Thought Step 1 going pass/fail was the end of the big changes? What if Step 2 CK is next? The rumors are getting louder, and if they’re true, they could change how you plan your entire residency strategy. While nothing has been officially confirmed yet, the rumors are strong enough to take seriously. So what would a pass/fail Step 2 CK mean for you? And what can you do to stay prepared?
In this article, we’ll explain why Step 1 became pass/fail, whether Step 2 CK might follow, how this change could affect your chances for residency and most importantly, how to prepare, no matter what happens.
Why Did Step 1 Go Pass-Fail?
To understand why people think Step 2 CK might change, we need to look back at why Step 1 became pass/fail.
Step 1 was first made to check if students had enough basic knowledge to be safe doctors, not to decide who gets into competitive specialties like dermatology or neurosurgery. But as residency applications became more competitive, program directors started using Step 1 scores to quickly sort through the huge number of applicants.
The numbers show why. In 2022, the average residency program got over 1,000 applications, but only looked carefully at about 435. Out of those, only 130 were invited to interviews, and about 100 were ranked. With so many people applying, programs used Step 1 scores as a filter. This put huge pressure on students to get very high scores.
Because of this pressure, a 2019 meeting called the InCUS conference was held to talk about the problem. A few months later, in 2020, USMLE announced that Step 1 would become pass/fail starting in 2022. The main goals were to reduce stress, use Step 1 for what it was meant for, and push programs to look at applicants as a whole and not just a number. It was also an effort to reduce racial and economic unfairness.
Now, similar problems are happening with Step 2 CK. That’s why many believe it could be next.
Is Step 2 CK Going to Become Pass/Fail?
Now that Step 1 is pass/fail, programs are looking more at Step 2 CK scores. Step 2 CK is meant to test how well you apply clinical knowledge in real-life situations. But just like Step 1, it’s being used to rank students, which wasn’t the original goal.
There are signs that a change might be coming. For example, someone heard from a program director at a competitive East Coast specialty who seemed sure that Step 2 CK would eventually become pass/fail. This isn’t official proof, but it’s enough to get students thinking and planning ahead.
What Might Happen If Step 2 CK Goes Pass/Fail?
If Step 2 CK becomes pass/fail, it could change the residency application process in a big way. Here’s what might happen:
More Students Might Fail
When Step 1 became pass/fail, failure rates went up. In 2020, only 2% of U.S. MD students failed Step 1. By 2022, that number jumped to 7%. For DO students, it went from 3% to 11%, and for IMGs, it rose from 13% to 26%.
Why? Some students didn’t study as hard, thinking a simple pass was enough. Step 2 CK might see the same trend, especially since it’s a harder more clinical exam.
One Less Way to Compare Applicants
Program directors use Step 2 CK scores to compare students from different schools. If it goes pass/fail, that tool disappears. Instead, they may focus more on things like:
- Research experience: Publications or projects could matter more.
- Letters of recommendation: Personal, detailed letters will carry more weight.
- Connections: Knowing the right people could help more.
- School reputation: Being from a well-known school might give an edge.
This change might make the process feel less fair and more based on who you know.
Some Students Could Be at a Disadvantage
A pass/fail Step 2 CK could hurt some students more than others. For example, IMGs often rely on high USMLE scores to stand out. If that’s taken away, they may struggle to compete. The same goes for students at smaller or lesser-known schools, or those without strong research experience.
Even though holistic review sounds fair, it can sometimes help those who already have more support, money, or connections.
When Might the Change Happen?
Let’s be clear: this is just a rumor right now. No one has officially said Step 2 CK will become pass/fail. But if it follows the same path as Step 1, here’s what might happen:
Step 1’s change took about three years, from the 2019 InCUS meeting to the 2020 announcement, to the 2022 rollout. If Step 2 CK takes the same path, the earliest change might come in 2028 or later.
So current students are probably safe. But future students, especially those in MD-PhD programs or taking longer paths might be affected.
How to Prepare for Step 2 CK—Pass/Fail or Not
Even if it’s just a rumor, this is a good reminder to rethink your game plan. Here are five simple but smart things to do right now:
Take Step 1 Seriously
Even though it’s pass/fail, Step 1 builds your base knowledge. Students who barely pass often struggle with Shelf exams and Step 2 CK. So don’t just try to pass, aim to understand the material deeply.
Focus on Shelf Exams
If Step 2 CK becomes pass/fail, shelf exams might be used more. These exams test your clinical thinking and are a good sign of how ready you are for residency. Doing well starts with a strong Step 1 foundation.
Build a Strong Application
With fewer test scores, your whole application matters more. Start now:
- Do research and aim to publish or present your work.
- Get great letters by building good relationships with your teachers.
- Choose schools wisely, if you haven’t started med school yet.
- Find mentors who can support and guide you.
Treat Clinical Rotations Like Job Interviews
Every rotation is your chance to impress. Be prepared, show interest, and do your best with both patients and faculty. These efforts lead to better evaluations and stronger connections.
Master the Material—Don’t Just Memorize
Whether Step 2 CK stays scored or not, your goal is to be a great doctor. Use smart techniques like:
- Feynman Technique: Teach concepts to yourself in simple words.
- Spaced repetition: Use tools like Anki to remember things long-term.
- UWorld practice: Focus on understanding the why behind each answer.
Conclusion
The possibility of Step 2 CK going pass/fail shouldn’t cause panic, but it should prompt smart, strategic planning. Whether or not the scoring system changes, your focus should remain steady: master the material, retain it for the long period, and apply it confidently in real clinical settings.
At the end of the day, what matters most hasn’t changed. Strong clinical knowledge, thoughtful preparation, and meaningful mentorship are still the keys to a successful residency application and to becoming the kind of doctor every patient hopes for.
