Do you have what it takes to get into your dream residency? How much does your Step 1 score matter? Or Step 2 CK score? How much research do you need?
In this article, we will address the numbers you need to know. Specifically, we’ll look at the average Step 1 and Step 2 CK scores for matched and unmatched applicants by specialty. Also, we’ll look at the average research successful applicants had. Finally, we’ll compare numbers for both US Seniors and IMGs (International Medical Graduates)
Note: Updated with new data for 2025: This article now includes the latest data from the 2024 Main Residency Match and the Program Director Survey.
Table of Contents
Why Are Step 1 and Step 2 CK Scores Important?
Residency program directors are busy. As such, they rely heavily on Step 1 and Step 2 CK scores to sort through applicants. In fact, in a 2021 survey of program directors, Step 1 was the highest-cited factor for giving interviews. (NOTE: in future years, given that Step 1 is now pass-fail, Step 2 scores will likely factor much more heavily for interviews). For competitive specialties, research is a common factor that helps students stand out.
| Characteristics Considered in Deciding Whom to Interview | Percentage of Respondents Endorsing | Mean Importance Rating |
|---|---|---|
| USMLE Step 1 pass | 90% | 4.5 |
| Medical Student Performance Evaluation (MSPE/Dean's Letter) | 85% | 4.1 |
| Letters of recommendation in the specialty | 84% | 4.2 |
| USMLE Step 2 Clinical Knowledge (CK) score | 83% | 4.2 |
| Personal Statement | 81% | 4 |
| Any failed attempt in USMLE | 77% | 4.4 |
| History of having overcome significant obstacles | 74% | 4.1 |
| Perceived commitment to specialty | 72% | 4.4 |
| Diversity characteristics | 72% | 4 |
| Leadership qualities | 72% | 4.2 |
| Grades in required clerkships | 70% | 4 |
| Class ranking/quartile | 66% | 3.9 |
| Evidence of professionalism and ethics | 66% | 4.5 |
| Receipt of preference (program) signal | 63% | 4.1 |
| COMLEX-USA Level 1 pass | 62% | 4.5 |
| Any failed attempt in COMLEX-USA | 62% | 4.4 |
| Volunteer/extracurricular experiences | 61% | 3.9 |
| Geographic preferences | 60% | 3.9 |
| Other life experience | 60% | 4 |
| Grades in clerkship in desired specialty | 60% | 4.2 |
| Audition elective/rotation within your department | 60% | 4.2 |
| Personal prior knowledge of the applicant | 58% | 4.2 |
| COMLEX-USA Level 2 Clinical Evaluation (CE) score | 56% | 4.2 |
| Consistency of grades | 50% | 4 |
| Awards or special honors in clinical clerkships | 48% | 3.6 |
| Gold Humanism Honor Society (GHHS) membership | 48% | 3.6 |
| Evidence of continuous medical education without gaps | 43% | 3.9 |
| Alpha Omega Alpha (AOA) membership | 43% | 3.5 |
| Demonstrated involvement and interest in research | 42% | 3.7 |
| Awards or special honors in clerkship in desired specialty | 39% | 3.8 |
| Accreditation status of applicant's medical school | 37% | 4.2 |
| Passing USMLE Step 2 Clinical Skills (CS) | 36% | 4.2 |
| Ability to work legally in the U.S. without a visa | 35% | 4.2 |
| Visa status | 33% | 3.9 |
| Graduate of highly-regarded medical or osteopathic school | 31% | 3.5 |
| Fluency in language spoken by your patient population | 30% | 3.7 |
| Away rotation in your specialty at another institution | 26% | 3.8 |
| Passing COMLEX-USA Level 2 Performance Evaluation | 25% | 4.2 |
| Applicant was flagged with Match violation by the NRMP | 23% | 4.8 |
| Sigma Sigma Phi (osteopathic honor society) membership | 21% | 3.5 |
| Interest in academic career | 19% | 3.7 |
| Awards or special honors in basic sciences | 18% | 3.1 |
| USMLE Step 3 score | 13% | 3.4 |
| COMLEX-USA Level 3 score | 10% | 3.4 |
| How applicant's medical school handled virtual rotations | 5% | 3.3 |
Program Directors rely on what they can measure. Who is most likely to be screened out?
