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US Doctor Specialties by USMLE Step 2 CK Scores

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With the recent change of the United States Medical Licensing Examination (USMLE) Step 1 transitioning to an entirely pass-fail examination, more emphasis will likely now be placed on the USMLE Step 2 Clinical Knowledge (Step 2 CK) score in the residency selection process.

 

While your Step 2 score is not the only factor that programs use to evaluate you as a residency applicant, it is one of the most important. This is because it allows program directors to directly compare applicants using a standardized benchmark. Students frequently ask, “What is a good Step 2 score?”. First, it is important to recognize that good depends on what specialty you are applying for – some specialties tend to have higher Step 2 scores than others. In this blog post, we review the most recent data on USMLE Step 2 scores and provide some recommendations on what score you should aim for and how to interpret your score. To be fully prepared for this year’s match cycle, we recommend taking a look at our residency application timeline.

 

 

Step 2 CK Score Data Set – Charting Outcomes in the Match, 2022

 

We first took a look at a data set provided by the National Resident Matching Program (NRMP) called Charting Outcomes in the Match, 2022. Specifically, this is a biennial report published by the NRMP which includes data about Senior Students that are from U.S. MD Medical Schools and U.S. DO Medical Schools, and those who are International Medical Graduates (IMGs). In these data sets, you can find information regarding the number of applicants and available positions, match rates, USMLE scores, and applicant characteristics (research, work experience, volunteer experiences, etc.) of recent matching senior medical students. Additionally, the NRMP provides aggregated data of all applicants and also breaks the data down by individual specialties.

 

It is important to know where this data comes from. Applicant characteristics (USMLE Step 1 and Step 2 scores, academic degrees, publications, Alpha Omega Alpha Honor Medical Society, Research, and Work and Volunteer Experiences) were self-reported. Reporting this data was optional and you can see the consent rates in each of the data sets online. The NRMP validated U.S. MD and DO USMLE Step 1 and Step 2 scores with data reported from medical schools and found high concordance between the student-reported value and values reported by the medical school. Specialties that offered 50 or more positions were included in these reports. This means that most major residency specialties are found in these datasets. 

 

An Important Caveat

 

This report examines whether a match was made to the specialty of the applicant’s first-ranked program, or “preferred specialty,” because that is assumed to be the specialty of choice. U.S. MD Seniors who match into a specialty not ranked first on the rank order list or who do not match are not included in these analyses. 

 

Similar statements can be in the data sets for IMGs and U.S. DO students. Why are these statements important? When the NRMP does analyses based on each residency specialty (OB/Gyn, Neurosurgery, etc.), they only include students who ranked that specialty first, and ultimately matched into that specialty. For example, if a student ranks a Family Medicine program #1, and then matches into her #4 program, which is also FM, she is included in the analysis for FM. However, if a student ranks an Internal Medicine program #1, but she matches into her #8 program which is a General Surgery program, she is not included in this specialty-specific analysis as this was not her top specialty of choice. So, when reviewing these reports, remember that the data reflects those students who had that specialty as their top choice.

 

Lastly, it is important to consider what data you DON’T see. The NRMP states that the data used in these reports does not include, “course evaluations, reference letters, and the Medical School Performance Evaluation (MSPE).”

 

 

Step 2 CK Score Data

 

Let’s first look at all of the applicants together across the three data sets:

 

Mean USMLE Step 2 CK for all applicants
U.S. MD Seniors U.S. DO Seniors U.S. IMGs* Non-U.S. IMGs*
Matched 248 241 233 243
Not Matched 242 236 225 234

*An IMG is a student who received a medical degree outside of the U.S. and Canada. Individuals who are U.S. citizens when they graduate from an international medical school are U.S. IMGs while those who are not U.S. citizens are Non-U.S. IMGs. Non-U.S. citizens who graduate from medical school within the U.S. or Canada are not IMGs.

 

From this data, we can see the trend that those who matched generally have a higher USMLE Step 2 score. This is not too surprising as students with higher Step 2 scores tend to be stronger applicants. We can also observe that U.S. MD Seniors have the highest scores, followed by U.S. DO Seniors and Non-U.S. IMGs, and finally U.S. IMGs. 

 

 

Data by Applicant Type and Specialty

 

Shown below are three charts obtained from the NRMP (references are mentioned above). These charts show the median USMLE Step 2 score and the interquartile ranges for those who matched and did not match for each specialty. Importantly, this data only includes those applicants who matched into their preferred specialty (as described above), not all applicants. For most specialties across applicant types, the interquartile range of applicants who matched to their preferred specialty was higher than those who did not match. 

 

USMLE Step 2 CK scores of US MD seniors by preferred specialty and match status.

 

Charting outcomes from the 2022 residency match cycle showing the average Step 2 CK scores of matched and unmatched DO graduates by preferred specialty.

 

 

USMLE Step 2 CK scores of international medical graduates by preferred specialty, match status, and IMG applicant type.

 

Here is a table listing all of the median values shown in the aforementioned charts. When trying to determine what is a “good” USMLE Step 2 score, we recommend looking at this table. Find the specialty you are applying for, and try to aim for the score listed for those students who matched. 

