“Good” depends entirely on where you’re applying. Passing Step 2 CK requires 218, but a score that’s perfectly fine for one residency application would sink another: matched US MD seniors in the most competitive specialties have posted mean scores above 250, the broad middle tier clusters in the 240s, and the larger primary-care specialties in the 230s, according to the NRMP’s most recent Charting Outcomes data. With Step 1 now pass/fail, Step 2 CK is the one scored USMLE result on your application — which is exactly why the “what number do I need?” question deserves a real answer instead of a vague one.
Let’s separate the two questions people actually mean: what does it take to pass, and what does it take to compete.
Passing vs. Competitive: Two Different Numbers
The passing standard is set by the USMLE program: 218, effective July 2025. Everything about that threshold — what changed, how scoring works, what happens if you’re close to the line — is covered in our dedicated guide to the Step 2 CK passing score. This article is about the second question.
Competitiveness is set by the applicant pool, specialty by specialty, and it’s documented rather than guessed: the NRMP publishes Charting Outcomes in the Match, which reports the score profiles of matched and unmatched applicants. That’s the primary source behind every legitimate “target score” table, including the one below — and it’s worth knowing that the most recent fully published edition reflects the 2024 cycle, with the 2026 edition expected over the summer. Numbers below are that 2024 baseline; the gradient they describe has been stable for years.
What Score Do You Need for Your Specialty?
| Tier | Specialties (examples) | Matched US MD senior mean (Charting Outcomes 2024) |
| Most competitive | Dermatology, Plastic Surgery (Integrated), Orthopaedic Surgery, ENT | Above 250 |
| Middle tier | Anesthesiology, Radiology, Ophthalmology, Emergency Medicine, OB/GYN | 240s |
| Broad/primary-care tier | The larger primary-care specialties | 230s |
Three notes that keep this table honest:
- These are means of matched applicants, not cutoffs. People match below these numbers every year — with strong research, letters, audition rotations, or a compelling story. People also go unmatched above them. A mean describes the crowd, not your fate.
- Research and specialty signals travel with the scores. In the most competitive tier, matched applicants also posted the highest research output. The score gets your file read; it doesn’t finish the argument.
- The tiers move slowly. Fill rates and applicant profiles shift year to year (our 2026 Residency Match results breakdown covers what actually changed this cycle), but the competitiveness ordering has been remarkably stable. Planning against last cycle’s tiering is reasonable; planning against a forum rumor is not.
Why Step 2 CK Carries More Weight Now
Since Step 1 went pass/fail, program directors lost their traditional first-pass screening number — and Step 2 CK inherited that role. For your application, that has two practical consequences.
Your Step 2 CK score is now doing the work two scores used to share. There’s no earlier scored exam to offset a weak result, which changes the risk calculus around when you sit the exam: taking it after your strongest clerkships, with a real dedicated period, matters more than it did for previous cohorts. (Our Step 2 CK study schedule maps 6- and 12-week versions of that dedicated period.)
And an honest flip side: because everyone knows Step 2 CK matters more, cohort scores have drifted upward over the years. Aiming for “the mean of matched applicants” is aiming at a moving target — which is another reason to anchor to the current Charting Outcomes edition rather than a number remembered from someone’s older advice.
How Should IMGs Read These Numbers?
The table above describes US MD seniors — the group Charting Outcomes reports most prominently. If you’re an international graduate, two adjustments apply. First, the same gradient holds: the specialties demanding the highest scores from US seniors demand them from everyone. Second, IMGs generally can’t afford to sit below a tier’s benchmark — a strong Step 2 CK score is one of the clearest signals available to an IMG application, alongside the ECFMG pathway itself. The encouraging context: US-citizen IMGs matched at 70.0 percent in 2026, a record high. For the full pathway — certification, timing, strategy — start with our IMG guide to the USMLE.
Setting Your Personal Target
To turn all this into one number on your whiteboard:
- Find your tier in the table above (or the current Charting Outcomes edition when the 2026 version lands).
- Set your target at or slightly above the matched mean for your specialty — that positions you in the comfortable half of the distribution rather than at its edge.
- Build backwards from the target: a dedicated period with weekly practice-test checkpoints, weak-system triage, and a daily question volume you can actually sustain. The Step 2 CK Qbank is built for exactly that loop — questions tied to concept-level video review, so every miss becomes a targeted lesson.
- Reassess honestly at each checkpoint. If practice scores sit well below target three weeks out, moving your exam date is a strategic decision, not a defeat.
Score is one factor among many — programs weigh letters, clinical grades, research, and fit. But it’s the factor most within your control during a dedicated study block, and that makes it worth planning deliberately.
FAQ
What is the minimum passing score for Step 2 CK? 218, effective July 2025. Passing and being competitive are different questions — the specialty tiers above describe the second.
Is 240 a good Step 2 CK score? For most specialties, yes — 240s sit at or above the matched-applicant means outside the most competitive tier. For Dermatology, Plastic Surgery, Orthopaedics, or ENT, matched means run above 250, so 240 would be below the typical matched profile there.
Do program directors screen by Step 2 CK score? Many use score filters in initial screening, which is precisely why Step 2 CK inherited so much weight after Step 1 went pass/fail. A tier-appropriate score keeps your application in the pile; the rest of the file does the persuading from there.
Where do these specialty numbers come from? The NRMP’s Charting Outcomes in the Match — the published score profiles of matched applicants. Check the newest edition when setting your target; this article’s table reflects the 2024 edition, the most recent fully published.
