Three numbers define Step 2 CK in 2026: the passing standard is 218, the mean for US and Canadian first-takers is about 250, and the number that actually matters for you is your target specialty's matched average. Passing at 218 clears the floor; it does not make you competitive, and with Step 1 now pass/fail, your Step 2 CK score carries the quantitative weight in residency screening. Here are the numbers, where they came from, and how to set your target.
Key takeaways
- The Step 2 CK passing standard is 218, effective July 1, 2025, up from 214.
- The mean for US and Canadian MD first-takers is about 250, with a standard deviation of 15.
- First-attempt pass rates are about 96 percent for US and Canadian grads and about 68 percent for IMGs.
- With Step 1 pass/fail, Step 2 CK is now the primary numeric filter for residency.
- Passing is the floor; set your target 5 to 10 points above your specialty's matched average.
The three numbers that matter
Start with the framing that keeps you sane. The passing standard, 218, is the floor everyone must clear. The mean, about 250, tells you where the middle of the distribution sits. And your specialty's matched average, from NRMP data, is your real target, because competitiveness is specialty-specific. A 218 is a pass and a 250 is roughly average; neither is automatically "good" or "not good" until you set it against the specialty you want.
The passing standard, and its history
The passing standard has climbed in steps. It sat at 209 for years, rose to 214 in July 2022, and rose again to 218 for examinees testing on or after July 1, 2025, a change the USMLE Management Committee announced on June 16, 2025. The 4-point increase corresponds to roughly 4 to 6 more correct answers across the exam, and it applies to everyone, including retakers. These reviews happen every three to four years, using physician panels, program director surveys, and performance-trend analysis, and the standard is raised as mean scores rise to keep the competency bar meaningful.
The score distribution
The official norms make the picture precise. For first-takers from LCME-accredited medical schools, the mean and standard deviation were 248 (15) in 2022-2023, 249 (15) in 2023-2024, and 250 (15) in 2024-2025, so the mean has drifted up to about 250 with an SD of 15. Note that beginning in 2025, Canadian schools were removed from this reporting group. On the percentile scale, 218 sits around the 3rd percentile, roughly 235 is the 25th, about 249 to 250 is the 50th, and 256 to 260 is around the 75th. The exam also carries a standard error of measurement of about 6 points and a standard error of difference of about 8, so treat scores as bands, not exact values.
Pass rates by group
The headline pass rate hides the number that matters for many candidates. First-attempt pass rates are about 96 percent or above for US and Canadian MD graduates, but about 68 percent for international medical graduates, which is the widest gap of any Step and has fallen from around 83 percent in 2020, attributed to a larger and more varied applicant pool rather than an easier-to-fail exam. That roughly 96 versus 68 gap is the single most important context missing from most pass-rate discussions, and it means an IMG should plan against the IMG base rate, not the reassuring headline. Among those who match, US IMG averages sit in the low 240s, so IMGs targeting most specialties should aim well above the pass mark. For the fuller pass-rate and difficulty breakdown across all three Steps, see our USMLE pass rates and difficulty guide.
Why the stakes rose
Step 2 CK matters more than it used to for one structural reason: Step 1 became pass/fail in January 2022, with a behind-the-scenes standard of 196, which removed the first numeric score from the sequence. That made Step 2 CK the first and primary quantitative measure residency programs use to compare applicants, so a strong score now does work that a Step 1 number used to. The higher 218 standard, combined with pass/fail Step 1, is why "just passing" is no longer a sensible goal for anyone competing for a spot.
What did not change
Amid the numbers, the exam itself is stable. The content outline, the nine-hour test day, and the multiple-choice format are unchanged, and the score scale remains 1 to 300. One administrative change worth noting for IMGs is that USMLE registration for international candidates has moved to the USMLE's co-sponsors rather than the previous ECFMG process, so confirm your current registration route. The exam content you are preparing for is the same; what shifted is the standard and the weight the score carries.
Setting your target by specialty
Translate all this into one target. Take your specialty's matched average from NRMP data, then aim 5 to 10 points above it, and 5 to 15 points above for IMGs, to compete on equal footing. For most specialties a competitive range runs roughly 240 to 260, with the most competitive fields expecting the upper end and above. Do not aim at 218, and do not aim at 250 by default; aim at your specialty's number plus a margin, and benchmark toward it with official NBME forms. For how to read practice scores against this target, see what a good UWorld percentage actually means.
Frequently asked questions
What is the Step 2 CK passing score in 2026? It is 218 on the 1 to 300 scale, effective for exams taken on or after July 1, 2025, up from the previous 214. It applies to all examinees, including retakers.
What is the average Step 2 CK score? About 250 for first-takers from LCME-accredited schools, with a standard deviation of 15. The mean has drifted up from 248 over recent years, and Canadian schools were removed from the reporting group in 2025.
What Step 2 CK score do I need? Passing needs 218, but competitiveness needs your specialty's matched average plus a margin, usually 5 to 10 points above, and 5 to 15 for IMGs. Most specialties are competitive in roughly the 240 to 260 range.
What are the Step 2 CK pass rates? About 96 percent or above for US and Canadian graduates on a first attempt, and about 68 percent for IMGs, which is the widest gap of any Step and has declined from around 83 percent in 2020.
Why does Step 2 CK matter more now? Because Step 1 became pass/fail in January 2022, Step 2 CK is now the primary numeric score residency programs use to compare applicants, so a strong score carries more weight than before.