Let me try to give you a concrete advice, and not some bs answer like "it depends." Largely, the attitude towards step II has not changed. It's far better to rock step I. However, step II can be valuable if you didn't score well on step I. Here is the break down.

240+: don't take step II.

230-239: solid score, no one will fault you for this score but since there are so many candidates with 240+ score you might want to consider if you are interested in very, very competitive programs. If you are from an ivy league or top medical school, you need not worry. In general, don't take step II. If you do, you better study hard to beat your step I score solidly.

220-229: same as above, except students from top med school might consider it as well. If you are interested in less competitive program in a less desirable location, it's definitely not worth retaking the test. I know a couple of residents at top programs with this score.

210-219: definitely can match with this score, but don't expect interview invitations from Harvard or UPenn. It's definitely possible if you are STELLAR in other areas. I recommend step II.

210 or below: step II no matter what.

Please note that these recommendations are not based on whether you'll match or not (you can match with a score of 205), but for those who are interested in top-middle to top tier programs, and want to look back and not regret about their USMLE score.

Good advice. i don't think anyone can say it better.

Generally, I agree with Loving Ortho...

However, I will say that if you fall below 240, are motivated to strengthen your application, and have an extra 2 weeks off to study for Step 2, definitely consider it. Let me explain:

For Step 1 I studied hard for 4 weeks using QBank and First Aid. I completed about 70% of questions, was averaging 70-75% and scored just above the mean.

As a military applicant, I had to take Step 2 early. I studied using nothing but QBank for 2 weeks (First Aid for Step 2 is not nearly as good as it was for Step 1). Finished roughly 75% of the questions available, was averaging 70-75% on timed tests (notice this is the same as my Step 1 stats). My score jumped 27 points, and it made it onto my ERAS by late October... and I am certain it helped me quite a bit.

Obviously, if you can't put in the time, or are not scoring as highly on practice tests as you would like, don't risk it. But, if you aren't satisfied with your Step 1, and can take some time to study without sacrificing SubI's etc., it might pay off.

For those 240+ (or even high 230s), you would have to REALLY nail Step 2 to make yourself look much stronger in terms of standardized test-taking, so I wouldn't bother.

Just my opinion...

you guys are really stuck on the USMLE number thing ...

i think Loving_ortho gave good advice ... thing is, if a school has a USMLE cutoff, most don't look at part 2 ... so if you miss it, you missed it ...

those that look at more of the application, then USMLE part 2 can help.

for me, the number means nothing .... i like to see and increase or ~ the same number .... you see, numbers don't mean much when we don't get the percentiles ...

so recommendation, take part 2 ... do well and post it .... if you did poorly the fist time you need to rock it ... if you rocked part one, don't crash and burn on part 2 ...

you know choosing residents is kind of like cooking .... there are basic ingredients .... but most good cooks, cook to taste … a tad of this and a smidgeon of that .. no absolutes

as a side note... i wouldnt be surprised if step II becomes increasingly important in resident selection. pretty sure there was an article about it correlating with later resident performance and that sort of makes sense. but thats not really why i predict this will happen. mostly it will be because there are more applicants than there are spots, and as such, people will go to greater lengths to make themselves be more competitive. maybe a few program directors such as your own will mention that they feel it is important, then suddenly, a lot more applicants are going to be taking (or at least feeling like they should) this exam.

i would say take it. its one less thing out of the way and in most cases you score around your step I anyway.

Unfortunately, I have to agree w/ Cakes. I believe it will become more important in the near future. It is yet another measure with which the pack can be stratified. That being said I took Step II fairly early (Sept.) but after I had submitted my ERAS application and no one asked for my Step II score (though I suppose that the score report may have automatically appeared on my application).

In short, if you are going to take it early, make certain that you are prepared for the exam.

I took step 2 early, and improved 36 points over my step 1 score. At least half of my interviewers mentioned it during the interview, and were very impressed that I took it early and did so well.

So obviously I don't regret taking it early, and I can't imagine how horrible it would be studying for it later on in the year.

i'm going to disagree with all the above. first off, i took it at the end of february and it was not horrible at all. I was not on an orthopaedic rotation or working on applications/interviews like I would have been earlier in the year. Because of this i was able to study for almost two weeks and just take the thing during a period where my schedule was very light.

Secondly, of all the things on your app, board scores are the least interesting and important in the long run and i dont think that is going to change. Sure, it helps to have a score >230 and if you dont it is probably *helpful* to take step II early. that said i dont think it is essential because if you have good research, grades, LoR, extra-curriculars then boards become increasingly less important. If you are in a possition where your step one is not great or your app is light on other things, of course you will want to take it early. If you did better than 230, an impressive step II is not going to be the make-or-break item on your app, now or in the future. you are better served spending the early part of your M4 year doing research or other extracurriculars to set yourself apart.

The first response on this thread was the most accurate. you need to look at your own app as a whole and put your board score in perspective based on that information. You also have to be honest with yourself about how important it is to get interviews at the HSS's and Pitts of the ortho world. The dirty little secret that is seldom emphasized on this website is that they are like all the other programs out there--great at some things, not as great at others, and certainly not the ideal program for every budding orthopod out there.

dr. fxrx is correct at stating the USMLE should be taken in perspective with the rest of the application .... remember this, most of us know when you are padding an application (MS 4 research or extracurriculars) so be careful when following that advice .... there is not much you can do in your 4th year except clinical rotations that will make you more marketable and completing previous research

starting research in you 4th year looks desperate .... starting extracurriculars not previously involved in, desperate ...

in truth, and i have said this before ... know yourself, be honest with yourself ... do the best you can ... and work with what you have ...

i have not met a USMLE score 250 that i have liked ... but i know a lot of people that i have

The step score question will (likely) soon become obsolete. The USMLE people are strongly leaning towards combining step I and II into one exam that will be scored p/f. Their rationale is that the step exams were never intended to stratify students based on ability or knowledge level, rather they were designed to ensure a sufficient knowledge base amongst those that pass.

I'm not for their proposed changes, but should they occur, they will make the application process to competitive specialties "interesting."

The pass/fail options would be interesting. I never took USMLE as the FLEX exam was in its last year. I only took one exam in December of my M4 year, so I had no scores at all when I applied for residency. They had to only go on grades, LORs, AOA, etc...

unfortunately, I believe going with a pass/fail usmle exam will ultimately hurt diversity (not necessarily racial) in competitive fields. There is already a glut of applicants to competitive residencies from "big name" schools. Without some sort of objective comparison between students from different schools, i believe good applicants that happened to go to lesser known schools will be lost in the shuffle.

Their rationale is that the step exams were never intended to stratify students based on ability or knowledge level, rather they were designed to ensure a sufficient knowledge base amongst those that pass.

If that really were the case, why would they be handing out individual scores along with the national average and 2-digit score?

My understanding is that it would be strictly P/F, with no way to stratify individuals.
Nothing has been finalized so some changes certainly could be made (or not ;p ).