The U.S. residency application landscape has shifted dramatically since USMLE Step 1 became pass/fail. For today’s applicants, the Step 2 Clinical Knowledge (CK) exam is often the only numerical score available to program directors when comparing candidates. This change has made Step 2 CK more influential than ever before.

But what exactly counts as a “good” Step 2 score? The answer depends on your specialty of choice. Different fields have very different score expectations, and understanding these benchmarks can help you set realistic goals, evaluate your competitiveness, and build a stronger overall application.

In this article, we’ll explore how Step 2 scores vary by specialty, what the data shows about matched vs. unmatched applicants, and how to interpret your own score in the context of your residency goals.

Why Step 2 CK Matters More Than Ever

For residency programs, Step 2 CK provides a standardized, objective measure of clinical knowledge. With Step 1 no longer distinguishing applicants by score, and many programs using simply pass/fail metrics for student performance, program directors now lean on Step 2 to help them sort through thousands of applications.

Of course, Step 2 CK is not the only factor that matters — clinical evaluations, letters of recommendation, research, and personal statements all remain highly important. But a strong Step 2 score can open doors, while a weaker score may make interviews harder to secure, especially in the most competitive specialties.

Step 2 CK Benchmarks: The Big Picture

The most recent Charting Outcomes in the Match (2024) from the National Resident Matching Program (NRMP) gives us a clear snapshot of score distributions:

• The mean Step 2 CK score across all applicants hovers around 249.
• The minimum passing score is 218.
• Applicants who match tend to score higher than those who don’t, regardless of whether they are U.S. MD seniors, DO seniors, or international medical graduates (IMGs).

For example:

• Matched U.S. MD seniors averaged about 250.
• Matched DO seniors averaged about 244.
• Matched IMGs ranged from 236 to 245, depending on citizenship status.

These numbers highlight a consistent trend: while scores aren’t everything, there’s a measurable advantage to performing well.

Specialty Differences: High vs. Low Step 2 Expectations

Not all specialties weigh Step 2 scores the same. Generally, the more competitive the specialty, the higher the expected Step 2 score and the more weight programs give Step 2 when reviewing applications.

• Highly competitive specialties: Dermatology, Plastic Surgery, Orthopedic Surgery, Neurosurgery, Otolaryngology, and Interventional Radiology often report median Step 2 scores around or above 250. Applicants entering these fields are often clustered in the top percentiles, making it essential to score well if you want to be a strong candidate.
• Moderately competitive specialties: Internal Medicine, Emergency Medicine, General Surgery, and Anesthesiology usually fall closer to the national mean, with successful applicants often scoring in the 240–250 range. Strong letters of recommendation, research, and clinical evaluations can help balance out a slightly lower score here.
• Less competitive specialties: Family Medicine, Psychiatry, Pediatrics, and Pathology tend to have lower average Step 2 scores, often in the 225–235 range. These specialties still value clinical knowledge, but they emphasize other aspects of the application just as heavily, such as interpersonal skills, service orientation, and long-term commitment to the field.

In short: a “good” Step 2 score is highly context-dependent. A 235 may be very competitive for Family Medicine but unlikely to suffice in Dermatology.

The Specialty isn’t all That Matters, the Program Does Too

Students tend to focus on the specialty in order to determine their goal Step 2 score range. Remember, while a less competitive specialty may generally match students with lower average Step 2 scores, the reputation of the program matters too. The average Step 2 score for family medicine applicants who match at a highly rigorous academic center is going to be much higher than that of family medicine applicants who match at a smaller, rural program. If your dream program is at a strong, highly academic institution, your Step 2 score will likely need to reflect the strength of the program.  

Percentiles: Why They Matter More Than Raw Numbers

Step 2 CK is scored on a three-digit scale, but looking at percentiles may be more informative.

• 50th percentile ≈ 249
• 75th percentile ≈ 260

Being above the 75th percentile signals strong clinical mastery and significantly boosts your chances in competitive fields. Meanwhile, being at or above the median for your target specialty should be your baseline goal when preparing for Step 2.

Key Insights from NRMP Data

The NRMP’s specialty-specific breakdown provides some practical lessons:

1. Matched applicants almost always score higher than unmatched ones. The difference is often 5–15 points, which can be decisive in interview selection.
2. Specialties with higher average Step 2 scores tend to offer fewer positions. For example, Plastic Surgery and Dermatology are not only competitive because of high scores, but also because they have limited residency slots.
3. IMGs can and do match with strong Step 2 scores. A standout Step 2 CK score can be particularly important for international graduates, as it helps demonstrate readiness for U.S. clinical practice.

Interpreting Your Score: What It Means for Your Application

So, what should you do once you receive your Step 2 CK score?

• If your score is above 260, you are in an excellent position for nearly any specialty. Your challenge will be to round out your application with strong recommendation letters, research, and clinical performance.
• If your score falls between 245–255, you remain highly competitive for most specialties and will be a strong candidate in moderately to highly competitive fields.
• If your score is below 240, you’ll want to be strategic. This does not mean you cannot match, but you may need to apply more broadly, focus on specialties with lower average scores, or highlight unique strengths like research or service experiences.

Using Step 2 as Part of a Holistic Application

It bears repeating: residency programs don’t select residents based on Step 2 alone. Factors like letters of recommendation, clerkship evaluations, research, volunteer work, and personal statements carry significant weight. A high Step 2 score can catch a program director’s attention, but your broader story is what convinces them you belong in their program.

That said, aiming for a score at or above the median Step 2 score for matched applicants in your specialty is a practical, data-driven way to set your goals.

Final Thoughts: Step 2 as a Springboard

In the era of pass/fail Step 1, Step 2 CK has become a powerful benchmark in the residency selection process. Knowing where your score stands compared to your specialty’s averages can help you set realistic goals and plan your application strategy wisely.

But remember: your value as a residency candidate is more than a number. Step 2 CK is just one piece of the puzzle, and even if your score isn’t exactly where you hoped, strong clinical evaluations, leadership, and persistence can carry you forward.

As you prepare, aim to do your best — but also take time to strengthen the many other parts of your application that residency programs value. And if you’d like more structured, personalized support along the way, working 1:1 with an expert Step 2 tutor can help you target weaknesses, stay accountable, and build the confidence you need to reach your goal score, and the residency that’s right for you.