USMLE Step 2 CK exam: format, cost, scoring and preparation
The USMLE Step 2 CK exam is a one-day, 9-hour computer-based test of clinical knowledge, with no more than 318 multiple-choice questions in sixteen 30-minute blocks. The fee is $695 for 2026 and 2027. Unlike Step 1, Step 2 CK is scored: results range from 1 to 300, and the passing score is 218 for exams on or after 1 July 2025.
- Exam
- USMLE Step 2 Clinical Knowledge (CK)USMLE Step 2 CK, checked 18 October 2026
- Questions
- No more than 318 multiple-choice questions; up to 20 per blockUSMLE Step 2 CK and May 2026 software update, checked 18 October 2026
- Format
- Sixteen 30-minute blocks in one 9-hour session (from 7 May 2026)USMLE Step 2 CK, checked 18 October 2026
- Break time
- At least 55 minutes, plus a 5-minute optional tutorialUSMLE Step 2 CK, checked 18 October 2026
- Fee
- $695 (2026 and 2027); $235 region fee outside the U.S. and CanadaUSMLE Apply for Exams, checked 18 October 2026
- Score scale
- 1 to 300USMLE Score Interpretation Guidelines, checked 18 October 2026
- Passing score
- 218 (exams on or after 1 July 2025)USMLE Examination Results and Scoring, checked 18 October 2026
- Pass rate 2024–2025
- 98% of first-takers from U.S. MD schools; 90% of first-takers from non-U.S. schoolsUSMLE Performance Data, checked 18 October 2026
- Attempts
- Up to 3 in 12 months; ineligible after 4 attempts without a passUSMLE Bulletin of Information, checked 18 October 2026
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What the USMLE Step 2 CK exam tests
USMLE says Step 2 CK assesses your ability to apply medical knowledge, skills and understanding of clinical science essential for patient care under supervision, with emphasis on health promotion and disease prevention. Where Step 1 is about the basic sciences, the USMLE Step 2 exam is about diagnosing and managing patients.
For graduates of schools outside the U.S., Step 2 CK matters twice: Step 1 and Step 2 CK continue to be required by ECFMG for Certification.
Source: USMLE — Step 2 CK. Checked 18 October 2026.
USMLE Step 2 CK format and number of questions
Step 2 CK is a one-day exam. For exams on or after 7 May 2026 it is divided into sixteen 30-minute blocks in one 9-hour testing session. Each block has no more than 20 questions, and you get at least 55 minutes of break time and a 5-minute optional tutorial.
Before 7 May 2026 it was eight 60-minute blocks, and the total number of items did not exceed 318. USMLE states that the content, the total number of items and the length of the exam day did not change with the new blocks.
Source: USMLE — Step 2 CK. Checked 18 October 2026.
What USMLE Step 2 CK questions cover
USMLE Step 2 CK questions are classified by clinical discipline, organ system and physician task. Disciplines overlap, so their ranges add up to more than 100%. Medicine is by far the largest; surgery is also tested, but the two official documents we checked give different ranges for it, so we do not quote one.
- Medicine 55–65%
- Pediatrics 17–27%
- Obstetrics & Gynecology 10–20%
- Psychiatry 10–15%
- Systems with the highest ranges: Renal/Urinary & Reproductive 7–13%, Cardiovascular 6–12%, Musculoskeletal/Skin & Subcutaneous Tissue 6–12%
Source: USMLE — Step 2 CK Content Outline and Specifications. Checked 18 October 2026.
USMLE Step 2 CK cost and exam fees
The USMLE Step 2 CK cost is a $695 application fee in 2026 and in 2027, the same through NBME (U.S. schools) and FSMB (schools outside the U.S.). If you test outside the U.S. and Canada, a $235 region fee applies, which USMLE notes is not a USMLE fee. NBME lists $70 for an eligibility period extension.
So the USMLE Step 2 exam fee is $695 in the U.S. and Canada and $930 elsewhere, before any extension or local tax. In 2026, NBME also ran a fee assistance program with a $695 award towards Step 1 or Step 2 CK for eligible U.S. students; the 2026 window was 13 July to 23 August 2026.
Source: USMLE — Apply for Exams. Checked 18 October 2026.
Eligibility, registration and attempts
Eligibility is the same as for Step 1: you must be enrolled in or graduated from a U.S. MD program, a COCA-accredited U.S. DO program, or a school outside the U.S. listed in the World Directory of Medical Schools as meeting ECFMG eligibility requirements, both when you apply and on exam day. U.S. students apply through NBME; students and graduates of schools outside the U.S. apply through FSMB.
You may take Step 2 CK no more than three times in 12 months. After four attempts at a Step without passing, incomplete attempts included, you are ineligible for any Step. Attempts at the former Step 2 CS count toward that limit.
Source: USMLE — Bulletin of Information: Eligibility. Checked 18 October 2026.
Is USMLE Step 2 pass/fail?
No. Step 1 became pass/fail in January 2022, but Step 2 CK is still reported as a three-digit score from 1 to 300. The minimum passing score is 218 for exams on or after 1 July 2025. For first-takers from U.S. MD schools the mean in 2025–2026 was 251, with a standard deviation of 15.
