision to change Step 1 to pass/fail, Step 2’s numerical scoring has much more significance than in previous years. Previously, Step 2 CK was thought to carry much less weight. However, even then, average Step 2 CK scores for matched applicants were on average higher than average scores for unmatched applicants. Since transitioning Step 1 to PASS/FAIL, Step 2 scores have continued to rise. This is reflected in the 5 point increase for the passing standard for Step 2 in July of 2022 (https://www.usmle.org/change-step-2-ck-passing-standard-begins-july-1-2022). 

Although there are a variety of ways to  stand out as a residency applicant, we know from years of data that higher scores correlate with a better chance of matching. See the charting outcomes from prior cycles to get a better understanding of what scores help people match to what particular specialties.

USMLE Pass Rates

As of July 2022, a passing score on Step 2 CK is 214 (increased from 209). This is much higher than the passing score for Step 1 (196). That being said, Step 2 actually has a much higher pass rate than Step 1. In 2023, 90% of US/Canadian test takers passed Step 1 (https://www.usmle.org/performance-data). In contrast, 97% of US/Canadian test takers passed Step 2. The trend is similar for students from non-US/Canadian schools; 68% passed Step 1 and 86% passed Step 2. 

Before Step 1 transitioned to a pass/fail scoring system, the pass rates for the two exams were much closer. In 2020, 98% of test takers from US/Canadian Schools passed Step 1 and 95% passed Step 2. This shift is best explained by the transition to pass/fail; students may be spending less time studying for Step 1 (with lower goal scores that puts them at risk of failing) and more time studying for Step 2 (with higher goal scores).

How to Interpret Step 2 Percentiles Based on Preferred Residency Specialty

The key for interpreting Step 2 CK scoring is making specific goals for yourself based on a few factors. The first (and most important) factor to determine is your field of interest. The average scores of applicants vary significantly across different specialties. According to USMLE, the average score for matched applicants in surgical specialties such as plastic surgery is higher than the average score for family medicine. (This by no means negates the value of our family medicine colleagues. They are the backbone of healthcare for many patients!)

Additionally, in the more competitive fields, the standard deviation is much smaller. This means that there is less variation in the range of scores for applicants to the more competitive specialties. Because more competitive specialties require higher scores to successfully match, this often deters students with lower scores from applying and thus decreases the standard deviation. Of note, it also means that students with higher scores are applying to less competitive residencies. This ultimately increases the standard deviation as there is more variability in the scores seen.

The next factor is an honest evaluation of your scoring potential. Although test-taking skill levels can improve, you should have a reasonable goal of what you may be able to achieve. Speaking in broad terms, the average test taker does not commonly jump from the 5th percentile to the 95th percentile without extraordinary measures.

Consider Other Factors Which Contribute to Your Application

Other factors to consider in setting your personal goal are the strength of your application as a whole. Applicants with very meaningful extracurricular activities, research, and awards may be able to compensate (somewhat) for a slightly lower score. Alternatively, applicants who are very particular about the location of their residency or those applying from international programs may want to fall higher on the distribution of scores of applicants within their field. 

As a tutor I often hear students state that their goal score is to, “score as high as possible.” While I appreciate the sentiment (and agree, I want everyone to score as high as possible), I also think that a tangible goal can help you progress through your dedicated studying. It also helps as you prepare your application and choices for location. As previously mentioned, when trying to set a goal score, try to carefully balance aiming high with realistically setting expectations for yourself.

Why Step 2 CK Percentiles Matter for Your Residency Application

We don’t want to beat a dead horse over here, but it’s important, so we will say it again, “Step 2 scores are super important for matching to residency!” Whether you plan on becoming a neurosurgeon at a top hospital or are interested in neurology at a community program (both super important jobs!), your Step 2 score will help get you to where you want to be. Ultimately, the higher the score, the more options you are likely to have. 

We understand that this can be unfortunate…there is so much more to you than a number on a paper! Additionally, test day is ONE day and your score can vary a lot based on how you were feeling, the environment at the test center, and even the questions you happened to be tested on. We recognize that it is difficult so much hangs on one test. Nonetheless, Step 2 is a tangible number that programs have to compare students across the board.

