2021 USMLE Step 1 & Step 2 CK Score Percentiles – What’s A Good Score?

If you’ve completed medical school, the next step in starting your career is to pass the US Medical Licensing exam.

The three steps in this process each include a lengthy test that focuses on the practical application of scientific knowledge in a care setting.

The USMLE is long, hard, and competitive, but that doesn’t mean you’re not up for it.

With hard work and dedication, you can pass each test and become one (major) step closer to becoming the doctor of your dreams.

When you go into a life-changing test like this, you want to make sure you’re prepared. One way to do this is to know what score you need to get. Knowing what percentile you need to score in beforehand will help you decide where to dedicate the most study hours.

While the importance of these tests is abundantly clear, the scoring system is not. That’s why we’re here.

Whether you’ve already taken the exam and are trying to interpret your scores, or you’re studying and setting a percentile goal, we can help.

In this article, we’re going to strictly focus on step 1 and step 2 (otherwise known as the boards and the clinical knowledge exam.) Each of these exams is at least eight hours long and is made up of many lengthy questions.

First, we’ll break down what the exam entails. Then, we’ll show you how the individual scoring systems work.

USMLE Step 1 (The Boards)

The first step in the United States Medical Licensing Examination process tests one’s ability to apply foundational scientific knowledge to the practice of medicine. This will ensure the candidate has a competent grasp of the sciences and the skills to safely and accurately use them in a medicinal context.

The content of the exam includes questions on anatomy, biochemistry, microbiology, and genealogy. You can find the full list of disciplines you will be tested on here.

You will take the exam over the course of one day. It’s divided into seven one-hour testing blocks with infrequent breaks between them.

Passing the boards is the first step to practicing medicine without supervision. Therefore, it’s pivotal to score well on this test. Fortunately, the statistics are on your side.

Step 1 Scoring

While the scoring for these tests is historically based on percentile, that is no longer the case. As of 1999, a three-digit scoring system is the main measurement of a candidate’s success on the exam.

However, percentiles still matter. Percentiles rank you among your peers and are an easy way for prospective programs to calculate how you did in comparison.

Percentiles are calculated based on your numerical score. The percentile you are in is based on how much higher your score is compared to the average of all other test-takers.

This means if you scored in the 10th percentile, you scored better than the lowest 10% of all candidates. If you score in the 50th percentile, your score is in the middle of everyone else’s.

Scores on the Step 1 test range from 1-300. The passing score is 194, and the average among test-takers is 232 (with a standard deviation of 19.). Because 97% of candidates in 2020 passed, you only have to do better than 3% of your peers to pass. Therefore, you only need to score in the 3rd to 5th percentile to succeed.

However, if you’re applying for a competitive program and want to do a little better, a score of 200 will put you in the 9th percentile, and a score of 232 will put you in the 50th percentile.

Earning a high score on these exams is the best way to give yourself an advantage over your peers. Scoring at or above the 50th percentile will put you in the running for many great residency opportunities.

It’s important to note that the scoring system is about to change again. In January 2022, you won’t be compared to your peers with a numerical score. Instead, the metrics will be strictly pass/fail.

If you are taking your boards during or after this date, all you need to worry about is meeting a passing score of 194. However, if you plan to complete the exam before then, you should aim for scoring in at least the 5th percentile.

USMLE Step 2 CK (Clinical Knowledge)

Step 2 assesses a candidate’s ability to clinically apply their medical knowledge in a patient care environment (under supervision).

It specifically tests your skills and understanding of how the clinical sciences translate to proper patient care. It emphasizes subjects such as surgery, pediatrics, and obstetrics & gynecology.

The purpose of this exam is to ensure you are prepared to take on the responsibilities of being in residency. Prospective residency programs look at the CK scores specifically for that reason. Therefore, it’s extremely important to do well in this step.

On this test, you will encounter question topics that focus on all aspects of patient care. This includes diagnosis, disease prevention, and professionalism.

