The USMLE Step 2 CK (Clinical Knowledge) tests medical students on their knowledge of the clinical sciences and their patient care skills. The exam emphasizes prevention and health promotion. Medical students typically take Step 2 at the end of their third year. Below we explain the structure of the exam and list the distribution range for content areas tested on Step 2.

Structure of the USMLE Step 2 CK

Step 2 CK is divided into 8 blocks of multiple choice questions. The number of questions may vary between blocks. You will always be told how many questions are in a given block before you begin. You have the option to take a 15-minute tutorial prior to taking the exam. Break time may exceed 45 minutes if you finish early on one or more blocks. Below is a breakdown of the time and number of questions allotted on Step 2 CK.

Total Testing Time 8 hours and 45 minutes
Time per Block 60 minutes
Break Time Allotted 45 minutes
Total Multiple Choice Questions No more than 355
Questions per Block No more than 44

There are 3 types of questions on Step 2: Single-Item Questions, Sequential-Item Sets, and Matching Sets.

  1. Single-Item Questions will have 3 to 26 answer choices. You are told to choose the best answer. Only one answer is best, while others may be only partially correct.
  2. Sequential-Item Sets contain 2 or 3 consecutive questions that each address the same patient vignette. When you answer one of these questions, you will be brought to the next, and you will be unable to return to an earlier question to change your answer choice.
  3. Matching Sets contain at least 2 questions. The answers to these questions come from a bank of between 4 and 26 answer choices.

For examples of the above question types, see the USMLE Step 2 CK’s Sample Questions.

Content Areas

Area Range
General principles 1%-3%
Organ systems 85%-95%
Immune System
Blood and Lymphoreticular Systems
Behavioral Health
Nervous System & Special Senses
Skin & Subcutaneous Tissue
Musculoskeletal System
Cardiovascular System
Respiratory System
Gastrointestinal System
Renal and Urinary Systems
Pregnancy, Childbirth, and the Puerperium
Female Reproductive System and Breast
Male Reproductive System
Endocrine System
Multisystem Processes and Disorders
Biostatistics, Epidemiology and Interpretation of Medical Literature 1%-5%

Physician Tasks and Competencies Range
Medical Knowledge and Scientific Concepts 10%-15%
Patient Care: Diagnosis 40%-50%
History and Physical Exam
Laboratory and Diagnostic Studies
Diagnosis
Prognosis
Patient Care: Management Health Maintenance and Disease Prevention 30%-35%
Communication 3%-7%
Professionalism
Systems-based Practice and Patient Safety
Practice-based Learning

Preparing for Step 2 CK

Cram Fighter maintains a list of the most popular Step 2 CK textbooks, lecture series, question banks, and flashcards. Below we answer frequently asked question regarding Step 2 CK test preparation.

How long do most students study for Step 2 CK?

According to Cram Fighter’s statistics, most students study for Step 2 CK for 63 days.

When are the most popular months to take Step 2 CK?

The most popular period among Cram Fighter users for taking Step 2 CK is June-August. For a complete list, visit our page on the most popular months for taking Step 2 CK.

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