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Average Step 1, Step 2 CK Scores, Research by Specialty (US Seniors, IMGs)

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by Alec Palmerton, MD in IMG, Residency
USMLE Average Scores by Specialty

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)

Why is this 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 2018 survey of program directors, Step 1 was the highest-cited factor for giving interviews. For competitive specialties, research is a common factor that helps students stand out.

FactorPercent Citing FactorAverage Rating of Importance
USMLE Step 1/COMLEX Level 1 score94%4.1
Letters of recommendation in the specialty86%4.2
Medical Student Performance Evaluation (MSPE/Dean's Letter)81%4
USMLE Step 2 CK/COMLEX Level 2 CE score80%4
Personal Statement78%3.7
Grades in required clerkships76%4.1
Any failed attempt in USMLE/COMLEX70%4.5
Class ranking/quartile70%3.9
Perceived commitment to specialty69%4.3
Personal prior knowledge of the applicant68%4.2
Grades in clerkship in desired specialty67%4.3
Audition elective/rotation within your department64%4.2
Evidence of professionalism and ethics64%4.5
Leadership qualities61%4.1
Alpha Omega Alpha (AOA) membership60%3.9
Perceived interest in program59%4.1
Other life experience58%3.8
Passing USMLE Step 2 CS/COMLEX Level 2 PE56%4.2
Volunteer/extracurricular experiences54%3.8
Consistency of grades54%4
Lack of gaps in medical education53%4
Awards or special honors in clinical clerkships52%3.6
Graduate of highly‐regarded U.S. medical school50%3.8
Gold Humanism Honor Society (GHHS) membership47%3.8
Awards or special honors in clerkship in desired specialty46%3.8
Demonstrated involvement and interest in research41%3.7
Visa status (IMG only)40%4.1
Applicant was flagged with Match violation by the NRMP37%4.8
Away rotation in your specialty at another institution26%3.8
Interest in academic career24%3.8
Fluency in language spoken by your patient population24%3.7
Awards or special honors in basic sciences22%3.3
USMLE/COMLEX Step 3 score16%3.4
USMLE Average Scores by Specialty

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

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 2018 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)
Anesthesiology232212244236
Child Neurology233211246234
Dermatology249241256249
Diagnostic Radiology240223249235
Emergency Medicine233220247233
Family Medicine220206237223
General Surgery236219248233
Internal Medicine233207246223
Internal Medicine/Pediatrics235217250229
Interventional Radiology246242255248
Neurological Surgery245234249238
Neurology231213242229
Obstetrics and Gynecology230218247235
Orthopaedic Surgery248240255246
Otolaryngology248238254242
Pathology233216242238
Pediatrics227209243222
Physical Medicine and Rehabilitation225215239229
Plastic Surgery249239254248
Psychiatry226215239229
Radiation Oncology247238253243
Vascular Surgery236219244229
All Specialties Combined233224246236

US Seniors: Average Abstracts, Presentations, and Publications by Specialty

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)
Anesthesiology4.52.6
Child Neurology6.30
Dermatology14.78.6
Diagnostic Radiology63.9
Emergency Medicine3.72.9
Family Medicine32.3
General Surgery6.24.7
Internal Medicine5.12.9
Internal Medicine/Pediatrics4.84.9
Interventional Radiology8.47.3
Neurological Surgery18.38.9
Neurology6.37.3
Obstetrics and Gynecology4.93.3
Orthopaedic Surgery11.56.7
Otolaryngology10.45.3
Pathology6.76.8
Pediatrics4.13.2
Physical Medicine and Rehabilitation4.23.4
Plastic Surgery14.214.9
Psychiatry4.83.7
Radiation Oncology15.612.2
Vascular Surgery8.33.3
All Specialties Combined5.75

IMGs: Average Step 1 Scores by Specialty

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)
Anesthesiology231222240221
Child NeurologyN/AN/A235221
DermatologyN/AN/A238230
Diagnostic Radiology239226241232
Emergency Medicine232222229219
Family Medicine211207220212
General Surgery237228242236
Internal Medicine225210236222
Internal Medicine/Pediatrics224218238225
Interventional RadiologyN/AN/AN/AN/A
Neurological SurgeryN/A236246236
Neurology227214236224
Obstetrics and Gynecology229216231228
Orthopaedic Surgery239241239238
OtolaryngologyN/AN/AN/AN/A
Pathology226213230219
Pediatrics221211230213
Physical Medicine and Rehabilitation226217238221
Plastic SurgeryN/AN/A228228
Psychiatry214207222216
Radiation OncologyN/AN/AN/AN/A
Vascular SurgeryN/AN/A243229
All Specialties Combined222212234221