In the 2024–2025 reporting year, 98% of first-takers from U.S. MD schools, 96% of first-takers from U.S. DO schools and 90% of first-takers from schools outside the U.S. passed. More on scores, percentiles and score release is on our USMLE Step 2 CK exam page.
Source: USMLE — Examination Results and Scoring. Checked 18 October 2026.
USMLE Step 2 CK sample questions and NBME practice tests
USMLE publishes more than 100 free USMLE Step 2 CK sample questions, as a PDF and as an interactive testing experience. If you are searching for USMLE Step 2 questions and answers PDF, the official sample booklet includes an answer key. These are also the best USMLE Step 2 example questions to learn how items are written. If you test on or after 7 May 2026, use the new interactive version with 30-minute blocks.
The official USMLE Step 2 CK practice test is NBME’s, not USMLE’s. If you want an NBME USMLE Step 2 practice test, NBME’s Comprehensive Clinical Science Self-Assessment has four sections of 50 questions, seven forms and starts at $62. Its report gives your estimated probability of passing Step 2 CK. These are the official USMLE Step 2 CK practice exams.
Source: USMLE — Step 2 CK Sample Test Questions. Checked 18 October 2026.
Is there a USMLE Step 2 question of the day?
Not from USMLE or NBME: neither publishes a USMLE Step 2 question of the day on the pages we checked. A daily question is a useful habit, but your readiness is better measured with timed blocks of USMLE Step 2 questions and a self-assessment.
Source: USMLE — Step 2 CK Sample Test Questions. Checked 18 October 2026.
Step 2 CS: the USMLE Step 2 CS exam was discontinued
The USMLE Step 2 CS exam (Clinical Skills) was last administered on 16 March 2020, and on 26 January 2021 USMLE announced that it would discontinue Step 2 CS, with no plans to bring it back. If you are looking for a USMLE Step 2 CS practice note, there is no exam left to practise for. USMLE says elements of clinical reasoning and communication continue to be assessed on other exams.
Past Step 2 CS results still appear on the USMLE transcript, and past Step 2 CS attempts count toward the attempt limit.
Source: USMLE — Work to relaunch USMLE Step 2 CS discontinued. Checked 18 October 2026.
USMLE Step 2 CK preparation and review courses
Good USMLE Step 2 CK preparation starts with the content outline, because medicine alone accounts for 55–65% of the questions. A USMLE Step 2 review that follows those weights, plus timed practice in 30-minute blocks, prepares you for both content and pace. Our study guide covers preparation for USMLE Step 2 in detail.
Every USMLE Step 2 course you find, whether a USMLE Step 2 CK prep course, a USMLE Step 2 CK review course or a set of USMLE Step 2 classes, is a third-party product: USMLE states that none are affiliated with or sanctioned by the USMLE program. The best USMLE Step 2 prep course for you is the one whose syllabus follows the official outline and shows your weak areas. Check any USMLE Step 2 prep course against that standard before you pay.
Source: USMLE — Use caution in selecting review courses. Checked 18 October 2026.
USMLE Step 2 CK practice questions
Certsqill’s USMLE Step 2 CK practice questions are expert-developed and mapped to the Step 2 CK content outline, from medicine and pediatrics to obstetrics, gynecology and psychiatry. Use them as a USMLE Step 2 CK question bank alongside the official samples and NBME self-assessments.
Every question comes with an explanation for each answer option, and your results build a readiness score per content area, so you see which disciplines need more work before test day. A 7-day money-back guarantee applies.
USMLE Step 2 CK questions people ask
How many questions are on the USMLE Step 2 CK exam?
No more than 318, in sixteen 30-minute blocks of up to 20 questions. Source: USMLE, checked 18 October 2026.
What is the USMLE Step 2 cost?
$695 for 2026 and 2027, plus a $235 region fee if you test outside the U.S. and Canada. Source: USMLE Apply for Exams, checked 18 October 2026.
What are the USMLE Step 2 CK exam fees?
A $695 application fee in 2026 and 2027, a $235 region fee outside the U.S. and Canada, and $70 if you extend your eligibility period. Source: USMLE and NBME, checked 18 October 2026.
What is the USMLE Step 2 CK passing score?
218 for exams on or after 1 July 2025, on a scale of 1 to 300. Source: USMLE, checked 18 October 2026.
Is USMLE Step 2 CK pass/fail like Step 1?
No. Step 2 CK is reported as a three-digit score. Only Step 1 is pass/fail. Source: USMLE, checked 18 October 2026.
Where can I find USMLE Step 2 CK sample questions?
On usmle.org: more than 100 free sample questions as a PDF with answer key and as an interactive test. Source: USMLE, checked 18 October 2026.
Is there an official USMLE Step 2 question bank?
USMLE does not sell one. NBME sells self-assessments for Step 2 CK from $62, and USMLE publishes free samples. Source: NBME and USMLE, checked 18 October 2026.
Does the USMLE Step 2 CS exam still exist?
No. Step 2 CS was last given on 16 March 2020 and was discontinued in January 2021. Source: USMLE, checked 18 October 2026.
