What Step 2 CK score you need by specialty: the short answer
- Passing score on Step 2 CK: 218, raised from 214 for exams taken on or after July 1, 2025. The mean for first-time U.S. and Canadian test-takers is approximately 248–250.
- Matched applicants averaged roughly 244–257 on Step 2 CK depending on specialty in the NRMP Charting Outcomes edition that preceded the July 28, 2026 release, a spread of about 13 points. The figures on this page have not yet been re-checked against the new edition, and NRMP says past data does not predict future matches; confirm your specialty there.
- Dermatology tops the Step 2 CK matched averages at about 257 and Family Medicine sits at the bottom at about 244. Every matched average in that edition clears 240.
- Step 1 is pass/fail, so Step 2 CK is the only numeric USMLE score most programs see on your residency application.
- Target roughly five points above the matched Step 2 CK average for your specialty. That buffer is our suggestion, not an NRMP figure; programs do not publish their screening cutoffs.
On this page
Average Step 2 CK Score by Specialty (Matched Applicants)
The table below shows the approximate mean Step 2 CK score of U.S. MD seniors who matched into each specialty, compiled from the NRMP Charting Outcomes in the Match edition that preceded the July 28, 2026 release. These values have not yet been re-checked against the new edition, so treat them as a guide and confirm your specialty in the current report. Values are rounded. The "comfortable target" column is our study suggestion, roughly five points above the matched average. Programs do not publish screening cut-offs, so it is a target, not a prediction.
| Specialty | Average Step 2 CK (Matched) | Competitiveness | Comfortable target |
|---|---|---|---|
| Dermatology | ~257 | Very high | 260+ |
| Orthopedic Surgery | ~256 | Very high | 260+ |
| Plastic Surgery | ~256 | Very high | 260+ |
| Otolaryngology (ENT) | ~255 | Very high | 260 |
| Neurological Surgery | ~255 | Very high | 260 |
| Interventional Radiology | ~254 | High | 258 |
| Diagnostic Radiology | ~253 | High | 258 |
| General Surgery | ~252 | High | 257 |
| Internal Medicine–Pediatrics | ~252 | High | 257 |
| Anesthesiology | ~251 | High | 255 |
| Emergency Medicine | ~249 | Moderate | 253 |
| Internal Medicine | ~249 | Moderate | 253 |
| Obstetrics & Gynecology | ~249 | Moderate | 253 |
| Psychiatry | ~247 | Moderate | 252 |
| Pediatrics | ~246 | Moderate | 250 |
| Physical Medicine & Rehabilitation | ~245 | Moderate | 250 |
| Family Medicine | ~244 | Lower | 248 |
Two things to notice. First, the total spread from top to bottom is only 13 points (244 to 257). That is a narrow band, so small score differences carry outsized weight: a 5-point improvement can shift your standing meaningfully within your target specialty. Second, the matched average in every specialty exceeds 240, so in that edition 240 sat below every matched average; treat it as a baseline, not a strong score.
What Is the Average Step 2 CK Score?
For first-time test-takers from U.S. and Canadian medical schools, the mean Step 2 CK score is approximately 248–250, with a standard deviation in the mid-teens. The minimum passing score is 218, up from 214 for exams taken on or after July 1, 2025. The score scale runs to 300, though scores above 270 are rare.
Put those together and the reference points fall out. About 250 is average, and 260 is roughly one standard deviation above it, which is a strong result for any specialty. Around 235 is a full standard deviation below the mean: still passing, but below the matched average of every specialty in the table.
Note that "average Step 2 score" and "average matched Step 2 score by specialty" are different numbers. The first is the population mean of everyone who sits the exam. The second is the mean of applicants who successfully matched into a given specialty, which skews higher because it excludes unmatched applicants and those who did not apply to that field.
How to Read the Numbers
These are averages for matched applicants, not cutoffs. Plenty of people match with below-average scores, and plenty with above-average scores do not match. Your score is one component of a holistic application that includes clinical grades, research, letters of recommendation, personal statement, and interview performance.
