How Important is your Step 1 Score?

Step 1 has become an even higher high stakes exam. For better or worse, residency programs place a great deal of importance on Step 1 scores when assessing applicants. Grading systems in medical schools are not consistent and thus not comparable. Step 1 has therefore become the one objective measure common to all residency program applicants that program directors feel they can rely on to help them compare and assess applicants.

The more competitive the specialty (i.e., Plastic Surgery, Dermatology, Orthopedics), the more likely that programs will use Step 1 scores to screen residency applicants for interviews. A very good performance on Step 1 can help when it comes to securing a top-rate residency, and a poor score can hurt by limiting your options. A failure on Step 1 can likewise all but eliminate the possibility of some residencies altogether. Bottom line - although Step 1 is only one of many criteria that will be used in evaluating your residency application, it is in your best interest to do all you can to maximize your chances of doing well, regardless of what type of specialty training you may choose to pursue.

Although a score of 194 is required to pass the USMLE Step 1 exam, you need the following mean specialty averages to be competitive.

Please note the score tab for USMLE Preparation may change. Always check the NBME or AAMC website for updated score tab information.

  • Anesthesiology

    Recommended Specialty Advisor: David Forman, MD

    Min. Step 1 Mean Step 1 Does Step 2 CK influence rank? Min. Step 2 CK Mean Step 2 CK Mean # of contiguous ranks
    See below* 228 Yes See below* 238 14.3

     

    * There is not necessarily a "minimum" USMLE Step 1 or Step 2 score necessary to match in Anesthesiology. Many high profile academic programs will not give consideration to candidates with USMLE Step 1 scores less than 220. However, while anesthesiology continues to be a competitive specialty, there are over 100 programs offered in the Match and there are many programs across the country that vary in how competitive they are. It is important for a student interested in Anesthesiology to meet with a faulty advisor to review their entire application ( USMLE scores, academic grades, extracurricular activities, etc.) so that they can be guided as to which programs they will be most competitive candidates for. 

  • Dermatology

    Recommended Specialty Advisor: Marie Villegas, MD

    Mean Step 1 Does Step 2 CK influence rank? Mean Step 2 CK Mean # of contiguous ranks
    243 Yes 251 9.9
  • Emergency Medicine

    Recommended Specialty Advisor: Max Falkhoff, MD

    Min. Step 1 Mean Step 1 Does Step 2 CK influence rank? Min. Step 2 CK Mean Step 2 CK Mean # of contiguous ranks
    192* 230 Yes 209* 242 11

     

    *If the student does not perform well on the Step 1, then s/he must take Step 2 CK early in the fall (July-September 1) and do well. Your advisor can help you with this decision. It is recommended that all students have a Step 2 CK score prior to the program Rank Order List submission date in mid- February.

  • Family Medicine

    Recommended Specialty Advisor: Curtis Galke, MD, Miguel Tello, MD

    Mean Step 1 Does Step 2 CK influence rank? Mean Step 2 CK Mean # of contiguous ranks
    217 Somewhat* 232 10.2

     

    *Failing either Step 1 or Step 2 is a definite red flag. Many programs want applicants to have taken and passed Step 2 CK and CS by the end of the interview season and some programs are now requiring it. USMLE scores are just one criteria that programs will look at when deciding whether to interview and/or rank applicants. 

  • General Surgery

    Recommended Specialty Advisor: Samuel Snyder, MD

    Min. Step 1 Mean Step 1 Does Step 2 CK influence rank? Min. Step 2 CK Mean Step 2 CK Mean # of contiguous ranks
    200 232 Yes 213 244 10.5

     

  • Internal Medicine

    Recommended Specialty Advisor: Carlos T. Ramos, MD

    Min. Step 1 Mean Step 1 Does Step 2 CK influence rank? Min. Step 2 CK Mean Step 2 CK Mean # of contiguous ranks
    192 231 No 209 243 11.2

     

    * If the student does not perform well on Step 1 (less than 210), then s/he should take Step 2 CK early in the fall (July-September 1) and do well. Also, it is important that the student take and pass Step 1 CS prior to when programs will make their rank lists (usually mid -February). Many programs will not rank candidates if they have not yet passed this exam.

  • Internal Medicine & Pediatrics

    Recommended Specialty Advisor: Michelle Zeager, MD, Carlos T. Ramos, MD

    Mean Step 1 by US Matched Applicants Does Step 2 CK influence rank? Mean Step 2 CK by US Matched applicants Mean # of contiguous ranks of US Matched applicants
    232 Yes 245 8.6

     

    * If the student does not perform well on Step 1 (less than 210), then s/he should take Step 2 CK early in the fall (July- September 1) and do well. There is not necessarily a "minimum" USMLE Step 1 or Step 2 score necessary to match in Medicine/Pediatrics. For high profile academic programs you will likely need a USMLE Step 1 score greater than 220. However, there are many Medicine/Pediatric programs throughout the country that vary in how competitive they are. It is important for a student interested in Med-Peds to meet with a faculty advisor to review their entire application (USMLE scores, academic grades, extracurricular activities, etc.) so that they can be guided as to which programs they will be most competitive for. 

