USMLE Step 2 Guide | Study Plan, Tips, Strategies, and FAQs

March 19, 2024
8 min read


Reviewed by:

Luke Hartstein

Former Admissions Committee Member, NYU Grossman School of Medicine

Reviewed: 9/21/23

Are you gearing up to take Step 2 of the USMLE? Follow along for tips and tricks to ace the USMLE Step 2 exam. 

People taking an exam

Congratulations! If you’re ready for the USMLE Step 2 exam, you’re probably nearing the end of your medical school journey. The USMLE (or the United States Medical Licensing Examination) is a three-step examination required for US medical licensure. But what makes Step 2 of the USMLE different?

In this guide, we’ll talk about how to prepare for the USMLE Step 2 CK exam, including test material, length, format, study tips, and more. Read on for expert advice on how to ace Step 2 of the USMLE. Let’s get started!

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USMLE Step 2 Format

Step 2 CK is nine hours long and is divided into eight 60-minute blocks. There are about 40 questions in each block, sometimes less but never more. The total number of questions on the exam will not exceed 318.

Like Step 1, you’ll need to run the Step 2 CK interactive testing experience to learn the format of the questions you’ll have to answer and get familiar with the test software. The interactive testing experience includes:

  • Single multiple-choice questions
  • A sequential set of multiple-choice questions
  • A scientific abstract (a summary of a scenario with two or more questions)
  • Items (questions) with audio or video findings

It is worth noting that the Step 2 CK interactive testing experience contains more detailed explanations of the testing material than the tutorial provided at the beginning of your actual exam, so you should study it thoroughly before taking the test.

What Is On The USMLE Step 2?

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The “CK” at the end of Step 2 CK stands for Clinical Knowledge. According to the USMLE, Step 2 CK is designed to assess your ability to “apply medical knowledge, skills, and understanding of clinical science essential for the provision of patient care under supervision and includes emphasis on health promotion and disease prevention.”

The purpose of this exam is to ensure you can combine your knowledge of clinical science principles with patient-centered skills before you move on to residency. Soon after your exam, you’ll be moving on to practice medicine on patients under supervision, so the ultimate goal of the Step 2 CK exam is to test your readiness.

What Score Do You Need to Pass The USMLE Step 2?

The passing score of the USMLE Step 2 CK exam is a minimum of 214 out of 300 as of July 2022. This has been changed from the previous minimum score of 209 and means that you will now need to pass at least two-thirds of the questions on the exam to complete the test. 

A good score is considered to be around the 260 mark, based on USMLE Step 2 CK percentiles. Of course, the best score possible is 300, but you may take some comfort in knowing that it is quite uncommon for a student to receive a higher score than 280.

When Should You Take the USMLE Step 2 CK?

Most students take the USMLE Step 2 CK exam at the end of their fourth year in medical school, as recommended by the USMLE. According to our experts, it’s best to take the exam fresh out of your clinical rotations so that your experience can help you study.  

You should give yourself at least six weeks to study for your Step 2 CK exam before your scheduled test date. That said, the best course of action is to study throughout your entire clerkship year and continuously take notes for your test preparation. 

It’s also important to give yourself plenty of time to familiarize yourself with the test software and practice situational questions as much as you can before the exam.

How Long Is The USMLE Step 2?

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The USMLE Step 2 CK exam takes nine hours to complete and is administered over one day. You’ll have 60 minutes to complete each of the eight sections on the exam, as well as one scheduled break. If you need test accommodations, you can apply for them on the USMLE website.

How to Prepare for The USMLE Step 2

Here are our top tips on how to prepare yourself for the USMLE Step 2 exam. 

When Should I Start Building My Step 2 CK Study Schedule? 

According to the American Medical Association, most students aim to spend three or four months preparing for the Step 2 CK. We encourage med students to take as much time as they need to study based on their familiarity and proficiency. Start early whenever possible! 

Build A Comprehensive Study Schedule In Advance

Your best bet for acing any of the three USMLE Step exams is to build a long-term study schedule that takes your busy academic life into consideration. You should begin studying for the exam a year before taking the text by taking notes and reviewing what you’ve learned regularly—especially during your clinical rotations.

Take Notes During Your Clinical Rotations

Your clinical rotations will provide you with key information you’ll need for the Step 2 CK exam. That is why we recommend taking the test soon after your rotations. Testing your clinical knowledge is the main difference between USMLE Step 1 and Step 2. 

At this stage, you’re at the end of medical school. The USMLE wants to see that you’re capable of applying scientific principles alongside your knowledge of patient care and bedside manner. 

Get Familiar With The Software

We can’t stress it enough—you must familiarize yourself with the software at least four weeks before taking the exam. You should know your testing format inside out before taking the exam to ensure there are no technical hiccups. It would be a shame to miss out on some points due to a misunderstanding of the software!

Devote Equal Study Time To Each Subject

Although Step 2 CK focuses on clinical knowledge, your knowledge of scientific principles should be just as sharp. Do not focus all your study time on one area. Remember to space your time equally between subjects to keep everything sharp in your mind.