US Seniors: Average Step 1, Step 2 CK Scores by Specialty (2024 Match)
Step 1 and Step 2 CK are some of the most important factors for getting an interview. Below are the average Step 1 and Step 2 CK scores by specialty from the NRMP 2024 Match.
Want to know which specialties have the highest and lowest USMLE scores? Click on the column headers to sort by column.
| Step 1, US Senior (Matched) | Step 1, US Senior (Unmatched) | Step 2, US Senior (Matched) | Step 2, US Senior (Unmatched) | |
|---|---|---|---|---|
| Anesthesiology | 234 | 216 | 252 | 240 |
| Child Neurology | 230 | NA | 248 | 230 |
| Dermatology | 245 | 235 | 257 | 250 |
| Diagnostic Radiology | 241 | 224 | 256 | 241 |
| Emergency Medicine | 224 | 220 | 248 | 234 |
| Family Medicine | 217 | 208 | 244 | 231 |
| General Surgery | 235 | 215 | 253 | 238 |
| Internal Medicine | 234 | 220 | 251 | 234 |
| Internal Medicine/Pediatrics | 233 | 216 | 253 | 243 |
| Interventional Radiology | 247 | 237 | 253 | 245 |
| Neurological Surgery | 245 | 230 | 255 | 247 |
| Neurology | 231 | 228 | 250 | 236 |
| Obstetrics and Gynecology | 227 | 220 | 252 | 244 |
| Orthopaedic Surgery | 244 | 234 | 257 | 246 |
| Otolaryngology | 243 | 242 | 256 | 251 |
| Pathology | 235 | 232 | 247 | 232 |
| Pediatrics | 224 | 214 | 247 | 233 |
| Physical Medicine and Rehabilitation | 226 | 212 | 248 | 236 |
| Plastic Surgery | 247 | 226 | 256 | 247 |
| Psychiatry | 226 | 216 | 246 | 235 |
| Radiation Oncology | 238 | NA | 252 | 242 |
| Vascular Surgery | 239 | NA | 253 | 246 |
US Seniors: Average Abstracts, Presentations, and Publications by Specialty (2024 Match)
Research is important for competitive specialties, or particularly competitive residency programs. Here are the average numbers of abstracts, presentations, and publications by specialty.
| Mean number of abstracts, presentations, and publications, US Senior (Matched) | Mean number of abstracts, presentations, and publications, US Senior (Unmatched) | |
|---|---|---|
| Anesthesiology | 9 | 5.4 |
| Child Neurology | 9.8 | 1 |
| Dermatology | 27.7 | 19 |
| Diagnostic Radiology | 12 | 8 |
| Emergency Medicine | 5.7 | 5 |
| Family Medicine | 4.2 | 1.4 |
| General Surgery | 10.9 | 7.3 |
| Internal Medicine | 8.7 | 6.2 |
| Internal Medicine/Pediatrics | 6.9 | 6.2 |
| Interventional Radiology | 15.8 | 10.1 |
| Neurological Surgery | 37.4 | 31.8 |
| Neurology | 8.8 | 5.5 |
| Obstetrics and Gynecology | 9 | 6.8 |
| Orthopaedic Surgery | 23.8 | 18 |
| Otolaryngology | 20 | 15.6 |
| Pathology | 8.4 | 4.1 |
| Pediatrics | 6.4 | 21.5 |
| Physical Medicine and Rehabilitation | 8.6 | 6.4 |
| Plastic Surgery | 34.7 | 26.3 |
| Psychiatry | 7.5 | 4.6 |
| Radiation Oncology | 15.9 | 13.5 |
| Vascular Surgery | 12.8 | 8 |
IMGs: Average Step 1 Scores by Specialty (2024 Match)
IMGs face an uphill battle to enter US residencies. Here are the average Step 1 scores by specialty for US and Non-US IMGs.
