Medical specialties and careers ranked: USMLE mean score and average salary

The medical profession offers a wide array of career paths, with numerous specialties ranging from family medicine to general surgery, allowing physicians to devote their careers to mastering a single discipline. Each specialty comes with its own set of qualifications, training requirements, and salary expectations, and highly coveted specialties are among the most selective. For those starting to evaluate their long-term goals in medicine, understanding how factors such as the average USMLE Step 2 score by specialty influence competitiveness can help clarify your options and next steps.

To guide your decision, we have compiled a list of 14 popular residency programs pursued after medical school. Each specialty is detailed by:

• The nature of the work during residency and as a practicing physician
• The typical background and characteristics of applicants who match into related programs
• The specialty’s reputation and standing within the broader medical community
• Key requirements for acceptance, including USMLE Step scores

These specialties are listed in order of mean USMLE Step 2 score, from lowest to highest. Admissions teams use Step 2 Clinical Knowledge (CK) scores to determine a candidate’s match for residency programs. The more practical CK builds off the medical knowledge tested in the USMLE Step 1, and passing both exams is necessary for licensure and residency eligibility. It’s worth noting that Step 1 is a pass/fail exam that serves as an important benchmark for medical competency, while Step 2 performance greatly determines your options for residency.

For example, family medicine typically has lower average Step 2 scores, making it a less competitive option. Highly sought-after fields, such as dermatology and plastic surgery, are among the most selective medical specialties to enter. General surgery falls between these extremes and is characterized by its rigorous training and moderate competitiveness.

Let’s begin our overview of these residency programs by examining the unique characteristics, competitiveness, and average USMLE scores associated with each specialty. The 2024 Step 2 CK scores below, published by the National Resident Matching Program, reflect the performance of MD seniors. Salary estimates are based on data from the U.S. Bureau of Labor Statistics, published in May 2024.

Family medicine

Mean USMLE Step 2 score: 244

Average U.S. salary: $256,830

Among medical specialties, family medicine holds a critical role as the foundation of primary care. A family medicine practitioner serves as the first point of consultation for health concerns, providing comprehensive care across all ages, from infants to seniors. Family medicine doctors manage a wide range of responsibilities, from diagnosing and treating common illnesses to managing chronic diseases such as diabetes and hypertension to delivering palliative care.

Unlike many other top-earning specialties, family medicine offers physicians notable flexibility. It supports a more balanced lifestyle between professional duties and personal life, making it an appealing path for doctors seeking work-life balance.

Psychiatry

Mean USMLE Step 2 score: 246

Average U.S. salary: $269,120

Psychiatry focuses on diagnosing and treating disorders linked to the mind and body. Psychiatrists often combine traditional medicine with practices like yoga and meditation to treat mental illness. This approach, known as Psychotherapy, involves regular meetings with patients to assess their progress.

Key qualities of a good psychiatrist include empathy, flexibility, approachability, communication skills, and responsiveness. The American Board of Psychiatry and Neurology (ABPN) oversees this field, and passing the USMLE is required for residency applications.

Pediatrics

Mean USMLE Step 2 score: 247

Average U.S. salary: $222,340

Pediatrics, derived from the Greek for “Healer of Children,” is a medical specialty dedicated to the healthcare of patients under 21 years old. Prospective pediatricians should be aware that diagnosing and managing childhood illnesses requires unique skills, as children may struggle to describe their symptoms clearly. Physicians who are passionate about working with children and adept at communicating with parents often excel in pediatrics.

Pathology

Mean USMLE Step 2 score: 247

Average U.S. salary: $266,020

Pathology is a medical specialty that involves the meticulous observation and interpretation of human cells, tissues, and bodily fluids. Pathologists play a key role in disease diagnosis through both traditional tests and advanced diagnostic radiology techniques, thereby guiding patient treatment and management.

Pathology professionals often work in hospital settings, specialized clinics, and laboratories, allowing for exceptional career-life harmony. Common subspecialties within pathology include hemopathology and dermatology, and proficiency on Step 2 CK exams further enhances expertise in these fields.

Emergency medicine

Mean USMLE Step 2 score: 248

Average U.S. salary: $320,700

Emergency medicine physicians are among the highest-paid doctors trained to manage urgent and acute medical situations. They rapidly diagnose and treat patients with critical and severe health issues, often working closely with other top-earning medical specialists.

The demands of emergency medicine require doctors to think quickly, remain composed under intense pressure, and maintain excellent attention to detail in life-threatening situations.

Internal medicine

Mean USMLE Step 2 score: 251

Average U.S. salary: $262,710

Internal Medicine is a core specialty: internists, also known as Internal Medicine physicians, specialize in diagnosing and managing non-surgical conditions in adolescents and adults. They play a vital role in primary care and often collaborate closely with Family Medicine doctors to deliver comprehensive patient treatment. Internal Medicine offers a range of subspecialties, including highly sought-after fields like gastroenterology and cardiology, which frequently attract applicants with strong Step 2 CK scores.

Physicians in Internal Medicine are known for maintaining a better work-life balance than in other specialties, even though every medical career demands significant commitment. For those aiming for a rewarding career with opportunities for advancement into higher-paying specialties, Internal Medicine provides a versatile pathway.

OBGYN

Mean USMLE Step 2 score: 252

Average U.S. salary: $281,130

OBGYN stands for Obstetrics and Gynecology, focusing on childbirth and women’s reproductive health. Obstetricians must also be gynecologists, while gynecologists can practice independently.

