5 Things Every Medical Student Should Know About USMLE Step 2 CK

The USMLE Step 2 CK exam assesses clinical knowledge over nine hours. These tips can make exam day easier for medical students looking to land the residency of their dreams.

1. Take the exam before you submit your residency application

Although timelines differ across medical school curriculums, it is most common that USMLE Step 1 is taken at the end of the pre-clinical period and less commonly taken right after the clinical year (i.e., third year). Most medical schools traditionally require Step 1 to be completed before students move onto their clinical year. However, there is generally less guidance on when someone should take Step 2 Clinical Knowledge (CK).

Historically, only a Step 1 score has been required to submit a residency application and this is still true in many circumstances. However, it is important to note that even if you can submit your residency application with only a Step 1 score, most programs won’t interview or rank applicants until they receive their USMLE Step 2 CK score. This functionally means that the program will include the Step 2 CK score in the process of reviewing and ranking residency applications.

Ensure that you take your exam before submitting your application. The residency program is eventually going to see your Step 2 CK score and will require it before completely evaluating your application, so you may as well provide them with the score early. This will become even more important once USMLE Step 1 grading changes to Pass/Fail.

Try to take the exam soon after your clinical year and before you get busy with sub-internships and visiting rotations. This is especially true if you are taking a gap year in medical school to pursue other activities.

2. Spend adequate time studying

Since all residency programs will utilize Step 2 CK scores when interviewing or ranking candidates, it is important that you score well on this exam. This will also become critically important once Step 1 grading changes to Pass/Fail and the Step 2 CK score is the only objective measure of your scholastic performance.

With the ever-increasing demand on a medical student’s time and attention, students have adapted to live by the USMLE mantra of “2 months for Step 1, 2 weeks for Step 2 CK, #2 pencil for Step 2 CS”. However, in my experience, this can set students up for failure on Step 2 CK as it suggests that the exam is substantially easier than Step 1.

To clarify, Step 2 CK is not easier than Step 1. The content tested in Step 2 CK is clinically based and is generally more fun to study for than the basic science content that is tested in Step 1, but do not be tricked into thinking that the exam is easier.

It is important that you approach Step 2 CK similarly as Step 1. You want to ensure that you have adequate time, attention, and resources to prepare for the exam to maximize your performance. This is especially true with Step 1 becoming Pass/Fail. I recommend to most students that they spend 2-3 months studying full time for Step 2 CK.

Try to minimize distractions, avoid clinical and research commitments during this time, and set yourself up mentally to prepare for the exam. Studying for 2-3 months while spending 40-60 hours a week in the hospital, clinic, or doing research is not going to cut it.

3. Leverage shelf exams to improve your preparation

Students do not take the USMLE Step 2 CK until sometime after their clinical year. The benefit of this timing is that most students will have already taken several shelf exams that correspond to their core rotations. The good news is that the content and structure of the shelf exams are very similar to Step 2 CK and can give you a sense of what to expect and how you are performing.

Study hard during your core rotations and take the shelf exams seriously. Doing so will ensure that you are learning the necessary material and will help you succeed on Step 2 CK. If you have struggled to pass or perform well on your shelf exams, then make sure that you set aside more time to study for Step 2 CK. The shelf exams can also help you identify areas of content that you may need to spend more time reviewing before Step 2 CK.

4. Focus your resources

In contrast to USMLE Step 1, the best resources for USMLE Step 2 CK are less well-defined, and students often have a difficult time identifying which to use.

Although there is no perfect set of resources for this exam and different strategies will work for different people, I usually recommend a “less is more” approach here.

Make sure that you also have some sort of method for memorization and retention (e.g., note sets, flashcards, Anki). If you focus your time and attention on these resources, then you will feel well-prepared for your exam.

5. Maintain your focus… and your health

Many students find studying for Step 1 to be a grueling and painful process. The amount of challenging material tested on the exam and the length of the study period make it a difficult experience. Although the content tested on Step 2 CK is clinically focused and more interesting, it is still a ton of material to learn. There is also a lot of pressure to perform well on Step 2 CK and this is likely to increase tremendously when Step 1 becomes Pass/ Fail.

With that being said, it is very important that you take care of your physical and mental health while you study and doing so will help give you the energy to stay focused.

Make sure that you continue doing the things that you enjoy, whether that is exercising, spending time with friends and family, getting outdoors, or participating in hobbies. The path through medical school and residency can feel like a non-stop challenge.

Try to learn how to manage the rigors of studying for Step 2 CK while taking care of yourself.

At MedSchoolCoach, all our tutors have scored in the 95^th percentile on their USMLE Step 2 exams and are all 260+ scorers. They understand the goals of each question and can help students learn how to approach the exam. If you are interested in USMLE Step 2 CK tutoring, look us up and we will help you master the clinical material!

About the Author, Dr. Joel Ramirez

Dr. Ramirez is the Director of Medical School Tutoring at MedSchoolCoach, overseeing a team of elite USMLE and COMLEX tutors. He attended the University of California, San Francisco where he received a 266 on his USMLE Step 1, 265 on Step 2 CK, and 255 on Step 3. He is an experienced and passionate educator and mentor who enjoys helping students master the medical school admission process.

About The USMLE SmartBank Powered By TrueLearn

As a leading resource for USMLE exam prep, TrueLearn’s USMLE SmartBank empowers its learners to perform at their absolute highest levels on Step 1, Step 2-CK, and Shelf Exams. Trusted by thousands of medical students nationwide, the USMLE Step 1 SmartBank includes 2,200+ test items that are revised regularly to mirror the latest First Aid references and NBME changes, including removal of multi-step questions, longer stems, new testing interface, and blueprint updates.