top of page

Importance of the USMLE

Home  >  Specialty  >  Neurosurgery  >  Importance of the USMLE

USMLE Step 1 and 2 CK:  9 Important Points for the Neurosurgery Residency Applicant

1. In 2018, the mean USMLE Step 1 score among U.S. seniors who matched to neurosurgery was 249. Among unmatched U.S. seniors, the mean score was 238. 



2. In 2018, 32% of U.S. seniors with a USMLE Step 1 score of less than 230 failed to match into neurological surgery. “We do not have a predetermined score requirement but rather look at the various aspects of a candidate’s application to get an overall perspective,” writes the Department of Neurosurgery at the University of Illinois College of Medicine at Chicago. “Applicants with low scores are less likely to be competitive for an interview.”



3. In a survey of 25 neurosurgery residency programs, 100% cited the USMLE as a factor in selecting applicants to interview. “As some residency programs are becoming more competitive because of either the reduction in the number of positions or the increase in the number of applicants, the USMLE scores are being used in various ways in making decisions on whom to select for interviews,” writes the University of Washington School of Medicine. “The following programs consistently use the scores in the screening process: Anesthesiology, Emergency Medicine, Neurosurgery, Obstetrics & Gynecology, Ophthalmology, Orthopaedic Surgery, Otolaryngology, Radiology, Surgery, and Urology.”

4. Why are scores so important to neurosurgery residency programs? “It is important to the residency director that the student accepted into the program is capable of meeting licensure requirements,” writes the University of Washington School of Medicine. “If a resident is not successful in fulfilling the licensure examination requirement by the end of the first year of residency, the resident may not be able to continue in the program.”

5. Among the other reasons for the importance of the USMLE in the selection process is the desire to select residents who will pass the American Board of Neurological Surgery certification examination. Numerous studies have shown correlation between USMLE scores and specialty certification exam performance.

6. Although neurosurgery programs differ in how USMLE Step 1 scores are used in the residency selection process, the score is an important factor used to make interview decisions. 84% of programs have established a target score while 16% look for evidence of a passing score. “The minimum USMLE Step 1 Board score accepted is 230,” writes the Indiana University Department of Neurological Surgery.



7. The USMLE Step 2 CK score is also a factor used by many neurosurgery residency programs in deciding whom to invite for interviews. 64% of programs use the Step 2 CK score in their decision-making process.



8. Should you take the USMLE Step 2 CK exam before applying to neurological surgery? The decision should be based on your Step 1 performance and the requirements of the programs you’re applying to. Traditionally, applicants have been told that if the Step 1 score is competitive for matching, then you can take the Step 2 CK later. However, an increasing number of programs are requiring the Step 2 CK score for interview consideration. Please also note that there are some programs that will not place applicants on the rank-order list unless the USMLE Step 2 CK exam is passed. 



9. When neurosurgery residency program directors were asked, “Would your program consider applicants who fail their [Step 1] exam on the 1st attempt,” 58% of programs indicated that they never do and 38% reported that they seldom do. At MD2B and The Successful Match, we have helped applicants overcome such obstacles, and you are welcome to contact us for more information.

Some applicants are concerned about their chances of matching in the specialty or securing a position in highly competitive residency programs.


If you have such concerns, consider our Strategy for Success Session with Dr. Samir Desai.


Dr. Desai will perform a comprehensive review of your credentials, assess your strengths and weaknesses, and provide you with a specific plan to implement tailored to your unique situation and school.


This plan will significantly improve your chances of a successful outcome.

bottom of page