That said, program directors rank Step 2 CK among the factors they use to select applicants for interview. Programs do not publish any screening thresholds, and NRMP data cannot tell you where any program sets one. Scoring below the matched average for your target specialty does not disqualify you, but it does mean the rest of your application needs to compensate.
For DO applicants, the average matched Step 2 CK across all specialties was approximately 248, essentially the same as the MD average. The gap between MD and DO Step 2 scores has narrowed substantially, and programs that accept both increasingly evaluate them on the same scale. International medical graduates typically need to sit above the matched mean of their target specialty to be competitive, because programs weigh USMLE performance more heavily when they have less familiarity with the applicant's school.
Finally, remember that NRMP reports means, and the distribution within a specialty is wide. In the more competitive fields, the matched range commonly spans 20 or more points around the mean. The mean tells you where the center of the matched cohort sits; it does not tell you where the door closes.
Score Targets by Specialty Tier (Our Suggestions)
Just need to pass: 218+
This is a danger zone for residency applications. Even Family Medicine's matched average is 244. If you are at risk of scoring in the low 220s, the priority is a dedicated re-study period before the exam, not a retake plan after it. Step 2 CK can only be retaken after a failure.
Competitive for primary care (Family Medicine, Pediatrics, Psychiatry, PM&R): 245+
Aim for 250 to be comfortably above the matched average in each of these fields. Psychiatry's matched average of 247 sits above the other three, so give it the extra points.
Competitive for mid-tier specialties (Internal Medicine, Emergency Medicine, OB/GYN, Anesthesiology, General Surgery): 250+
Aim for 255 for a comfortable buffer. Anesthesiology and General Surgery sit at the upper end of this band (251–252 matched means), so the buffer matters most there.
Competitive for surgical and top-tier specialties (Dermatology, Orthopedic Surgery, Plastic Surgery, ENT, Neurosurgery, Radiology): 255+
Every point above 255 incrementally helps. 260+ puts you in the upper tier of matched applicants for any of these fields. Here, Step 2 CK is necessary but nowhere near sufficient. Research output and away-rotation letters carry at least as much weight.
These targets are approximate and shift slightly each cycle. Use NRMP Charting Outcomes data for your specific specialty as the most authoritative source.
Step 2 CK Scores for Individual Specialties
Average Step 2 CK score for Dermatology
Matched applicants averaged about 257, the highest of any specialty in the NRMP data. Dermatology remains one of the smallest and most selective matches, and among successful applicants a score in the high 250s is typical, not exceptional.
Average Step 2 CK score for Orthopedic Surgery
Matched mean of about 256. Orthopedics is a large surgical match with a heavy emphasis on away rotations and letters, but the score bar is effectively the same as Dermatology.
Average Step 2 CK score for ENT (Otolaryngology)
About 255 for matched applicants. ENT has one of the narrower matched ranges, so an applicant in the high 240s is noticeably below the cohort and will need strong research and sub-internship performance to compensate.
Average Step 2 CK score for Neurosurgery
Roughly 255. Neurosurgery programs tend to weight research productivity heavily alongside the score; a 255 with a thin research record is a weaker application than a 250 with substantial output.
Average Step 2 CK score for Radiology
Diagnostic Radiology matched applicants averaged about 253 and Interventional Radiology about 254. Both sit in the upper half of the table.
Average Step 2 CK score for General Surgery
About 252 for categorical positions. General Surgery spans a wide range of program types, so the mean hides a large gap between university and community programs.
Average Step 2 CK score for Anesthesiology
About 251. Anesthesiology has grown steadily more competitive, and its matched mean now sits closer to the surgical specialties than to Internal Medicine.
Average Step 2 CK score for Internal Medicine
About 249 across all categorical IM programs. This average blends highly selective academic programs with large community programs; competitive university programs typically expect scores in the mid-250s, while many community programs match applicants in the low-to-mid 240s.
Average Step 2 CK score for Emergency Medicine
About 249. Emergency Medicine leans heavily on standardized letters of evaluation (SLOEs), so the score is one input among several.
