Medical School - Clinical

How to Study for USMLE Step 2

Studying for the USMLE Step 1 is difficult, but Step 2 CK preparation can feel a bit more challenging because of when it falls during medical school. Now that Step 1 is Pass/Fail, scoring well on Step 2 is one of the most crucial steps for matching into your preferred residency. The test assesses your practical knowledge of medicine, including your ability to diagnose and manage conditions.

Essentially, the USMLE Step 2 CK tells potential residencies whether or not you know what you’re doing as a fourth-year medical student. Naturally, you want to ace it on test day!

If you know how to study for it and what online resources to use, you can feel less stressed and well-prepared for your Step 2 CK test date.

1. Choose a Study Schedule

Choosing a study schedule is key to preparing for your USMLE Step 2 CK in time. You should be reviewing Step 2 practice questions throughout your third year of medical school, especially during shelf preparation. However, when it comes to dedicated CK study time, there are a couple of routes you can take:

  • Take 4 weeks or less of dedicated study time (around 9-12 hours of studying per day for most of my students). This may be appropriate for students who performed well on shelf exams and Step 2 practice sets.
  • Take between 6-8 weeks of dedicated study time (around 6-9 hours of studying per day to avoid burnout). This is a useful option if you need to improve upon your shelf or practice set performance.

Which route you take should depend on a number of factors, including your performance on shelf exams and Step 2 practice sets, how much dedicated time your school gives you, and the trajectory of your performance during studying.

Keep in mind that adding days and weeks to your dedicated time only helps if your exam performance is improving. If you notice a plateau in your Step 2 performance or symptoms of burnout during your study time, that’s a sign that you’ve reached the point of diminishing returns. In that case, cut your dedicated time short and take your exam.

For most students, I recommend taking Step 2 by early August of your fourth year so that your score is available prior to the earliest ERAS submission date.

Consider tutoring during this time, especially if your shelf and clerkship performance is average or below average, and you need a high score to stand out during residency match. This is doubly important if you’re planning to prioritize a very competitive residency program.

Struggling to raise your Step 2 score? Partner with a 90th-percentile tutor to boost your score by an average of 22 points! 

2. Take Full Advantage of UWorld

Almost every single one of my tutoring students finds UWorld’s Step 2 CK Qbank helpful for clerkship study and shelf exams. Do not skip this resource!

Doing a “first pass” through the question bank during the clerkship year ensures you cover every topic and integrate clinical knowledge with exam essentials. You’ll also want to do a “second pass” through UWorld during your Step 2 study time. UWorld questions greatly mirror the real exam and provide a solid framework for a comprehensive study of all of the high-yield topics. 

3. Combine Shelf Exam Studying with Step 2 Preparation

Make the most of your shelf exam study time — you already have to take them, and since the questions are from previous years’ USMLE exams, they’re a great way to help you prepare. Shelf exam study can reinforce your understanding of core concepts and help you get familiar with the format and style of USMLE Step 2 CK questions.

AMBOSS is a another great platform with realistic practice questions to help you study for shelf exams and, by extension, Step 2 CK.

Read Next: COMLEX vs USMLE: A Comparison for Osteopathic Medical Students

4. Take Practice Tests

Practice makes perfect, as the saying goes, and it holds especially true when it comes to Step 2! While studying, integrate practice exams into your schedule. Here are a couple that I often recommend to my tutoring students:

  • USMLE’s Sample Test: This is a free practice test that offers over 100 sample Step 2 CK questions. There’s both a PDF and an interactive version of the sample practice test. 
  • NBME’s Self-Assessment: This is not a free practice test, but it is one of the most highly recommended across the board for Step 2. It contains multiple-choice questions covering topics typically covered in core clinical clerkships and allows you to view answer explanations to help reinforce concepts and help you understand what types of answers the test is looking for.

Additionally, if you’re curious about what score you need to aim to make to get into your residency of choice after taking a practice test or two, check out our USMLE Score Estimator to make sure you’re on the right track!

