The Ultimate Guide to Preparing for the USMLE Step 2CK

Since the transition of Step 1 to pass/fail, the importance of the Step 2 CK score has drastically increased. Therefore, it’s very important to give it your all when preparing for the USMLE Step 2 CK. 

The good news is that Step 2CK is generally considered easier than Step 1, and test-takers traditionally score higher in this exam. 

Why? Because Step 2CK will mainly test your knowledge of clinical concepts rather than basic sciences. 

Of course, this doesn’t mean you can take its preparation lightly, nor that Step 2CK doesn’t have its own challenges. 

But with a good preparation strategy, you can reach a stellar score that has the potential to dramatically boost your application for a residency match!


Then let’s review all you need to know for acing your Step 2CK preparation!

Get familiar with the Step 2CK exam

Same as your Step 1 preparation, it’s important to understand the content and familiarize yourself with the format. 

Step 2CK tests your ability to apply medical knowledge with a great emphasis on health promotion and disease prevention. 

Similar to Step 1 and Step 3, the items consist of clinical scenarios in one of these disciplines

  • Medicine
  • Surgery
  • Pediatrics
  • Obstetrics & Gynecology
  • Psychiatry

Each discipline covers various systems, including: 

  • Endocrine System                                                                 
  • Renal & Urinary System & Male Reproductive
  • Gastrointestinal System
  • Respiratory System
  • Cardiovascular System
  • Musculoskeletal System/Skin & Subcutaneous Tissue
  • Nervous System & Special Senses
  • Multisystem Processes & Disorders
  • Biostatistics & Epidemiology/Population Health/Interpretation of Medical Literature
  • Social Sciences: Legal/Ethical Issues & Professionalism/Systems-based Practice & Patient Safety
  • Behavioral Health
  • Blood & Lymphoreticular System
  • Immune System
  • General Principles of Foundational Science

The exam will assess your skills in the following: 

  • Laboratory & Diagnostic Studies
  • Diagnosis
  • Prognosis & Outcomes 
  • Health Maintenance & Disease Prevention
  • Pharmacotherapy
  • Clinical Interventions
  • Mixed Management
  • Practice-based Learning & Improvement
  • Professionalism
  • Systems-based Practice & Patient Safety

This scope is from USMLE’s official website.

Let’s take a look at an example I’ve drafted for you:

A 33-year-old woman comes for follow-up visits. She feels well and has no medical problems. Her father has been recently diagnosed with colon cancer at 68-years-old. She is concerned about her risks of developing colon cancer and asks how to prevent that risk. 

The discipline tested here is Medicine, the system is Gastrointestinal, and the question assesses your Health Maintenance and Disease Prevention skills

The exam day lasts 9 hours (yes, you read it correctly!) and is divided into 8 blocks of 60 minutes each. 

The number of questions per block might vary, but it will never exceed 40, and at the end of this very long day, you will have answered approximately 318 questions! 

Kind of an accomplishment if you ask me!  

How does Step 2CK feel different from Step 1?

Step 1 tests your knowledge of basic sciences, whereas Step 2CK will mainly focus on your clinical knowledge.

In other words: 

  • Step 1 tests your understanding of clinical concepts.
  • Step 2CK tests your ability to apply clinical concepts.

This distinction is essential as it informs how to prepare for each exam. 

During my Step 1 preparation, I mainly focused on building my knowledge. Therefore, I concentrated on using online courses such as Board and Beyond, Pathoma, or First Aid Step 1 along with doing my QBank. 

Later, during my Step 2CK preparation, I focused intently on applying this knowledge by practicing as many questions as possible! Therefore, my study was almost entirely focused on doing my QBank. 

Hence, the purpose of the exam dictates your study strategy. 

When should I take Step 2 CK?

Let’s get straight to the point: Is it a good idea to start with Step 2CK? 

I think one of the best ways to answer this question is to understand why IMGs prefer to start their journey preparing for Step 2CK. 

Many IMGs start preparing for the USMLE exams during their final year of medical school or even after graduation, when they’ve already begun practicing as doctors in their home country. 

Therefore, they’re likely to be more familiar with clinical concepts than all the enzymes involved in the Krebs Cycle.

In addition, Step 2CK is perceived as more accessible, whereas studying for Step 1 seems more tricky and tedious for many USMLE aspirants. 

Consequently, many IMGs prefer to start their journey preparing for Step 2 CK. 


Depending on your year of graduation and overall medical knowledge, starting with Step 2CK might not be the best idea, even if it seems more convenient. 

Here’s another of my culinary metaphors for you… 

Let’s say you want to cook a recipe. To do so, you need all the ingredients ready, right? 

Now, imagine having all the ingredients prepared and to hand; the cooking should go smoothly and rapidly.  

But if you don’t have your list of ingredients on hand, you’ll lose time going to the grocery shop each time you need an element. 

Pretty inconvenient! 

In other words, good Step 1 preparation is the foundation of a high Step 2 CK score!

What are the best resources for the Step 2 CK exam?

The study materials will differ depending on whether you start your journey preparing for Step 2CK or taking the exam after Step 1. 

Regarding your choice of study materials, if you start Step 2CK preparation after Step 1, remember this:

Less is more.

Don’t encumber yourself with too many study resources, as mastering your QBank is more than enough for the exam. 

I highly recommend Uworld QBank for this purpose, as it contains a large pool of questions similar to the actual exam.  

However, if you decide to start with Step 2CK, doing a QBank might not be enough; thus, I highly recommend you build your knowledge.  

Depending on your weakness, you can use various study materials such as: 

  • Sketchy for pharmacology and microbiology to help master those concepts.
  • Board and Beyond and Osmosis to strengthen your knowledge of pathology.
  • Physeo, Board and Beyonds, and Step 1 First Aid to review physiology topics. ( NB: Physiology concepts are heavily tested in Step 2CK, especially in Cardiology, Renal, and Respiratory; therefore, I highly recommend you take the time to review these topics).
  • First Aid Step 1 to review Ethics and Biostatistics.

Finally, regarding Step 2 CK’s books, such as Master the Board and First Aid 2CK, I personally didn’t use them as Uworld QBank is a practice tool and a learning tool. 

You can also read my test taking strategies for the USMLE Step article!

How long should I study for Step 2 CK?

 The answer to this question depends on two factors: 

  • Whether or not you have already taken Step 1. 
  • If you have already taken Step 1, how much time has passed?  

Generally speaking, passing Step 1 before Step 2CK will shorten your preparation time, especially if you took Step 1 recently.

For example,  if you took Step 1 less than 6 months ago, your preparation time for Step 2CK will probably be around 4 months.  

On the other hand, if you decide to take Step 2CK first or if a long period has passed since you sat Step 1, you’ll need more time to prepare for the exam. 

Whatever scenario you fall into, keep in mind that Step 2CK’s score heavily impacts your application. 

Therefore, make sure to take the exam when you’re ready. 


Since Step 1 changed to pass/fail, Step 2CK’s score carries an even more significant impact on residency applications. 

A great Step 2 CK score is within your reach, provided that you: 

  • Understand the purpose of the exam and what you’ll be assessed on. 
  • Use the study materials wisely according to your needs.
  • Give yourself time to prepare for the exam and take it whenever you’re ready. 

Looking to maximize your USMLE Step 2 CK score? Check out the comprehensive STEP 2CK study plan I have built!

Good luck!

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