IMGs: Average Step 2 CK Scores by Specialty

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)
Anesthesiology237230244228
Child NeurologyN/AN/A242227
DermatologyN/AN/A246232
Diagnostic Radiology242233243236
Emergency Medicine241230234228
Family Medicine225219231223
General Surgery245236249240
Internal Medicine234220241228
Internal Medicine/Pediatrics233224240230
Interventional RadiologyN/AN/AN/AN/A
Neurological SurgeryN/A242243242
Neurology234223240227
Obstetrics and Gynecology238228237237
Orthopaedic Surgery245241237243
OtolaryngologyN/AN/AN/AN/A
Pathology230221233224
Pediatrics23222238224
Physical Medicine and Rehabilitation235226242231
Plastic SurgeryN/AN/A242239
Psychiatry227217232224
Radiation OncologyN/AN/AN/AN/A
Vascular SurgeryN/AN/A247238
All Specialties Combined232222240228

IMGs: Average Abstracts, Presentations, and Publications by Specialty

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)
Anesthesiology2.12.277
Child NeurologyN/AN/A6.515.2
DermatologyN/AN/A12.312.2
Diagnostic Radiology2.63.215.99.7
Emergency Medicine2.227.64
Family Medicine22.72.73.1
General Surgery4.23.41511.7
Internal Medicine2.22.34.64.5
Internal Medicine/Pediatrics2.42.955.4
Interventional RadiologyN/AN/AN/AN/A
Neurological SurgeryN/A5.246.629.1
Neurology2.65.37.39
Obstetrics and Gynecology2.52.49.16.7
Orthopaedic Surgery37.119.81429
OtolaryngologyN/AN/AN/AN/A
Pathology511.811.514.7
Pediatrics1.83.64.14.4
Physical Medicine and Rehabilitation2.542.45.9
Plastic SurgeryN/AN/A2814.9
Psychiatry2.436.44.5
Radiation OncologyN/AN/AN/AN/A
Vascular SurgeryN/AN/A36.316.5
All Specialties Combined2.53.45.96.2

IMGs vs. US Seniors: Average Step 1, Step 2 CK Scores

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)
Anesthesiology232231240
Child Neurology233N/A235
Dermatology249N/A238
Diagnostic Radiology240239241
Emergency Medicine233232229
Family Medicine220211220
General Surgery236237242
Internal Medicine233225236
Internal Medicine/Pediatrics235224238
Interventional Radiology246N/AN/A
Neurological Surgery245N/A246
Neurology231227236
Obstetrics and Gynecology230229231
Orthopaedic Surgery248239239
Otolaryngology248N/AN/A
Pathology233226230
Pediatrics227221230
Physical Medicine and Rehabilitation225226238
Plastic Surgery249N/A228
Psychiatry226214222
Radiation Oncology247N/AN/A
Vascular Surgery236N/A243
All Specialties Combined233222234

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)
Anesthesiology244237244
Child Neurology246N/A242
Dermatology256N/A246
Diagnostic Radiology249242243
Emergency Medicine247241234
Family Medicine237225231
General Surgery248245249
Internal Medicine246234241
Internal Medicine/Pediatrics250233240
Interventional Radiology255N/AN/A
Neurological Surgery249N/A243
Neurology242234240
Obstetrics and Gynecology247238237
Orthopaedic Surgery255245237
Otolaryngology254N/AN/A
Pathology242230233
Pediatrics243232238
Physical Medicine and Rehabilitation239235242
Plastic Surgery254N/A242
Psychiatry239227232
Radiation Oncology253N/AN/A
Vascular Surgery244N/A247
All Specialties Combined246232240

IMGs vs. US Seniors: Average Abstracts, Presentations, and Publications by Specialty

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)
Anesthesiology4.52.17
Child Neurology6.3N/A6.5
Dermatology14.7N/A12.3
Diagnostic Radiology62.615.9
Emergency Medicine3.72.27.6
Family Medicine322.7
General Surgery6.24.215
Internal Medicine5.12.24.6
Internal Medicine/Pediatrics4.82.45
Interventional Radiology8.4N/AN/A
Neurological Surgery18.3N/A46.6
Neurology6.32.67.3
Obstetrics and Gynecology4.92.59.1
Orthopaedic Surgery11.537.114
Otolaryngology10.4N/AN/A
Pathology6.7511.5
Pediatrics4.11.84.1
Physical Medicine and Rehabilitation4.22.52.4
Plastic Surgery14.2N/A28
Psychiatry4.82.46.4
Radiation Oncology15.6N/AN/A
Vascular Surgery8.3N/A36.3
All Specialties Combined5.72.55.9

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 that 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.

Sources: National Resident Matching Program, Charting Outcomes in the Match: International Medical Graduates, 2018. National Resident Matching Program, Washington, DC 2018.

National Resident Matching Program, Charting Outcomes in the Match: U.S. Allopathic Seniors, 2018. National Resident Matching Program, Washington, DC 2018.

National Resident Matching Program, Data Release and Research Committee: Results of the 2018 NRMP Program Director Survey. National Resident Matching Program, Washington, DC. 2018.

Photo by patricia serna

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Want FREE Cardiology Flashcards?

Cardiology is key for impressive USMLE scores. Master cardiology from a Harvard-trained anesthesiologist who scored 270 on the USMLE Step 1 with these 130+ high-yield flash cards. You’ll be begging for cardio questions - even if vitals make you queasy.

Subscribe