5. Study by Exceling During Your Clinical Rotations

Studying does not always mean studying by the book. During your clinical rotations, you have invaluable opportunities to learn, broaden your knowledge, and put theoretical concepts into real-life practice. This will help you get more prepared for those patient care and practice-based learning questions on the CK exam.

BONUS: Get a Good Night’s Sleep

Studying hard is exactly what you want to do when it comes to the USMLE Step 2. However, to make the most of all your hard work and preparation, get plenty of sleep before exam day. Aim to get the recommended 7-9 hours of sleep the night before the Step 2 CK — or maybe even two nights before, if you’ve been consistently burning the midnight oil!


➕ What is the format of Step 2?

Step 2 is a one-day examination divided into eight 60-minute blocks and administered in one 9-hour testing session. You’ll be tested on clinical knowledge in various subjects, including internal medicine, surgery, pediatrics, OB/GYN, psychiatry, first aid, and other clinical areas relevant to patient care.

➕ When should I take Step 2 CK?

It’s highly recommended that you take Step 2 CK no later than early August at the beginning of your 4th year of medical school. Some of my students schedule it a bit earlier, near the end of third year, when the clinical science content is fresh on their mind.

➕ What score do I need to pass the USMLE Step 2?

The current minimum passing score for the USMLE Step 2 is 214. While you’ll technically pass with that score, it can make residency placement more challenging, so try to make the most of your study period to score higher than the minimum.

➕ What happens if I fail Step 2?

You can retake the exam. However, failing Step 2 reduces your chances of getting matched to a residency program. The most recently available data from the NRMP Program Director Survey in 2020 found that 90% of schools “never” or “seldom” consider students who failed on the first attempt.

You can only attempt Step 2 a total of four times, and you cannot retake more than three times in a year. Also, it’s important to note that attempts at the formerly administered Step 2 CS (though discontinued) count toward the limit. If you fail Step 2 after all attempts, you cannot move on to Step 3.

➕ How many questions are on USMLE Step 2?

The exam consists of up to 40 questions per block (8 blocks total), accounting for up to 318 questions across the exam.

➕ How long does it take to get my Step 2 score report?

Score reports are usually available within four weeks of taking Step 2. However, according to the USMLE website, you should allow eight weeks for your results, as there can be delays in the score reporting process.

➕ What happened to USMLE Step 2 CS?

USMLE Step 2 CS was permanently discontinued in January 2021 due to a combination of challenges and restrictions imposed by the COVID-19 pandemic. Critique was also voiced to the National Board of Medical Examiners and the Federation of State Medical Boards regarding the effectiveness, relevance, and value of the exam within the medical licensure process.

The official United States Medical Licensure Examination Step 2 exam is still referred to as USMLE Step 2 CK, even though the CS (critical skills) exam has ceased to exist and there are no plans for it to return. 

➕ How important is my Step 2 CK score?

Your Step 2 CK score is incredibly important, as Step 1 is now Pass/Fail, and this is one of the few objective metrics on your residency application. Not performing strongly on the USMLE Step 2 CK will decrease your chances of matching into your preferred residency.

➕ Are there any extra study resources I should consider for CK prep?

These are some extra study materials you could utilize on your journey to master the boards: 

  • MedSchoolCoach Step 2 Tutoring: Our tutors help students increase their score by an average of 22 points, which can be the difference between the residency (and career) you want versus one for which you feel like you’re settling.
  • Anki: This a free flashcard program that is designed to optimize memory retention. 
  • OnlineMedEd: You have to pay for this resource, but it may be one of the best if you’re looking for medical knowledge and concepts broken down into easy-to-digest study content. 

Don’t stumble on the most important exam of your life! Partner with one of our 90th-percentile USMLE tutors to boost your Step 2 score by an average of 22 points.

Joel Ramirez MD

Dr. Ramirez attended University of California, San Francisco where he is a vascular surgery resident. He received a 266 on Step 1 and 265 on Step 2 CK. He oversees the team of elite USMLE and COMLEX tutors.

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