Average Step 2 CK score for OB/GYN
About 249. OB/GYN weighs clinical performance and letters heavily alongside the score.
Average Step 2 CK score for Psychiatry
About 247. Psychiatry's mean has risen as the field's popularity has grown, so plan a buffer above 247.
Average Step 2 CK score for Pediatrics
About 246. Pediatrics matches a large number of applicants each year and is one of the more accessible fields by score.
Average Step 2 CK score for Family Medicine
About 244, the lowest matched mean in the table. Family Medicine is the most accessible specialty by score, but "accessible" still means the average matched applicant scored roughly 26 points above the passing threshold.
Why Step 2 CK Matters More Than It Used To
Before January 2022, residency programs had two numeric filters: Step 1 and Step 2 CK. With Step 1 now binary, Step 2 CK absorbed essentially all of the differentiating power that Step 1 used to carry. In a 2024 NRMP survey of program directors, Step 2 CK score was the fourth most frequently considered factor in deciding who to interview, behind only the USMLE transcript, the MSPE, and letters of recommendation.
The practical consequence: your Step 2 CK score is simultaneously your floor (you must pass at 218) and your ceiling (programs weigh it when selecting interviews). The 4-point increase in the passing standard is not dramatic in absolute terms, but the bar did move up.
How Step 1 preparation feeds Step 2 CK
Students who engage deeply with Step 1 material (pathophysiology, pharmacology, microbiology, biochemistry) consistently outperform on Step 2 CK. The foundational science does not disappear when you enter clerkships; it becomes the substrate for clinical reasoning. This is the strongest argument against "just passing" Step 1 in the pass/fail era. For more on that: USMLE Step 1 in the Pass/Fail Era.
If you are building your Step 2 CK study plan now, PassExams USMLE Step 2 CK practice covers all 11 content areas with worked clinical reasoning on every question, and the free tier needs no credit card.
Frequently Asked Questions
What is a good Step 2 CK score?
Anything at or above the national mean of roughly 248–250 is a solid score for most specialties. From 255 up you sit near or above the matched average of every specialty in the table, and 260+ is above the top of the table.
What is the passing score for Step 2 CK?
218, effective for exams taken on or after July 1, 2025. The previous passing score was 214.
What Step 2 CK score do you need for orthopedic surgery?
Matched applicants averaged about 256. Our suggested target is 260. Below the matched mean, the rest of the application has to carry more weight.
What Step 2 CK score do you need for internal medicine?
The matched mean is about 249. NRMP reports the distribution for the specialty as a whole, not by program type, so use the mean plus a five-point buffer as your target.
What Step 2 CK score do you need for anesthesiology?
About 251 was the matched average. Aim for 255 to be comfortably above the cohort mean.
Is 240 a good Step 2 CK score?
240 is a passing score with a buffer of about 22 points above the minimum, but it is below the matched average of every specialty, including Family Medicine (about 244). It sits closest to the primary care averages and furthest below the surgical ones.
Do DO students need a higher Step 2 CK score than MD students?
Not by the data. The matched DO average is about 248, in line with the MD average. Some competitive surgical programs still match fewer DO applicants overall, but Step 2 CK is evaluated on the same scale.
How often does NRMP update this data?
NRMP publishes Charting Outcomes in the Match after each Match cycle, typically in the summer; the latest edition was released on July 28, 2026. This table is refreshed after each edition is checked.
Sources and Methodology
- NRMP Charting Outcomes in the Match (Senior Students of U.S. MD Medical Schools; Senior Students of U.S. DO Medical Schools). Table values are the reported mean Step 2 CK scores of matched applicants, rounded to the nearest whole point and marked with "~".
- NRMP Program Director Survey (2024), for the ranking of factors used in interview selection.
- USMLE Scores and Transcripts, for the passing standard and score interpretation.
"Comfortable target" values are PassExams' recommendation (roughly five points above the matched mean) and are not NRMP figures. Specialties that match outside the NRMP Main Residency Match (Ophthalmology, Urology) are not included.