To read The IMG’s Guide to Obtaining Residency in the United States, click here.
| Step 1, US IMG (Matched) | Step 1, US IMG (Unmatched) | Step 1, Non-US IMG (Matched) | Step 1, Non-US IMG (Unmatched) | |
|---|---|---|---|---|
| Anesthesiology | 231 | 220 | 240 | 239 |
| Child Neurology | 231 | 214 | 201 | 216 |
| Dermatology | N/A | N/A | 228 | 238 |
| Diagnostic Radiology | 233 | 237 | 250 | 242 |
| Emergency Medicine | 215 | 210 | 223 | 216 |
| Family Medicine | 207 | 204 | 217 | 211 |
| General Surgery | 236 | 222 | 245 | 235 |
| Internal Medicine | 219 | 210 | 239 | 230 |
| Internal Medicine/Pediatrics | 196 | 209 | 221 | 220 |
| Interventional Radiology | 197 | 238 | 239 | 243 |
| Neurological Surgery | 231 | 218 | 249 | 243 |
| Neurology | 215 | 219 | 236 | 233 |
| Obstetrics and Gynecology | 221 | 217 | 245 | 231 |
| Orthopaedic Surgery | 220 | 238 | 244 | 250 |
| Otolaryngology | N/A | N/A | N/A | N/A |
| Pathology | 221 | 220 | 232 | 225 |
| Pediatrics | 210 | 206 | 223 | 215 |
| Physical Medicine and Rehabilitation | 214 | 215 | 239 | 223 |
| Plastic Surgery | 246 | 235 | 243 | 238 |
| Psychiatry | 212 | 204 | 228 | 216 |
| Radiation Oncology | N/A | N/A | 240 | 221 |
| Vascular Surgery | N/A | N/A | 224 | 229 |
IMGs: Average Step 2 CK Scores by Specialty (2024 Match)
Step 2 CK doesn’t rank as highly as Step 1 for residency program directors. However, for IMGs, Step 2 CK is another opportunity to stand out. Here are the average Step 2 CK scores by specialty for US and Non-US IMGs.
| Step 2, US IMG (Matched) | Step 2, US IMG (Unmatched) | Step 2, Non-US IMG (Matched) | Step 2, Non-US IMG (Unmatched) | |
|---|---|---|---|---|
| Anesthesiology | 249 | 237 | 249 | 246 |
| Child Neurology | 237 | 233 | 241 | 228 |
| Dermatology | 242 | 238 | 256 | 241 |
| Diagnostic Radiology | 251 | 241 | 252 | 250 |
| Emergency Medicine | 233 | 222 | 239 | 229 |
| Family Medicine | 226 | 219 | 229 | 225 |
| General Surgery | 247 | 238 | 251 | 244 |
| Internal Medicine | 237 | 224 | 249 | 242 |
| Internal Medicine/Pediatrics | 224 | 238 | 247 | 236 |
| Interventional Radiology | 229 | 245 | 256 | 244 |
| Neurological Surgery | 257 | 255 | 242 | 246 |
| Neurology | 236 | 230 | 244 | 239 |
| Obstetrics and Gynecology | 240 | 234 | 252 | 241 |
| Orthopaedic Surgery | 253 | 251 | 247 | 251 |
| Otolaryngology | 265 | 245 | 250 | 245 |
| Pathology | 236 | 231 | 243 | 232 |
| Pediatrics | 234 | 220 | 239 | 228 |
| Physical Medicine and Rehabilitation | 233 | 231 | 243 | 228 |
| Plastic Surgery | 261 | 239 | 248 | 242 |
| Psychiatry | 231 | 222 | 238 | 232 |
| Radiation Oncology | 260 | 226 | 249 | 221 |
| Vascular Surgery | 240 | 221 | 243 | 243 |
IMGs: Average Abstracts, Presentations, and Publications by Specialty (2024 Match)
Research is particularly important for IMGs. As we’ll discuss below, research is the area where successful IMGs seem to need much more than US Seniors.
