What Is a Good Step 2 Score? A Committee Member's Honest Answer

Everyone will tell you "it depends on the specialty." That's technically true and completely useless advice if you're staring at a 242 and trying to figure out whether you're competitive for radiology.

So let's skip the hedging. Here's what a committee member actually thinks when they see your Step 2 score — and what the real benchmarks look like for the specialties most applicants are considering.

Why Step 2 Matters More Than It Used To

Before Step 1 went pass/fail in 2022, programs used Step 1 as their primary numeric filter. Step 2 was secondary — a confirmation. That dynamic flipped overnight.

Now Step 2 is the only standardized numeric score programs can use to compare applicants across schools. It carries more weight than it ever has, and programs that previously screened on Step 1 cutoffs have simply migrated those cutoffs to Step 2. If you're applying in 2026 or beyond, your Step 2 score is doing the work of two scores.

The Three-Tier System Programs Actually Use

Most programs don't have a single cutoff — they operate with three informal tiers:

Above threshold: Score is a non-issue. The committee moves on to everything else.
In range: Score doesn't help you, but it doesn't hurt you either. Other factors carry the file.
Below threshold: Score becomes a flag. The rest of the file needs to compensate — and compensate convincingly.

The thresholds shift by specialty, by program tier, and by how competitive the applicant pool is in a given cycle. But the structure is consistent: there's a score above which nobody talks about your score, and a score below which everyone does.

Specialty Benchmarks: What Programs Are Actually Looking For

These ranges reflect what competitive applicants — not just matched applicants — look like in the current cycle. A score at the low end of a range will match at programs in that specialty, but likely not at competitive programs within it.

Dermatology: 255 and above. This is the floor for serious candidacy at most programs. Top programs routinely average 260+.
Orthopedic Surgery: 255+. Competitive programs in major academic centers often average higher.
Neurological Surgery: 250+. Small program count makes every score matter more.
Plastic Surgery: 255+. Among the most competitive in absolute terms.
ENT (Otolaryngology): 250+. Fewer spots than most applicants realize.
Radiology (Diagnostic): 245–250. Slight softening in recent cycles but still demanding.
Anesthesiology: 245+. More spots than the surgical subspecialties, but the bar is real.
Emergency Medicine: 245+. Programs vary widely — community EM programs are more flexible.
General Surgery: 245+. Academic programs want higher; community programs are more range-based.
OB/GYN: 240+. Competitive applicants score higher; the specialty has tightened over recent cycles.
Internal Medicine: 240+. Highly variable — university programs want 250+, community programs are flexible.
Neurology: 240+. More IMG-friendly than most, which affects how programs use scores.
Psychiatry: 235+. Lower floor, but top academic programs still want 245+.
Pediatrics: 235+. Score matters less relative to clinical evals and school reputation.
Physical Medicine & Rehabilitation: 235+. Less competitive overall; strong clinical evaluations can compensate.
Family Medicine: 225+. The most forgiving specialty for scores; character and fit often outweigh numbers.

The Score That Actually Hurts You vs. The Score That Just Doesn't Help

There's an important distinction applicants miss. A score 5–8 points below the specialty benchmark is different from a score 15–20 points below it.

A score that's close to threshold — but below — is a yellow flag. It prompts reviewers to look harder at the rest of the file. If everything else is strong, it often doesn't matter. Programs fill their classes with applicants whose scores are just below average all the time.

A score that's significantly below threshold is a red flag. It creates a burden of proof. The committee needs to see something compelling enough to justify the statistical risk — because programs track their own match outcomes and they know what happens when they go too far below their usual range.

The score isn't the whole story. But below a certain point, it becomes the first story — and everything else has to overcome it.

What Committees Look at Alongside the Score

Step 2 rarely exists in a vacuum. The factors that most often offset a below-benchmark score:

Clerkship grades: Honors in the relevant specialty carries real weight. If you're applying to surgery with a 240 but you Honorsed surgery everywhere, committees notice.
Research: Particularly in academic and research-heavy programs. A publication or two in the specialty softens a borderline score.
School tier: An applicant from a top-20 medical school with a 240 will be evaluated differently than an applicant from a community school with a 240. That's not fair, but it's accurate.
Away rotations: A strong sub-I evaluation from a program you're targeting is the closest thing to a guaranteed interview that exists. It moves scores to the background.
Narrative: The personal statement, letter content, and research story all contribute to a file that feels coherent and purposeful. Incoherent files feel riskier, regardless of score.

The honest answer to "what's a good Step 2 score" is this: good enough is whatever gets your file into the review pile at programs where you actually want to train. That number is different for every specialty and every program tier within it. Knowing where you actually stand — across the full picture of your application — is more useful than fixating on a single number.