  • Neurology

    Recommended Specialty Advisor: Victoria Parada, MD

    Mean Step 1 by Stony Brook Program Does Step 2 CK influence rank? Mean Step 2 CK Stony Brook Program Mean # of contiguous ranks of Stony Brook Applicants
    229 Yes 239 12.1

     

    * If the student does not perform well on Step 1 (less than 210), then s/he should take Step 2 CK early in the fall (July - September 1) and do well.

  • Obstetrics & Gynecology

    Recommended Specialty Advisor: Tony Ogburn, MD

    Min. Step 1  Mean Step 1 Does Step 2 CK influence rank? Min. Step 2 CK Mean Step 2 CK Mean # of contiguous ranks
    203 225 No 209 241 10.6
  • Ophthalmology

    Recommended Specialty Advisor: Victor Gonzalez, MD

    Mean Step 1 Does Step 2 CK influence rank? Mean Step 2 CK Mean # of contiguous ranks
    237 Yes* Not Available 11

     

    * If you have a good Step 1 score 240 or greater, delay taking Step 2 until after the application season.

  • Orthopaedic Surgery

    Recommended Specialty Advisor: Kip Owen, MD

    Min. Step 1  Mean Step 1 Does Step 2 CK influence rank? Min. Step 2 CK Mean Step 2 CK Mean # of contiguous ranks
    212 244 No 246 249 11.2

     

  • Otolaryngology

    Recommended Specialty Advisor: Carlos Ayala, MD

    Min. Step 1 Mean Step 1 Does Step 2 CK influence rank? Min. Step 2 CK Mean Step 2 CK Mean # of contiguous ranks
    225 247 No 230 251 11.2

     

    * Step 2 CK reports can help if a student's Step 2 score is low.

  • Pathology

    Recommended Specialty Advisor: Alicia Murphy, MD

    Min. Step 1 Mean Step 1 Does Step 2 CK influence rank? Min. Step 2 CK Mean Step 2 CK Mean #  of contiguous ranks
    210 231 No 209 240 9.8
  • Pediatrics

    Recommended Specialty Advisor: Michelle Zeager, MD

    Min. Step 1 Mean Step 1 Does Step 2 CK influence rank? Min. Step 2 CK Mean Step 2 CK Mean # of contiguous ranks
    206* 226 Yes 227 24 10.6

     

    * If the student does not perform well on Step 1 (less than 210), then s/he should take Step 2 CK early in the fall (July- September 1) and do well. There is not necessarily a "minimum" USMLE Step 1 or Step 2 score necessary to match in Pediatrics. For high profile academic programs you will likely need a USMLE Step 1 score greater than 220. However, there are many pediatric programs throughout the country that vary in how competitive they are. It is important for a student interested in Pediatrics to meet with a faculty advisor to review their entire application (USMLE scores, academic grades, extracurricular activities, etc.) so that they can be guided as to which programs they will be most competitive for. Also, it is important that the student take and pass Step 2 CS prior to when programs will make their rank lists (usually mid- February). Many programs will not rank candidates if they have not yet passed this exam.

  • Plastic & Reconstructive Surgery

    Recommended Specialty Advisor: Luis Rios, MD

    Min. Step 1 Mean Step 1 Does Step 2 CK influence rank? Min. Step 2 CK Mean Step 2 CK Mean # of contiguous ranks

                                               

    NO DATA AVAILABLE

  • Psychiatry

    Recommended Specialty Advisor: Francisco Fernandez, MD

    Min. Step 1 Mean Step 1 Does Step 2 CK influence rank? Min. Step 2 CK Mean Step 2 CK Mean # of contiguous ranks
    *195 220 Yes 217 232 9.4

     

    * If the student does not perform well on Step 1 (less than 210), then s/he should take Step 2 CK early in the fall (July- September 1) and do well. There is not necessarily a "minimum" USMLE Step 1 or Step 2 score necessary to match in Psychiatry. For high profile academic programs you will likely need a USMLE Step 1 score greater than 220. However, there are many psychiatric programs throughout the country that vary in how competitive they are. It is important for a student interested in Psychiatry to meet with a faculty advisor to review their entire application (USMLE scores, academic grades, extracurricular activities, etc.) so that they can be guided as to which programs they will be most competitive for. 

  • Physical Medicine & Rehabilitation

    Recommended Specialty Advisor: Cynthia Garcia, MD

    Mean Step 1 Does Step 2 CK influence rank? Mean Step 2 CK Mean # of contiguous ranks
    217 No 233 6.8

     

    * Step 2 CK reports can help if a student's Step 1 score is low.

  • Radiology

    Recommended Specialty Advisor: Oscar Cano, MD

    Min. Step 1 Mean Step 1  Does Step 2 CK influence rank? Min. Step 2 CK Mean Step 2 ck Mean # of contiguous ranks
    225 238 Yes 225* 245 13.3

     

    * In most cases this score was not available when candidates were invited for interviews. USMLE Step 2 could help the applicant if it is substantially higher than the Step 1 score. 

  • Radiation Oncology

    Recommended Specialty Advisor: Don Carlson, MD

    Mean Step 1 Does Step 2 Ck influence rank? Mean Step 2 CK Mean # of contiguous ranks
    242 No 245 13.3
  • Urology

    Recommended Specialty Advisor: Manuel Espinoza, MD

    Min. Step 1  Mean Step 1 Does Step 2 CK influence rank? Min. Step 2 CK Mean Step 2 CK Mean # of contiguous ranks
    239 240 Yes 220 244 Not Available