The USMLE Step 2 CK (Clinical Knowledge) tests your patient-centric clinical frame of mind. The process of Medical PG in USA begins with passing the USMLE Step 1. Then, you must complete a Clinical Green Book Rotation of 2 years from a teaching hospital in the USA, approved by ACGME.

Finally, you set about to clear the USMLE Step 2 Exam. This Step used to have 2 parts – USMLE Step 2 CK & CS. As an aftereffect of the COVID 19 outbreak and some popular objections, the USMLE Step 2 CS has become a thing of the past. So, now for all purposes, Step 2 is Step 2 CK.

The purpose of the USMLE Step 2 Exam has always been to assess the comprehension of Clinical Science and application of the knowledge of medicine. Certainly, a doctor and her methods have to be patient-centric and its extent is exactly what the USMLE Step 2 Exam measures.

You will find some changes in the Step 2 CK scoring pattern in 2021-22. There is quite some speculation among interested parties regarding this. Most of the experts are opining that as a consequence of the discontinuation of USMLE Step 2 CS, there will be some alterations. We are not asserting or predicting anything. One can only wait and watch.

Prometric test centers

The Prometric Test Centers are USMLE Exam Centers. The Prometric is a testing agency that conducts the USMLE. The USMLE Steps are Computer-Based Tests (CBTs). The Tests are organized by Prometric at Prometric USMLE test centers. There are 345 such centers in the US & Canada while 110 USMLE test centers are international. You may appear in Step 1 & 2 Exams without having to be physically present in the USA. The only requirement is that your country should have a Prometric Center.

Step 2 CK price

The current Step 2 CK cost for Registration is $985 (around 74K INR). The USMLE fees get updated very regularly. You can find updated details on this link.

Application process

How to apply for USMLE Step 1? For the US/Canada Medical University students, the application portal is the NBME login portal at the NBME website. This is where you do your USMLE registration. If you are an IMG, for USMLE step 1 registration and USMLE Step 2 registration, you will have to go through the ECFMG Official Website. Also, this is where you take care of your Step 2 CK scheduling. The entire process is simple and direct. Finally, you will have to visit the website of Prometric USMLE to lock your Prometric USMLE Step 1 & 2 test date.

Available dates 2022

The Step 2 CK testing dates are available for most of the year except for major holidays.

Exam pattern

To decide how to study for Step 2, you need to know the Step 2 CK format. Let us try and understand what one may expect from the Step 2 CK. The exam takes a day.

How many questions on Step 2 CK? Well, in the USMLE Step 2 CK test pattern, you will come across 8 blocks. Each block will have a set of questions or ‘test items’. The number of such items in the block will be visible at the outset. The maximum Step 2 CK number of questions in a block is 40. To be precise, there are 7 blocks with 40 test items each and 1 block with 38 questions. Irrespective of the number of items, one has to finish the block in 1 hour.

There is an upper limit to the total number of test items in the entire exam too. There are 318 questions in total.
During your USMLE Step 2 CK exam, you get a break time of 45 minutes, and then there is a 15-minute tutorial that is optional. If you so wish, you can have some more break time by skipping the tutorial. To do that you must read this section carefully. While preparing for Step 2 CK, make sure you practice within the actual time frame that you have on a per question basis. That is the best way to study for Step 2.

You have another scope of extending your break time. If you manage to finish the blocks before the allotted 60 minutes, you can use that time as a break. The breaks are important in such exams that go on for hours. You must plan your breaks properly and have a set pattern of relaxation techniques to give your best efforts.

How long is Step 2 CK?

As mentioned, Step 2 CK starts and ends the same day. How long is Step 2 CK? The USMLE Step 2 CK duration is 9 hours with an hour for break and tutorial.

Step 2 CK scores declaration

The USMLE Step 2 CK score release takes place on a Wednesday. When do Step 2 CK scores come out? Usually, you get your Step 2 CK score after 3-4 weeks of appearing in it. Your USMLE Step 2 score is posted on the website on which you registered which for an IMG is ECFMG Official Website.

If your USMLE Step 2 CK score reporting does not happen even after 8 weeks of appearing, report here.

Step 2 CK passing score

The USMLE Step 2 CK score that is accepted as a passing score for Step 2 CK stands at 214. Meanwhile, the average Step 2 CK score over the past few years has been 242. You may see certain changes in USMLE Step 2 passing score and also Step 2 CK average score soon. For now, that is merely speculation.

Step 2 CK Question Type

In short, the USMLE Step 2 CK questions are such that they test those sections of medicine that are crucial to undertake supervised clinical practice during medical PG. Some experts are not wrong in calling Step 2 your first step towards post-graduation in medical science.

Who sets the USMLE Step 2 CK question paper? Well, medical professionals, medical college faculty, and medical investigators brainstorm to come up with the 318USMLE Step 2 questions that you have to answer. The Committee that formulates the questions includes representatives from the practicing, licensing, and academic sections of the medical fraternity.

In addition, you will be looking at MCQs on your screen when you appear for the USMLE Step 2 Exam. The options that you need to choose from maybe as few as 3 and as many as 26. These options are present mostly in alphabetical order. Many times, they may follow a logical order.
Most importantly, almost all the options in these items appear ‘likely’. However, there is only 1 option that is the best. It is not advisable to take the questions lightly and hurriedly.