Practice Tests 

One of the best ways to study for the Step 2 CK is to use practice tests. Taking them is an excellent way to gauge your progress and gain familiarity with what you’ll see on the real test.

Start your journey to success today with our USMLE Practice Questions Quiz with free sample questions and answers!

Additionally, you can access practice questions for free on the USMLE website or visit the National Board of Medical Examiners website for a self-assessment.

Common Mistakes to Avoid 

One common mistake test-takers tend to make is to approach USMLE questions like they’re trying to trick them, especially as some UWorld questions can follow the “trick” format. However, you will not face trick questions on the real USMLE Step 2 CK! 

Another common mistake is to not build stamina for test day—since the test is so long, some students may give themselves extensive breaks or “rewards” (snacks, phone time, etc.) when they finish a section. 

Always practice under test-day conditions: ensure your space is quiet, you’re working at a table or desk, and you take breaks at the appropriate times if you’re taking practice tests.

FAQs: USMLE Step 2

Here are our answers to some of the most frequently asked questions about the USMLE Step 2 exam.

1. What is Step 2 of the USMLE?

Step 2 CK of the USMLE is the second of three Step exams required for medical licensure in the US. The nine-hour exam is designed to test your clinical knowledge and application of scientific principles. 

2. Is USMLE Step 2 Hard?

Most students report having an easier time with Step 2 than Step 1 of the USMLE, even with fewer hours of study time. By now, you’ll already have familiarized yourself with the software and will have four years of medical school under your belt. With adequate studying, the USMLE Step 2 CK will not be overly difficult.

3. What Is A Good Score For USMLE Step 2?

A 260 out of 300 is considered a good score for the USMLE Step 2 CK exam. 

4. Is USMLE Step 2 Required For Residency?

Most residency programs require a passing score on the USMLE Step 2 exam. It is not impossible to match into a residency without a Step 2 score, but it is strongly advised that you take and pass the exam. 

5. What Is The Difference Between USMLE Steps 1 and 2?

Step 2 of the USMLE focuses on your application of scientific principles and your clinical knowledge, while Step 1 mainly focuses on science. Many report Step 2 as being significantly easier than Step 1, especially if the exam is taken soon after completing clinical rotations. 

6. What Happened To The USMLE Step 2 CS?

Medscape has announced that the USMLE Step 2 CS is officially canceled and will not be administered until further notice.

7. How Much of Each Content Area Appears on the Examination?

All questions are classified into one of 18 categories (system specifications):

System Specification Range of Questions (%)
General Principles of Foundational Science 2-4
Immune System 3-5
Blood & Lymphoreticular System 4-6
Behavioral Health 6-8
Nervous System & Special Sense 6-8
Musculoskeletal System/Skin & Subcutaneous Tissue 6-10
Cardiovascular System 8-10
Respiratory System 7-9
Gastrointestinal System 7-9
Renal & Urinary System & Male Reproductive 4-6
Pregnancy, Childbirth & the Puerperium 4-6
Female Reproductive System & Breast 4-6
Endocrine System 4-6
Multisystem Processes & Disorders 4-6
Biostatistics & Epidemiology/Population Health/Interpretation of Medical Literature 3-5
Social Sciences: Legal/Ethical Issues & Professionalism/Systems-based Practice & Patient Safety 10-15

All questions are also classified by physician tasks and competencies into 10 categories: 

Competency Range of Questions (%)
Patient Care: Laboratory/Diagnostic Studies 13-17
Patient Care: Diagnosis 16-20
Patient Care: Prognosis/Outcome 5-9
Patient Care: Health Maintenance/Disease Prevention 8-12
Patient Care: Pharmacotherapy 8-12
Patient Care: Clinical Interventions 6-10
Patient Care: Mixed Management 12-16
Practice-Based Learning and Improvement 3-5
Professionalism 5-7
Systems-based Practice & Patient Safety 5-7

Additionally, all test content covers these discipline areas: 

  • Medicine: 50-60% of content
  • Surgery: 35-30% of content
  • Pediatrics: 20-25% of content
  • Obstetrics & Gynecology: 10-20% of content
  • Psychiatry: 10-15% of content 

8. How Much Does the USMLE Step 2 CK Cost? 

The Step 2 CK costs $660 in 2023 and $670 in 2024

9. How Long to Study for Step 2? 

The AMA suggests that most medical students aim to study for three or four months before their test day. How long you need to study depends on your proficiency, initial score, and target score. 

10. What Should I Do If I Failed? 

If you failed Step 2 CK, you can retake the test. We recommend identifying where you went wrong and seeking a USMLE tutor’s help to give you the best chance of scoring high next time. 

Remember, low USMLE scores don’t have to set the tone for the rest of your career; Inspira Advantage has helped students with low USMLE scores craft stellar ERAS applications! 

Final Thoughts

As long as you take plenty of notes throughout your clinical rotations, begin studying early, and familiarize yourself with the testing software, the USMLE Step 2 exam should be a breeze. 

If you are concerned about taking or retaking the Step 2 exam, consider hiring an experienced USMLE tutor to help you build the right study schedule for you. Good luck!

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