Here are the average abstracts, presentations, and publications by specialty.
| Mean number of abstracts, presentations, and publications, US IMG (Matched) | Mean number of abstracts, presentations, and publications, US IMG (Unmatched) | Mean number of abstracts, presentations, and publications, Non-US IMG (Matched) | Mean number of abstracts, presentations, and publications, Non-US IMG (Unmatched) | |
|---|---|---|---|---|
| Anesthesiology | 5.9 | 4 | 12 | 6.9 |
| Child Neurology | 4 | 8.3 | 10.8 | 7.5 |
| Dermatology | N/A | N/A | 28.5 | 7.2 |
| Diagnostic Radiology | 15.8 | 6.7 | 20.4 | 13.7 |
| Emergency Medicine | 2.4 | 3.1 | 8 | 5.1 |
| Family Medicine | 2.7 | 6.2 | 3.7 | 4.5 |
| General Surgery | 8.3 | 8.5 | 22.2 | 11.6 |
| Internal Medicine | 3.6 | 4.7 | 7 | 5.8 |
| Internal Medicine/Pediatrics | 4 | 4 | 2.8 | 9.6 |
| Interventional Radiology | 6 | 7.4 | 16.1 | 8.8 |
| Neurological Surgery | 32.8 | 22.2 | 87.8 | 51.1 |
| Neurology | 10.2 | 6.7 | 13.3 | 8.8 |
| Obstetrics and Gynecology | 4.5 | 3.8 | 11.4 | 8.5 |
| Orthopaedic Surgery | 30.3 | 27 | 100 | 38.6 |
| Otolaryngology | N/A | N/A | N/A | N/A |
| Pathology | 10.1 | 8.2 | 12.1 | 7.1 |
| Pediatrics | 2.5 | 3.3 | 5.1 | 4.6 |
| Physical Medicine and Rehabilitation | 4.2 | 2.1 | 9 | 11.1 |
| Plastic Surgery | 7 | 23.7 | 55.7 | 37.1 |
| Psychiatry | 3.4 | 3.6 | 8 | 6.6 |
| Radiation Oncology | N/A | N/A | 24.2 | 11.8 |
| Vascular Surgery | N/A | N/A | 38.3 | 15.4 |
IMGs vs. US Seniors: Average Step 1, Step 2 CK Scores (2024 Match)
See anything surprising when comparing the USMLE scores of US Seniors and IMGs? They’re not all that different! When I compiled the data, there didn’t seem to be huge discrimination against IMGs based on USMLE scores. (There are other ways in which IMGs may have discrimination, which I’ve detailed here).
Here are the average Step 1 scores for matched applicants for IMGs vs. US Seniors.
| Step 1, US Senior (Matched) | Step 1, US IMG (Matched) | Step 1, Non-US IMG (Matched) | |
|---|---|---|---|
| Anesthesiology | 235 | 231 | 240 |
| Child Neurology | 225 | 231 | 201 |
| Dermatology | 247 | N/A | 228 |
| Diagnostic Radiology | 243 | 233 | 250 |
| Emergency Medicine | 223 | 215 | 223 |
| Family Medicine | 214 | 207 | 217 |
| General Surgery | 236 | 236 | 245 |
| Internal Medicine | 236 | 219 | 239 |
| Internal Medicine/Pediatrics | 232 | 196 | 221 |
| Interventional Radiology | 250 | 197 | 239 |
| Neurological Surgery | 248 | 231 | 249 |
| Neurology | 232 | 215 | 236 |
| Obstetrics and Gynecology | 225 | 221 | 245 |
| Orthopaedic Surgery | 247 | 220 | 244 |
| Otolaryngology | 242 | N/A | N/A |
| Pathology | 236 | 221 | 232 |
| Pediatrics | 222 | 210 | 223 |
| Physical Medicine and Rehabilitation | 225 | 214 | 239 |
| Plastic Surgery | 248 | 246 | 243 |
| Psychiatry | 228 | 212 | 228 |
| Radiation Oncology | 237 | N/A | 240 |
| Vascular Surgery | 240 | N/A | 224 |
Here are the average Step 2 CK scores for matched applicants for IMGs vs. US Seniors.