Step 2 CK Question Type: Abstract Format

You will find another kind of test item in the USMLE Step 2 CK blocks which is the Abstract Format. These items present the scenario of a clinical experiment. The Abstract describes the experiment for which you have to present a report (like in the medical journal). Your response should broadly include:

  • Diagnostic details
  • Epidemiology/Biostatistics
  • Therapeutics/Pharmacology
  • Patient Care

Step 2 CK Sample Questions 2022

To download and solve original USMLE Step 2 qbank / Sample Questions, PDF.

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Step 2 CK Syllabus 2022

The USMLE Step 2 subjects are concurrent with the content outline pdf. The Step 2 CK USMLE syllabus is broadly classified into 2 sections – the Organ Systems and the Physician Competencies.

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Step 2 CK Syllabus: Organ Systems

There are 18 major Organ Clusters or Systems that constitute this section of the USMLE Step 2 CK content outline. Also, there is one section of General Principles of Foundational Science that has a weightage range of 1-3% (See Table 1).

The questions, though related to the various body systems, have hardly anything to do with their physiology. On the contrary, the test items will ask about disease processes or pathology of these systems and, of course, the therapy. You should expect more items that call for knowledge spanning multiple organ systems.

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

Step 2 CK Syllabus: Physician Competencies

The other major section of the USMLE Step 2 CK curriculum covers the topics on Physician Tasks & Competencies. For your easy comprehension, we have created a digest of the major headings you need to control.

  • How to apply basic medical knowledge & concepts of basic science.
  • Patient Care: Diagnosis & proper management, Step 2 CK First Aid.
  • Professional legalities & ethics.
  • Skills of communication.
  • Patient safety oriented systems based practice.
  • Practice based learning: Biostatistics & Epidemiology.

Refer to the Table below for the weightage of specific topics.

Competency Range, %
Medical Knowledge: Applying Foundational Science Concepts 0**
Patient Care: Health Maintenance/Disease Prevention 8–12
Patient Care: History and Physical Exam 0***
Patient Care: Mixed Management 12–16
Patient Care: Diagnosis 16–20
Patient Care: Prognosis/Outcome 5–9
Practice-based Learning & Improvement 3–5
Patient Care: Pharmacotherapy 8–12
Patient Care: Laboratory/Diagnostic Studies 13–17
Professionalism 5–7
Patient Care: Clinical Interventions 6–10
Systems-based Practice & Patient Safety 5–7

The test items that you will find will be from these sections. However, the primary requirement is to integrate these two sections with the basic disciplines of medicine. These disciplines include:

  • Surgery
  • Internal Medicine
  • Obstetrics & Gynecology
  • Pediatrics
  • Preventive medicine
  • Psychiatry

In other words, you must have the capability of integrating and applying the principle concepts of all these disciplines and subjects to perform well in the USMLE.

Other areas of emphasis of the questions pool for the USMLE Step 2 CK are prevention of diseases and promotion of health. The Step 2 Exam ensures that the ones who qualify are well-versed and ready to take up medical practice under supervision. Also, they will do so in a state of absolute devotion towards ethics & principles of clinical medicine while being completely patient-centric.

In short, the USMLE Steps are based on an integrated content outline. It has 18 major areas. Download the detailed official content outline -PDF.

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Step 2 CK Preparation Strategies

USMLE Step 2 CK Preparation Strategies

How to study for Step 2 CK? This is the part that is going to be really valuable for a serious aspirant looking for Step 2 CK preparation tips & tricks. After much deliberation and close observation, we can share the most prominent of our conclusions here:

Be alert in your clinical rotations

We can’t stress enough the importance of observing carefully the patient history, symptoms, diagnostic logic, therapeutics, interpersonal skills, and patient care strategies that you get exposed to during your clinical rotations.

Build your basics from 3rd year of MBBS

How long to study for Step 2 CK? The entire exam as a whole and especially the Step 2 CK requires prolonged concept building. It is a cumulative aggregation of related concepts that finally make sense to the Doctor. This is what eventually cures a patient. Stop looking for Step 2 CK study schedule 6 weeks / 3 weeks. Our students with successful Step 2 experience say that the Step 2 CK preparation should begin as your 3rd year starts. Hold on to the concepts that may appear random and unrelated till 3rd year. Rest assured that they will visit you here during Step 2 USMLE.

Key Resources are the key

There are no specific Step 2 CK books that could prepare you completely. When it comes to choosing the study resources you will rely on, you have to be careful. Many times, students commit the error of amassing a lot of material going through them superficially. Instead, select the best USMLE Step 2 CK tutorial resources and study exhaustively. Also, get access to as many Step 2 CK practice questions as possible.

USMLE Step 2 CK Test Taking Strategies

When do you take USMLE Step 2 CK? Generally, medical students appear in the 4th year. When the time to actually face the music comes, make sure you:

Understand the test before hand

Indeed, you must be well aware of what to expect in the exam hall. Every aspect of the test is explained in great detail in the USMLE Official Website. Apart from avoiding any surprises, you will also have the scope of skipping the tutorial and adding 15 precious minutes to your break time.

Understand the mind-set of the Test-makers

USMLE Step 2 CK practice test solving gives you this advantage. You will always be a step ahead if you feel what the examiner is looking for in you. Everything that the examiner wishes to see in you as a Doctor is clear. All you need to do is think like them and prepare and perform accordingly.

Rest adequately

You will come across a lot of myths when you embark on your journey towards your Medical PG in US. A very popular notion doing the rounds since forever is that one must study for 14 hours a day to perform in this Exam. Nothing could be farther from the truth. On the contrary, we have different advice for you altogether. Study hard and well but make sure you rest for at least 8 hours a day. Doing well in USMLE is all about building bridges between concepts and applying them differentially.


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