All Important Info about the USMLE Step 2 CK Exam

The USMLE exam is divided into three steps testing every aspiring med school student on their knowledge and application skills related to the various physical, physiological and psychological health of living beings. Each step is important and is varied in its approach, duration, time, topics to be covered, and sequence levels. 

Every person aspiring to be a doctor and practice medicine without supervision needs to clear all the steps. Step 1 of the USMLE exam is usually taken in the second year of med school when an examinee is confident about recalling science concepts from what they learned during undergrad school. But Step 2 CK is an exam that tests future doctors on their clinical knowledge. The USMLE Step 2 practice and preparation is ideally taken in the final year of medical school. 

Before taking up the Step 2 CK it is important to gather all the important information about this exam.


Anyone who is enrolled in a school of medicine or osteopathy in the US and Canada is eligible to take the USMLE exam. If an examinee is outside of US and Canada, then any student enrolled in a med school recognized by the world directory of medical schools is eligible to take this exam in an approved proctored center outside of the US or Canada. 

Sequence of Steps

Step 1 and Step 2 can be taken in any sequence. But without clearing a step, the next in sequence exam cannot be attempted by an examinee. It is a common practice for eligible med school students to take Step 1 in their second year of med school and then prepare for Step 2 Ck in the final year of their four-year medicine program. 

Content of Step 2 CK

Step 2 CK tests the understanding of the examinee on their applied clinical knowledge in practical scenarios. The format of the questions gives due importance to the principle of clinical sciences and patient-centric skills that are imperative for safety standards of practice of medicine. Some questions also stress a future physician’s skills in disease prevention and health promotion.    

Examination format

Step 2 CK examination is conducted on a single day. There is no specific day when it is conducted and can be scheduled anytime by checking the availability of the slots. The exam is held for nine hours. It is divided into 8 blocks. Each block is for a maximum of sixty minutes. There are a maximum of 318 questions or items in the Step 2 CK exam and each block can vary in the number of multiple-choice questions but will not exceed 40 items. 

Examinees are allowed a forty-five-minute break in totality with only five minutes between the other blocks. A break time increases if the examinee can complete any block before time. There is also a fifteen-minute optional tutorial.

Content weightage

The content weightage of different topics varies with a maximum weightage for legal and professional ethics topics. Most professional examiners give the least importance to the preparation of ethics-related topics for exams. Such practice can be very detrimental to the performance of even a highly skilled and abled examinee. 

Examinees can enroll in an online course that is designed to help in their preparation through question banks, practice exams, and explanations for correct and incorrect answers. These courses offered by ed-tech platforms are easily accessible, affordable, and reliable as they prepare an exam taker with NBME questions that enable the feel of an actual exam. 

Preparation time

Although some schools may give a dedicated time to prepare for the Step 2 CK exam, most schools may allow a lighter clinical rotation time that gives you time to prepare. Instead of depending on how it works with your school, it is better to start your preparation well in advance. It is a common practice among students to start their preparation alongside their self-assessment and shelf tests.

Practice tests

Step 2 CK has fewer practice tests on all platforms in comparison to the Step 1 exam. There is no logical explanation as to why both NBME and Prometric offer fewer practice exams for this exam, but it is a fact that one needs to live with and work around. Currently, the cost of the NBME self-assessment test is sixty dollars and that of shelf exams costs up to twenty dollars. A practice test held by the Prometric Center is close to seventy-five dollars. The practice tests of NBME are most recommended and as close as they can get to the actual exam. These practice tests offer a predictive score but that is highly indicative and does not mean that your actual performance will be on the same lines.

Based on the predictive scores of the NBME exam one should know how to deal with their anxiety. It is not advisable to repeat the same NBME exam. 

Use the self-assessment to highlight the areas of improvement. If you got a good chunk of questions wrong because of misinterpretation, then work on your reasoning and applied clinical skills. These tests also help an examinee understand the placement of a red herring in the answers as a trick question. 

The NBME self-assessment exams are either standard or self-paced. It is pointless to give a self-paced exam as the actual exam conditions will not give the examinee any room and space for error or time. 

The medical field is going through leaps of transformations and the resources available to  prepare for the licensure exams are also changing for the better. Today, a med school graduate has technical aids to prepare for the exam through their smartphones. If pursuing medicine to practice it and offer the best to the cause of healthcare is your purpose, then there has to be a plan at every step of your preparation. Every step of the USMLE is important to clear to be a practicing doctor in the US. Adequate knowledge, logical reasoning, clinicals skills, and smart preparation will help one clear this step of the exam.

Written by Frederick Jace

A passionate Blogger and a Full time Tech writer. SEO and Content Writer Expert since 2015.

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