| Step 2, US Senior (Matched) | Step 2, US IMG (Matched) | Step 2, Non-US IMG (Matched) | |
|---|---|---|---|
| Anesthesiology | 253 | 249 | 249 |
| Child Neurology | 248 | 237 | 241 |
| Dermatology | 258 | 242 | 256 |
| Diagnostic Radiology | 256 | 251 | 252 |
| Emergency Medicine | 247 | 233 | 239 |
| Family Medicine | 245 | 226 | 229 |
| General Surgery | 254 | 247 | 251 |
| Internal Medicine | 252 | 237 | 249 |
| Internal Medicine/Pediatrics | 254 | 224 | 247 |
| Interventional Radiology | 254 | 229 | 256 |
| Neurological Surgery | 255 | 257 | 242 |
| Neurology | 251 | 236 | 244 |
| Obstetrics and Gynecology | 252 | 240 | 252 |
| Orthopaedic Surgery | 257 | 253 | 247 |
| Otolaryngology | 258 | 265 | 250 |
| Pathology | 248 | 236 | 243 |
| Pediatrics | 248 | 234 | 239 |
| Physical Medicine and Rehabilitation | 249 | 233 | 243 |
| Plastic Surgery | 257 | 261 | 248 |
| Psychiatry | 245 | 231 | 238 |
| Radiation Oncology | 253 | 260 | 249 |
| Vascular Surgery | 253 | 240 | 243 |
IMGs vs. US Seniors: Average Abstracts, Presentations, and Publications by Specialty (2024 Match)
The USMLE scores aren’t as different between US Seniors and IMGs. However, there is a much larger difference in abstracts, presentations, and publications.
Here are the average abstracts, presentations, and publications for US Seniors and IMGs.
| Mean number of abstracts, presentations, and publications, US Senior (Matched) | Mean number of abstracts, presentations, and publications, US IMG (Matched) | Mean number of abstracts, presentations, and publications, Non-US IMG (Matched) | |
|---|---|---|---|
| Anesthesiology | 9 | 5.9 | 12 |
| Child Neurology | 9.8 | 4 | 10.8 |
| Dermatology | 27.7 | N/A | 28.5 |
| Diagnostic Radiology | 12 | 15.8 | 20.4 |
| Emergency Medicine | 5.7 | 2.4 | 8 |
| Family Medicine | 4.2 | 2.7 | 3.7 |
| General Surgery | 10.9 | 8.3 | 22.2 |
| Internal Medicine | 8.7 | 3.6 | 7 |
| Internal Medicine/Pediatrics | 6.9 | 4 | 2.8 |
| Interventional Radiology | 15.8 | 6 | 16.1 |
| Neurological Surgery | 37.4 | 32.8 | 87.8 |
| Neurology | 8.8 | 10.2 | 13.3 |
| Obstetrics and Gynecology | 9 | 4.5 | 11.4 |
| Orthopaedic Surgery | 23.8 | 30.3 | 100 |
| Otolaryngology | 20 | N/A | N/A |
| Pathology | 8.4 | 10.1 | 12.1 |
| Pediatrics | 6.4 | 2.5 | 5.1 |
| Physical Medicine and Rehabilitation | 8.6 | 4.2 | 9 |
| Plastic Surgery | 34.7 | 7 | 55.7 |
| Psychiatry | 7.5 | 3.4 | 8 |
| Radiation Oncology | 15.9 | N/A | 24.2 |
| Vascular Surgery | 12.8 | N/A | 38.3 |
Concluding Thoughts
There’s no question that USMLE Step 1 and Step 2 CK play huge roles in residency applications. In addition, research is another way applicants can stand out, particularly for competitive specialties or IMGs. Knowing the numbers is powerful and can help guide important decisions, like whether you should delay an exam or what scores you should aim for.
Photo by Patricia Serna
