Your USMLE Step 2 CK score is the most essential hard metric assessed by residency programs. But what score do you need to be a competitive residency applicant?
While the minimum passing score of USMLE Step 2 CK is 214, a passing grade is far from what you need to match into a residency program.
As we share average Step 2 scores by specialty in this video, keep in mind that these numbers reflect averages only. There are medical students who scored much higher and others who scored well below the average but had other impressive application components—such as research experience, a compelling narrative, and glowing letters of recommendation—to make up for a low Step 2 score.
Whether or not you match into your ideal program is not solely determined by meeting average hard metrics, but they are a good starting point.
Additionally, keep in mind that the competitive nature of residency applications results in average Step scores increasing from one year to the next. To ensure you match into your ideal specialty and preferred program, aim for a higher-than-average Step 2 CK score.
Step Score: 244
First up with the lowest average Step 2 score is family medicine at 244. Family medicine is a specialty that continuously has the lowest Step 2 score of all specialties. That said, note that the current 244, based on 2024 data, is an increase from 241 in 2022 and 238 in 2020.
For context, a Step 2 CK score of 245 is at the 37th percentile, meaning 37% of exam takers scored lower than 245.
A notably lower Step score is one of the major contributing factors for family medicine ranking as the least competitive specialty year after year. Check out our least competitive doctor specialties guide.
Step Score: 246
Next up, near the bottom of the pack, is psychiatry, with a score of 246. Psychiatry also consistently ranks in the top five least competitive specialties.
Step Score: 247
At a tie with a Step score of 247 are pediatrics and pathology. Pediatrics is the next least competitive specialty, following family medicine, and pathology also ranked in the top five least competitive in 2024.
If you’re sensing a trend, that’s because there is one. While not the only factor, average Step 2 scores are significant in determining a specialty’s competitiveness. In fact, we weigh Step 2 CK scores at 30% in our Specialty Competitiveness Index. But that’s not the only factor we compile to determine competitiveness. The index also factors in match rate, research items, AOA status, and top 40 NIH funding.
There’s a high degree of correlation among these various factors because students who are aiming for more competitive specialties tend to cluster with higher Step scores, more research items, AOA status, and they often go to higher-ranked schools with top 40 NIH funding. If you’re dedicated to killing your Step 2 CK score, there’s a good chance you’re crushing other aspects of your medical journey, too.
You can access our complete specialty competitiveness index and even manipulate it yourself through the link in the description.
Step Score: 248
Following the trend, we have emergency medicine at 248, and it’s the last specialty to rank in the bottom five least competitive.
Along with EM, child neurology and PM&R also have a Step 2 score of 248.
Step Score: 250
Next up, jumping by two significant points, is neurology, with an average Step 2 score of 250.
Scoring a 250 puts you in the 50th percentile, meaning 50% of exam takers had a lower score than yours, placing you right in the middle of the pack.
Step Score: 251
Internal medicine has an average Step 2 score of 251.
Internal medicine is the most pursued medical specialty.
For context, in 2025, 11,379 positions in internal medicine were filled, while the next most popular was family medicine, which filled just over 4,500 positions.
This is due to the many subspecializations doctors can pursue following internal medicine, including cardiology, oncology, gastroenterology, and pulmonology. Since these are all subspecialties of IM, you won’t find them on this list of categorical residency programs.
Step Score: 252
Next, tying each other with a score of 252, is radiation oncology, OB/GYN, and anesthesiology.
Step Score: 253
With a score of 253, general surgery, vascular surgery, interventional radiology, and internal medicine-pediatrics, also known as Med-Peds, are all tied.
Note that Med-Peds, the combination of internal medicine and pediatrics, has a higher average Step 2 CK score than each of the separate paths of internal medicine and pediatrics, and it ranks as more competitive than both as well. However, the compensation of Med/Peds physicians is in between those of dedicated pediatricians and internal medicine doctors.
This is due to the fact that children are more resilient and, therefore, require fewer procedures.
Unfortunately, since procedures are where most of the money comes from in the US, pediatric physicians typically don’t have as high a salary as physicians who treat adults.
Step Score: 255
With a score of 255, neurosurgery is in the 63rd percentile.
When accounting for ties, neurosurgery has the sixth most competitive Step 2 score. However, when considering all factors on our competitiveness index, neurosurgery currently ranks as the second most competitive.
It’s a specialty that attracts a personality type that’s willing to endure and work very hard, which is why they have by far the most research items at 37.4 on average as of 2024.
Another reason for its attraction among Type A personalities and workaholics is the notably high salary. Neurosurgeons make more than any other specialty at over $760,000 a year on average. Unfortunately, they also have one of the worst lifestyles. As the saying goes, while neurosurgeons make the most money, they have no time to spend it.
Step Score: 256
Plastic surgery, otolaryngology, and diagnostic radiology tie each other for the second most competitive average Step 2 score at 256.
Interestingly, while diagnostic radiology has a highly competitive Step 2 score that’s only surpassed by two specialties, it only ranks as the eighth most competitive in our specialty competitiveness index.
This is due to a lower likelihood of attending a top 40 NIH school and a much higher match rate than the top five leaders.
Step Score: 257
Tied for the highest average Step 2 score of all categorical specialties is orthopedic surgery and dermatology with 257.
The current highest average score of 257 falls somewhere between the 63rd and 76th percentile, which requires a score of 260.
Orthopedic surgery currently ranks as the fourth most competitive, with its high average Step score being a notable contributing factor.
Dermatology ranks as the most competitive medical specialty based on 2024 data. If you want to earn almost $500,000 a year without sacrificing your work-life balance, derm is the specialty for you—the only downside is that everyone else agrees.
Just like with the least competitive specialties, all five of the most competitive specialties also have the highest average Step 2 score, with the exception of diagnostic radiology.
If you’re thinking Step 2 scores must be the determining factor in competitiveness, keep in mind that Step 2 scores are only weighted at 30% of our overall ranking system. The other competitiveness factors include match rate, research items, AOA status, and top 40 NIH funding.
That said, these results do point to clear trends across clusters of specialties when considering competitiveness. Specialties with the highest average Step 2 scores are competitive for other reasons as well, and the same is true of the least competitive specialties.
No matter the specialty you’re aiming for, it’s critical to remember these are only averages. While residency programs consider the whole applicant and not simply what they scored on Step 2, it is a major determining factor and often times used as a cutoff, and the more competitive a specialty is, the more ways you’ll need to stand out.
Step 2 CK is a mammoth nine-hour test, which is intimidating, to say the least. There’s a lot riding on your performance, as Step 2 CK is the number 1 most important test that determines your residency competitiveness. It can easily get the better of students if they don’t have a study plan tailored to their specific needs, and it’s not a test you can simply retake.
No top score can be achieved without a customized, bulletproof plan. And that’s exactly what we provide with our dedicated Step 2 CK tutoring services at Med School Insiders.
Because we believe no two students are the same, you’ll work one-on-one with a tutor who aced their own Step 2 and made the cut to become a Med School Insider—it’s the most rigorous process in the industry.
Through our diagnostic process, your personal Insider will evaluate the exact areas where you can make the greatest impact on improving your score in as little time as possible. This is the secret sauce to our proprietary Strategic Score Optimization method that consistently gets the best results for our students.
It’s a custom, one-of-a-kind approach that’s hand-built just for you.