OBGYN professionals typically work in labor wards, monitoring mothers and babies, and making critical decisions about their care. Specialties under OBGYN include infertility, pregnancy, and gynecological oncology.

Anesthesiology

Mean USMLE Step 2 score: 252

Average U.S. salary: $336,640

Anesthesiology involves administering anesthesia and making important decisions before surgery to ensure patients are fully prepared. Anesthesiologists ensure patients remain unconscious and pain-free during procedures, closely monitoring their vital signs. Usually, either general or local anesthesia is administered as required by the invasion methods and the surgeon's instructions.

The demand for anesthesiologists remains high due to the necessity of anesthesia in surgeries, with over 40 million surgeries performed worldwide each year.

General surgery

Mean USMLE Step 2 score: 253

Average U.S. salary: $371,280

General surgery is a core surgical specialty focused on diagnosing and treating a wide range of conditions that often require operative intervention within the torso, including the digestive tract, endocrine system, and abdominal organs. General surgery professionals are responsible for patient evaluation, determining the necessity and timing of surgical procedures, performing operations, and ensuring comprehensive post-operative care.

A career in general surgery demands not only surgical skill, stamina, and dexterity but also a commitment to lifelong learning as techniques and technology advance. General surgeons operate in fast-paced environments, and staying current with modern practices is critical for optimal patient outcomes.

Diagnostic radiology

Mean USMLE Step 2 score: 256

Average U.S. salary: $359,820

Diagnostic radiology is a highly specialized, technology-driven medical field where specialists interpret medical imaging to deliver precise diagnoses. Professionals in diagnostic radiology use advanced imaging techniques such as X-rays, CT scans, MRI, and ultrasound to support patient care. Subspecialties within this field include nuclear radiology and pediatric radiology, allowing radiologists to focus on specific patient populations or imaging modalities.

A diagnostic radiology residency lasts five years, and board certification through the American Board of Radiology (ABR) or the American Osteopathic Board of Radiology (AOBR) is necessary for clinical practice in this specialty. A good diagnostic radiologist must be skilled in visual analysis, attention to detail, analytical thinking, problem-solving, report writing, and communication. Interest and competency in physiology, anatomy, and pathology are also required, even if this role is more technical than other physician specialties.

Otolaryngology

Mean USMLE Step 2 score: 256

Average U.S. salary: $337,283

Otolaryngology is the study of the ears, nose, and throat, often shortened to ENT. Otolaryngologists treat a range of conditions, employing various methods, including targeted head and neck surgery, medications, immunotherapy, and reconstructive techniques. Patients are commonly older people between the ages of 45 and 65.

An ENT residency typically lasts five years, with additional training required for specialization. Their practice differs from that of general physicians and surgeons because they operate on some of the body's most fragile organs.

Plastic surgery

Mean USMLE Step 2 score: 256

Average U.S. salary: $396,684

Plastic surgery is the study of physical defects, repair or replacement, reconstruction of the skin, hand, breast, musculoskeletal system, or the external genitalia. While often associated with cosmetic procedures, plastic surgery also addresses critical care needs. Burn surgeons, for instance, are plastic surgeons who provide critical care for those with burn injuries, wounds, or scars.

Most plastic surgeons practice independently after completing residency programs and obtaining required certifications and licenses. Applicants who have completed training in general surgery, ENT, neurosurgery, or orthopedics may apply to plastic surgery residency programs.

Orthopedic surgery

Mean USMLE Step 2 score: 257

Average U.S. salary: $365,060

Becoming an orthopedic surgeon is as difficult and requires the same level of investment as becoming a general surgeon. Surgeons in this field focus on helping patients with musculoskeletal diseases and injuries. These doctors strive to relieve patients of pain by providing medical, surgical, or physical treatments as required by the severity of the condition. Usually, 50% of the time is spent on non-surgical treatment and other interventions.

Early practitioners in this specialty rarely have a consistent schedule or an easy work-life balance, as they need to be available for almost all hours of the day to care for patients. However, orthopedic surgeons are driven by helping patients recover and seeing their success. Orthopedic subspecialties focus on specific joints or body parts, such as the hands, knees, and shoulders.

Dermatology

Mean USMLE Step 2 score: 257

Average U.S. salary: $347,810

Dermatologists treat skin, hair, and nail conditions. Their work involves diagnosing abnormalities and determining treatment plans. A dermatologist's routine involves identifying the abnormality, administering medication, assessing surgical requirements, and determining the patient's condition. Most often, dermatologists are presumed to be only cosmetic surgeons, though cosmetic treatment is only a portion of dermatology.

A medical school graduate is required to complete a dermatology residency of about three years and earn the required licenses and certifications to practice clinical services independently. However, they have opportunities to either work as private practitioners or be employed at hospitals and other clinical centers.

Conclusion

Deciding to specialize is one of the most important commitments a future physician can make. Becoming a specialist offers practitioners the chance to hone their expertise in a specific field while increasing their salary prospects. The dedication and training required to become a specialist are well rewarded not only by competitive compensation but also by patients' trust and appreciation. To improve your chances of being accepted into a residency program in your chosen field, aim for high scores on the USMLE Step 2 and bolster your clinical experience throughout medical school. With a strong footing built on academic achievement, practical experience, and extensive preparation for the foundational Step 1, you will be able to skillfully take on Step 2 and specialized training.

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