USMLE® Step 2 Exam Guide

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What is the USMLE?

USMLE® stands for the United States Medical Licensing Examination® and is comprised of a series of exams—Step 1, Step 2 CK, Step 2 CS, and Step 3. All medical students and graduates must pass each of these exams to obtain medical licensure in the United States. The USMLE is sponsored by the National Board of Medical Examiners® (NBME®) and the Federation of State Medical Boards (FSMB)

The USMLE’s purpose is to assess whether you can integrate and apply the knowledge, values, and skills you have gained in medical school. Successful completion of the USMLE helps demonstrate your competency as a soon-to-be practicing physician to licensing authorities.

What is on the USMLE Step 2?

There are two parts to the USMLE Step 2. These are administered as separate examinations: Step 2 CK (Clinical Knowledge) and Step 2 CS (Clinical Skills).

Step 2 CK is a multiple-choice exam featuring patient-centered vignettes that assess whether you understand the principles of clinical science and the basic patient-centered skills needed for the safe and competent practice of medicine under supervision. The USMLE program provides a Step 2 CK Content Description outlining the distribution of disciplines, subjects, and competencies covered on the Step 2 CK exam. Tested disciplines include:

  • Medicine
  • Surgery
  • Pediatrics
  • Obstetrics and Gynecology
  • Psychiatry

Step 2 CS is a standardized patient-based exam that assesses your ability to gather history from patients, perform physical examinations, develop a differential diagnosis, and communicate your findings and plan to patients and colleagues. The USMLE program provides a Step 2 CS Content Description outlining common presentation categories featured in the Step 2 CS standardized patient encounters. Commonly tested categories include:

  • Cardiovascular
  • Constitutional
  • Gastrointestinal
  • Genitourinary
  • Musculoskeletal
  • Neurological
  • Psychiatric
  • Respiratory
  • Women’s Health

How long is the USMLE Step 2 CK?

  • One-day examination divided into eight 60-minute blocks
  • Administered in one 9-hour testing session
  • Maximum of 40 questions per block
  • Maximum of 318 questions on the overall examination

How long is the USMLE Step 2 CS?

  • One-day examination consisting of 12 standardized patient encounters
  • Administered in one 8-hour testing session
  • Each encounter allows 15 minutes for interaction with the standardized patient and 10 minutes for creating a patient note

Where is the USMLE Step 2 exam administered?

The USMLE Step 2 CS is administered only at select test centers located in Atlanta, Chicago, Houston, Los Angeles, and Philadelphia. The USMLE Step 2 CK is conducted at Prometric test centers across the US.

When should I take Step 2 CK and Step 2 CS?

  • Step 2 CK: Most US medical students take the USMLE Step 2 CK during their third or early fourth year of medical school, following completion of their core clinical rotations. This timing allows the Step 2 CK score to be included in residency program applications.
  • Step 2 CS: Most US medical students take the USMLE Step 2 CS during their third or fourth years of medical school. Although Step 2 CS is graded pass/fail, a passing score is a prerequisite for graduation at most medical schools and a requirement for beginning residency training.
  • For international medical graduates, passing scores on Step 2 CK and Step 2 CS are part of the requirements for certification by the Educational Commission for Foreign Medical Graduates (ECFMG).

When should I start studying for Step 2 CK?

Most US medical schools give their students a dedicated study period or elective rotation time that they can use to focus on studying for the USMLE Step 2 CK. However, many successful students begin studying for Step 2 CK much earlier, often in parallel with studying for the NBME shelf exams taken at the end of each of the core clinical rotations.

How do I study for Step 2 CK?

Start by familiarizing yourself with the 2020 USMLE Bulletin of Information, which contains essential information such as eligibility requirements, test scheduling, exam procedure, and score reporting. To study for the USMLE Step 2 CK, most medical students use a question bank (QBank) alongside a comprehensive review book. 

We recommend our USMLE Step 2 CK learning platform, the number one question bank for medical students, which has been expanded and tailored to help you master the Step 2 CK exam and the NBME shelf exams associated with each of the core clinical rotations. Using the Step 2 CK learning platform throughout the third and fourth years of medical school will test and reinforce the clinical knowledge you’re gaining on your rotations and give you a head start on studying for Step 2 CK.

How is the USMLE Step 2 scored?

  • Step 2 CK is scored on a 3-digit scale ranging from 1 to 300, with most students scoring between 211-275. From 2018-2019, the mean Step 2 CK score was 243 for first-time takers attending US and Canadian medical schools.
  • Step 2 CS is scored as pass/fail.

What is the USMLE Step 2 CK passing score?

The USMLE program provides a recommended minimum passing score, which usually translates to test takers answering approximately 60% of the questions correctly. The current USMLE minimum passing score for Step 2 CK is 209.

How soon will I get my USMLE Step 2 results?

  • Step 2 CK: It typically takes 3-4 weeks to receive your Step 2 CK score.
  • Step 2 CS: It may take up to a few months to receive your Step 2 CS score due to the more complex nature of scoring standardized patient encounters and simulated medical notes.

The USMLE program provides an approximate timeline for Step 2 CS score reporting on its website.

How many times can I take the USMLE Step 2?

You may take any individual Step exam, such as Step 2 CK or Step 2 CS, up to six times, including incomplete attempts. The USMLE program has announced that the total number of attempts may be reduced from six to four times as early as January 2021.

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