This is a nine-hour multiple-choice test. Similar to the first step, it’s divided into eight one-hour blocks with breaks.

Step 2 CK Scoring

Similar to the first step, scores for the Step 2 clinical knowledge test range from 1-300. The passing score for this test is 209, and the average was 245 (with a standard deviation of 15) as of 2020.

While the scoring for the first step is transitioning to pass or fail, this scoring criteria is staying the same. This means that your score on the clinical knowledge test will be even more important to residencies when they consider you.


It’s pivotal to do well on this exam, but don’t stress–most candidates pass with flying colors. 98% of candidates made a 209 or higher in 2020. That means you only have to outscore 2% of your peers and be in the 2nd to 4th percentile.

Succeeding in this step of the exam process will set you up for many great opportunities.

How to Score Well

Studying hard and making the grade is the goal, but it’s easier said than done. Of course, you want to make sure you are as prepared as possible, but where should you start?

That depends on where you are in the process. If you’ve passed step one of the USMLE, then you should obviously focus your energy on Step 2 CK. If you are taking or retaking the first step, invest your time into reaching a passing score.

We have some tips on how to do that below.

Scoring Well on Step 1

While you will only have to worry about reaching a passing score as of January 2022, it’s still important to strive for a high score.

The best way to start is to get familiar with the material. The USMLE’s website has free sample test questions and practice materials. They also offer practice sessions for a small fee.

You should also make sure you have a working knowledge of the subjects on the exam. These are primarily disciplines of science, but the test will also include patient care and interpersonal skills. When studying, prioritize analyzing experiments and pathology.

If you’re not comfortable with the sciences, you’re going to have a lot of trouble.

If you haven’t started already, start now. Integrate practice questions and exams into your daily study routine. Read free online materials and join study groups and practice sessions. The more time you spend with the material, the more confident you will be on exam day.

Because this test primarily focuses on your academic abilities, you should treat it the same way you would any other test (albeit much more seriously.) It’s a standardized multiple-choice test, which means you have the advantage of test-taking strategies such as the process of elimination.

The most important part of scoring well on step 1 is to set aside study time. You absolutely have to dedicate the weeks leading up to your exam to preparing for the test if you want to succeed.

The USMLE recommends standard testing practices such as reading the questions carefully and trying to come up with your own answer before looking at the options. Reading the questions multiple times will prevent you from making simple mistakes.

If you don’t pass, you can always try again. You can take this exam up to six times, but no more than three times in twelve months.

Scoring Well on Step 2 CK

Because the clinical knowledge test is becoming even more important, it’s pivotal you score well.

USMLE’s website offers more than 100 free practice questions for this exam. They provide additional materials and content outlines. You can find the exact format of the test questions here.

Unfortunately, this exam is not a standard test. It’s a continuously evolving exam, and not all basic study methods will be useful.

Because the exams build off each other, you should take how long it’s been since you took the first one. You may need to re-familiarize yourself with the first step’s content to maximize your potential fully.

This test will most likely take more time to study for than step 1. One reason not all of the questions are multiple-choice.

Another reason is that many of the answers are based on practical experience, which you just can’t memorize. That knowledge is exactly what residency programs are looking for in candidates.

Start studying as early as possible. Take notes on your rotations during your clerkship year because many of the questions will involve diagnosing a patient or choosing the next procedure. That firsthand experience will serve you well if you make the most of it.

Another way to score well is to change up your study patterns. Switching locations and the time of day you study certain subjects will help you better remember the material.

It’s also important to take frequent breaks. Students retain information better when they stop to rest and process it. While you’ll be dedicating all of your time to studying in the weeks before step 2 CK, you won’t remember anything if you don’t allow yourself time off.

The secret to doing well on these exams is not to burn yourself out. If you don’t get good sleep and eat well when studying and taking the test, your results will suffer (along with your health.)

While these exams are important to the advancement of your career, you have the option to take them again. Practice makes perfect.

Was this article helpful? Share it!
Brett Gordon
 

Founder of ExamCave.com