USMLE Step 2 CK Study Guide
USMLE Step 2 CK — clinical knowledge, the most weighted exam for residency match.
Overview
USMLE Step 2 Clinical Knowledge (CK) tests application of medical knowledge to patient care. Computer-based, 9-hour day, 8 blocks of up to 40 items each (~318 total). Since Step 1 went pass/fail in 2022, residency programs increasingly use Step 2 CK as the primary objective metric for ranking applicants. Most US students take it in M3 or M4 year.
Test Format
| Section | Duration | Max Score |
|---|---|---|
| USMLE Step 2 CK | 480 min | 100 |
Scoring
Step 2 CK is scored on the same three-digit scale as the old Step 1, with a passing threshold around 209 (subject to change by USMLE). Higher scores correlate with stronger residency applications, especially for competitive specialties like dermatology, plastic surgery, orthopedics, and ophthalmology. Aim for 250+ for competitive residencies.
Section Breakdown
usmle step2
Eight 60-minute blocks of up to 40 items each. Heavy clinical-vignette format integrating diagnosis, management, and prognosis across specialties.
Study Tips
- 1.UWorld is again the gold standard — do all 4,000+ Qs at least once.
- 2.Watch Online MedEd or Boards & Beyond clinical sciences during clerkships.
- 3.Take NBME CCS practice exams every 1–2 weeks in dedicated prep.
- 4.Prioritize: internal medicine, surgery, pediatrics, OB/GYN, psychiatry — 80% of the test.
- 5.Master ethical scenarios — they're high-yield and easy points.
- 6.Plan for a 4–8 week dedicated study period after clerkships.
Key Facts
- Length
- 9 hours (8 × 60-min blocks)
- Items
- Up to 318 MCQs
- Score
- Three-digit (~200–300)
- Cost
- $680 USD + Prometric fee
- Pass rate
- ~96% first-time US MD students
- Recommended timing
- After core clerkships (M3 or early M4)