As previously mentioned, Step 2 scores matter for your residency application because higher scores correlate with a higher chance of matching. Be sure to explore the charting outcomes provided by the NRMP to see this for yourself.

How to Score in the Top Percentiles for USMLE Step 2 CK

Enough about Step 2 scoring! We know it is important.  Now that you have a goal score, how can you make sure to achieve that goal? Like any test, unfortunately, there is no magic trick that can lead to a high score, but we have a few tips that will help contribute to your success.

Begin with a strong study plan and customize it to your needs

We highly recommend starting off with a pre-filled calendar and customizing it to your needs. This will maximize your study time as you focus on weaker subjects and create a plan based on your learning style. Our 4-week planner is a great place to get you started.

Fill out the form below to receive your free pre-filled Step 2 study planner via email!

Don’t sleep on your clerkships

I don’t mean this in the literal sense (you should definitely sleep). I mean that you shouldn’t overlook the importance of your clinical rotations. The USMLE said it themselves. They are testing your application of the knowledge you are expected to acquire during these rotations!

As much as the 45-minute discussion of the sodium shift on Internal Medicine rounds may make you yearn for a triple shot of espresso, this will be important knowledge for test day. And, you are far more likely to retain this information when you associate it with a patient that you are caring for. This also applies to those required journal clubs, not only are you learning important clinical information, but Step 2 expects you to interpret medical literature on the exam! As a rule of thumb, if you are putting energy into caring for your patients, playing an active role on your team, and performing well on your shelf exams, you are also preparing yourself for Step 2 CK.

Practice makes perfect when it comes to Step 2 CK

You simply cannot prepare for this exam without dedicating a good chunk of time to practice questions. You should subscribe to UWorld at the beginning of your clerkship year and work through questions in preparation for your shelf exams. Ideally, you will be through a pretty significant chunk (if not all) of UWorld by the time you have arrived at your dedicated Step 2 CK study time. As you begin your studying, you can finish up the few UWorld questions you have remaining, then you can reset it for your dedicated studying. Don’t worry about remembering the answers from the first pass, you are unlikely to remember the answers. And if you do, that’s great learning on your part! 

While doing practice questions, simulate real life as much as possible. I always recommend that when students are doing a “focused review” for a topic they struggle with, they should use tutor mode and timed mode. But, when you are completing your general practice questions for the day, turn off tutor and turn on timed mode to best simulate a testing environment. You should be doing questions in a quiet, distraction-free environment as much as possible. As always, make sure you review your blocks afterward and grow from the questions you answered incorrectly!

Wait until you are ready to take your Step 2 CK exam

Some students have less flexibility here, but when deciding how long to prepare for Step 2 CK, I always recommend against taking exams until you are scoring your target on practice exams. You should not expect your score to be magically higher on test day! If you are not reaching your target, you should consider delaying the test until you are ready. This leads me to my last tip, which is…

Get help when you need it

This process is challenging and there are a whole slew of issues that might come up. Ultimately, your success in this career will be dependent on your resilience and your ability to seek help when you need it. When you start struggling to understand a topic, ask one of the residents on your rotation (most residents love teaching). If you are struggling to navigate the crazy logistics of being a medical student, ask one of your colleagues who is the year ahead of you. If you are concerned about your schedule and considering pushing your exam, reach out to one of your advisors (do this early!!).

here are many Step 2 tutors who specialize in assisting students with their Step preparations. If you need help targeting the top percentiles for Step 2 CK, Elite Medical Prep is here to help! Purchase a trial session or schedule a free consultation to learn how our expert tutors can support you.

Achieving a top percentile for Step 2 CK is a challenge, but with a strategic approach and the right resources, it’s entirely possible. Focus on consistent improvement, leverage available support, and remember—your Step 2 CK performance is just one part of your journey to becoming a physician. If you’re ready to take the next step, purchase a trial session or schedule a free consultation today to get started.