 

Median USMLE Step 2 CK for Applicants Who Matched Into Their Preferred Specialty*

U.S. MD Seniors U.S. DO Seniors U.S. IMGs Non-U.S. IMGs
Specialty Matched     Not Matched Matched    Not Matched Matched    Not Matched Matched    Not Matched
Anesthesiology 248 231 245 236 240 236 243 239
Child Neurology 247 241 238 N/A 234 225 239 226
Dermatology 257 251 256 247 N/A N/A 252 241
Diagnostic Radiology 253 241 250 236 247 239 250 245
Emergency Medicine 247 232 241 224 238 225 240 233
Family Medicine 241 228 234 212 225 219 231 224
General Surgery 250 238 246 234 246 234 247 244
Internal Medicine 249 230 240 228 235 222 245 236
Internal Medicine/Pediatrics 250 234 252 237 229 231 243 239
Interventional Radiology 253 251 254 250 270** 244 246 243
Neurological Surgery 252 246 253 240 N/A 228 247 240
Neurology 246 229 237 227 235 225 245 233
Obstetrics and Gynecology 249 240 243 232 243 232 243 236
Orthopedic Surgery 256 249 250 244 255 241 249 242
Otolaryngology 257 250 249 245 N/A N/A N/A N/A
Pathology 245 232 238 N/A 228 221 238 230
Pediatrics 245 230 238 226 233 221 240 230
Physical Medicine and Rehabilitation   242 233 238 230 227 229 237 228
Plastic Surgery 257 247 N/A N/A 232 244 240 234
Psychiatry 242 233 236 228 228 222 236 227
Radiation Oncology 249 232 N/A N/A N/A N/A 240 224
Vascular Surgery 250 245 241** 244 N/A N/A 251 247

*Areas with a “N/A” are due to very few applicants reporting this data
**These data points reflect n=1 students

 

 

The Most Competitive Specialties

 

Determining which specialties are the most competitive depends on how you define competitive. There is more than one way to define this term. However, most people gravitate towards the specialties with the highest USMLE scores. If we look at the top and bottom five most and least competitive specialties, respectively, we have the following data:

 

Specialties with the highest and lowest median USMLE Step 2 CK scores
U.S. MD Seniors U.S. DO Seniors U.S. IMGs Non-U.S. IMGs
Highest Step 2 Scores    Dermatology Dermatology Interventional Radiology Dermatology
Otolaryngology Interventional Radiology Orthopedic Surgery Vascular Surgery
Plastic Surgery Neurological Surgery Diagnostic Radiology Diagnostic Radiology
Orthopedic Surgery Internal Medicine/Pediatrics General Surgery Orthopedic Surgery
Diagnostic and Interventional Radiology (Tie) Orthopedic Surgery/Diagnostic Radiology (Tie) Obstetrics and Gynecology Neurologic Surgery/General Surgery
Lowest Step 2 Scores         Pathology Child Neurology/Pathology/Pediatrics/PMR* (Tie)    Internal Medicine/Pediatrics Child Neurology
Pediatrics Pathology Pathology
PMR* Neurology Psychiatry PMR1
Psychiatry Psychiatry PMR1 Psychiatry
Family Medicine Family Medicine Family Medicine Family Medicine

*PMR = Physical Medicine and Rehabilitation

 

When using Step 2 scores as a metric of competitiveness, we can see that Dermatology, Orthopedic Surgery, Diagnostic and Interventional Radiology, and Neurologic Surgery tend to be some of the most competitive specialties. Pathology, Pediatrics, Psychiatry, PMR, and Family Medicine tend to be some of the less competitive specialties.

 

 

How Should I Use This Data?

 

Well, the first and arguably most important thing to take away from these data is that they are just ONE component of the residency application. While the USMLE Step 2 score is a critical component to your application, it is not the only one. Many programs take a holistic approach to your application. They consider multiple aspects of your application including test scores, clinical performance, letters of recommendation, academics, research, volunteering, etc. While a good Step 2 score is important, you need to also devote time to other components of your application.

 

When you are preparing for Step 2, we highly recommend aiming for a score at or above the median score for those who matched into your desired specialty. This is a quick and easy way to gauge what score you need to get to be competitive in this aspect of your application (we cannot stress enough that this is just one component!).

 

Join the Conversation

 

If you’re seeking further guidance or wish to engage in discussions around Step 2 CK and the residency application process, consider joining our reddit community at r/ask_a_usmle_tutor. It’s a space to share experiences, exchange insights, and connect with peers navigating similar journeys. Our tutors monitor for community questions and are ready to help!

 

Ready for Personalized Guidance?

 

Preparing for Step 2 is a multifaceted endeavor. Aiming for a competitive score is crucial, but it’s just one piece of the puzzle. For a comprehensive strategy tailored to your goals, consider scheduling a consultation. Our experienced tutors and residency advisors can provide expert insights on maximizing your Step 2 score and optimizing your residency application.

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Remember, success in your medical career is a journey, and we’re here to support you every step of the way. Let’s navigate this path together!

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About the Author

Dylan Eiger, MD/PhD Candidate

In 2016, Dylan Eiger graduated Cum Laude from Duke University with a BS in Chemistry with a concentration in Biochemistry. Matriculated in the MD/PhD Duke…

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