An Approach to No USMLE Step 2 CK Score

(Content Updated: August  7, 2019)

At this point, medical residency candidates are in the final stretch of putting their ERAS residency applications together. However, there is a group of candidates who have components of their application missing whether it’s a document like Letters of Recommendation, or a USMLE exam score. With this factor in mind, deciding when and which programs to apply to during September can be made more difficult.

One of the most pressing concerns facing many IMG residency candidates is whether or not they should apply without a USMLE Step 2 CK score. Many residency applicants have their USMLE Step 2 CS and/or USMLE Step 1 scores in hand, but have either failed the CK or haven’t taken it yet for their own reasons.

Side note: If you don’t have your USMLE Step 2 CS score, or you failed it and have to retest, your situation is even less ideal. You must schedule or retake BEFORE December 31, 2019, otherwise, you will not be able to receive the results by the NRMP Rank Order Deadline (Feb. 26, 2020).

Nonetheless, those who won’t have their USMLE Step 2 CK score until October or November are in a tough situation and have hard and personal decisions to face.

You primarily have two choices:

  1. Apply to programs in September without your USMLE Step 2 CK score
  2. Wait until you have your Step 2 CK

You can apply, but you have to consider both options carefully.


Most candidates are going to start applying in September. But, if you choose to apply in September without your USMLE Step 2 CK, it could create an additional obstacle. If you are an International Medical Graduate (IMG), there are programs who require the ECFMG Certification at the time of application, which means those programs require all three USMLE exams (USMLE Step 1, Step 2 CK, and Step 2 CS). You can consider applying to programs that do not require the ECFMG Certification, but this is possibly a risk. If you feel as though you are a stronger candidate, for example, having a high Step 1 score, a program may also choose to wait until your Step 2 CK score appears.

On the flip side, waiting for programs has its dangers as well. Even if your USMLE Step 1 score is excellent, by late October, the top programs are already beginning or have begun their interview process. Chances are they have already reached their saturation point with applications and will not give your application much attention. You may be able to obtain interviews this way, but applying late is also a risk.

So, what do you do? In the end, like with everything in your application, this decision will be up to you.

If you are leaning towards sending out applications regardless in September, try contacting a small sample of programs and gauging their feelings. Ask them if they would consider a candidate without the USMLE Step 2 CK score. Depending on how they answer, you can figure out if programs will consider you. If most of the programs are saying they won’t consider a candidate with no CK score, you may just have to wait and hope.

Suggested Approach:

If you don’t like either option above, you can choose to apply in two or more waves.

Create Two (or more) Lists:

List 1: The most lenient programs (For example, programs that do not require the ECFMG Certification at the time of application) and/or programs you have some history with (connections, local hospital, family/friends, etc.) in the first part of September

List 2: Every other program you are going to apply to later on when you get your score **Keep an eye out for individual program application deadlines 

Not having your USMLE Step 2 CK score can be a tough position to be in, but remember: You need to continue preparing your ERAS Application. Even if your score isn’t coming in until later, you should not ignore the rest of your preparations.

Keep working on your supporting documents. It takes time to write a good Personal Statement, and you do not want to leave your Letters of Recommendation to the last minute. You will also need to ensure the documents are being uploaded to the right places with the right amount of time.

Also important is to make time for your program research. Part of the battle is finding the most relevant programs for you to apply to so you aren’t wasting your time and money later on.

It’s easy to want to give up when you feel the odds are against you, but if you continue to work and push forward, there will be a much higher chance for you to succeed rather than leaving everything until your score arrives.

Want to discuss your USMLE exam circumstances? Registered members may contact us at 858-221-8510 or email us your question or phone number at and we will be happy to assist you!

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