How to Prepare for & Pass USMLE® Step 2 CK as an IMG - Osmosis - A Better Way To Learn (2023)

With USMLE® Step 1 becoming pass/fail and USMLE Step 2 CS on hiatus, there's a greater need for International Medical Graduates who wish to practice medicine in the US to do well on the USMLE Step 2 CK exam. In today's blog, Osmosis Medical Education Fellow and Regional Lead, Santiago Callegari (who scored 270 on the exam!) shares his advice on how to prepare for and pass USMLE Step 2 CK as an IMG.

Over the past year or so, USMLE® Step 2 CK scores are being increasingly recognized as one of the most important factors for International Medical Graduates (IMGs) looking to practice in the US. The pass/fail change for USMLE® Step 1 and USMLE Step 2 CS being canceled is only going to increase its importance. This new focus on Step 2 CK means new challenges for anyone looking to take this exam, especially for IMGs.

Generally, medical students and graduates have Step 1 figured out; there is a classic way to prepare for it (in my case, it was UFAP + Osmosis, but you can read more here). Step 2 CK is a whole new beast, and all of the established study resources are trying to catch up with this continuously changing exam. To give an example of just one of the changes, as of November 2020, there's now a much greater focus on medical ethics.

I was lucky in both exams and scored high in both (Step 1: 262, Step 2 CK: 270), but it wasn't easy, especially for Step 2 CK. In this blog, I will tell you the main differences you have to consider from Step 1 to Step 2 CK, high-yield resources you should check out, and talk the most important things to consider in your future prep.

(Video) "How do I get a 285+ on Step 2CK?"

How to Prepare for & Pass USMLE® Step 2 CK as an IMG - Osmosis - A Better Way To Learn (1)

USMLE Step 2 CK is the easy version of USMLE Step 1

Reality check: if you're going to start preparing for Step 2 CK thinking that it's easier than Step 1, you're going to have a hard time. Sure, Step 2 CK has some aspects that are easier (or at least less stressful!) than Step 1, but by no means you should underestimate the exam.

Ace your clinical rotations

Compared to Step 1, Step 2 CK prep is simpler, and it's easier to improve your score. But, doing many (many!) practice questions is still a must, so you can retain all that information you learned for Step 1. Most importantly, the single best way to prepare for Step 2 CK is by doing your best in every clinical rotation (and making your own flashcards on Osmosis is also very helpful). Many students prepare for the exam only using UWorld, but you should pick what works for you. As I said, many resources are continuously evolving, so be sure to check them all out to know what's best for you. For example, I found the Clinical practice videos on Osmosis incredibly helpful.

How Step 2 feels different from Step 1

When you actually take Step 2 CK it feels like an entirely different exam from Step 1. Although they follow almost the same protocols, Step 2's extra block, abstract questions, drug ad questions, many algorithms, occasional long vignettes, and occasional vagueness requires a slightly different approach. Try to simulate the exam at least once to understand how you'll experience the exam so you can be prepared when the time comes.

Is there one dominant resource for Step 2 CK?

"Is it only UWorld?"

I have seen this question repeated quite a few times on Reddit as well as from my fellow classmates—I even asked myself a few times! Sadly, the answer isn't a simple one: It depends. For me, I would have to say that the best preparation for the exam is to try to learn as much as possible in your clinical rotations, and I'd say this is more important than doing your UWorld questions.

(Video) How to start the Usmle step 2ck prep | Uworld vs Online MedEd |

UWorld's questions very closely match what you'll find on Step 1, but Step 2 CK is a bit more tricky, and if you only used UWorld to prepare, you're in for more than a few surprises. When it's time to take the exam, it is very important that you have a very solid foundation and thoroughly understand the concepts so you don't get fooled by unusual terms you may encounter.

Practice questions are useful, but they're not a substitute for experience

UWorld helps you learn new concepts and details that you might have forgotten or didn't learn during your rotations. But it is much easier to learn from it if you know what they are talking about. For example, when learning management of fetal heart tracings, it is easier to learn this when you've actually dealt with it in clinical rotations, rather than trying to understand it abstractly from the words of a vignette.

Try to learn solid concepts during your rotations (again, Osmosis's Clinical practice videos and USMLE Step 2 CK practice questions are a very good partner for this). Once you have this foundation and are ready to practice with questions during your dedicated period, you'll likely only need to adjust a couple of details before you're good to go.

How to Prepare for & Pass USMLE® Step 2 CK as an IMG - Osmosis - A Better Way To Learn (2)

What's the secret sauce for getting a good score on USMLE Step 2 CK?

Practicing self care > practice questions

For me, the secret sauce for Step 2 CK (and every other exam, actually!) is never forgetting about taking care of the most important thing during your prep... YOURSELF! Taking 100,000 questions won't get you anywhere if you don't prioritize yourself and your mental health.

(Video) The BEST Way to Study for USMLE Step 1 in 2022

I know this is easier said than done—especially in our current times. Do your best to continue doing non-study-related activities that you enjoy during your dedicated prep period (as much as you can, anyway). Elsewhere on the Osmosis blog, you can find some information about mindfulness or yoga and much more if you want to try new activities—check out this Wellness Guide for Future Health Professionals for more info.

Get some sleep

The most efficient thing to boost your score on the exam day is not reviewing thousands of flashcards before entering the exam room. It's actually way easier than that: Get a good night's rest! No exam that is more important than you and your mental health. A good score means nothing if you're too burnt out and miserable to celebrate your achievement.

You are not alone in this journey

Thousands of students around the world take Step 2 CK every year, and everyone has a unique experience. As IMGs, I think we need to have each other's backs and support each other as we go through this process collectively. Don't hesitate to ask a classmate, colleague, or mentor about the exam (especially on the bad days).

Always be true to yourself about your motivation. If what motivates you is to have the highest score of all, go for it. If you want to pursue residency at a specific clinic, use that to propel yourself forward when you're struggling to find motivation. Just as you need support from people along the way, you need to learn to find your own support and motivation inside yourself, too.

USMLE Step 2 CK is a very important exam, but at the end of the day, it is just that: an exam. Do your best during your clinical rotations, search for the best resources that work for YOU, make time and prepare adequately for dedicated period, and most importantly, build confidence in yourself. And I'll say it one last time: always remember that mental health takes priority above all else!

(Video) 7 Underrated resources for the USMLE exams to score 250+ | Step 1 | Step 2 CK | The IMG USMLE Series

About Santiago

Santiago Callegari is a third-year medical student at the Universidad de los Andes in Bogotá, Colombia, where he was born and raised. He hopes to one day become an amazing anesthesiologist or internist. When he’s not studying or in the clinic, he’s spending time with his five dogs and three cats!



(Video) USMLE Step 2 CK: Study plan, Resources, Preparation Timeline

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The United States Medical Licensing Examination (USMLE®) is a joint program of the Federation of State Medical Boards (FSMB®) and National Board of Medical Examiners (NBME®). Osmosis is not affiliated with NBME nor FSMB.


How long does it take to study for Step 2 CK IMG? ›

Your Step 2 CK study plan should include at least 10 hours per day for 4-6 (and up to 8) weeks. Remember, the harder you work, the higher your likelihood of a high score. Split up UWorld questions accordingly. You should allow yourself time to get through all of the questions at least once.

What is a good score in Step 2 CK for IMG? ›

A good USMLE Step 2 CK score is between 240 and 260. However, what qualifies as a “good” score ultimately depends on the residency program you are applying to. If you want to match to your first-choice program, you should aim for a score at or above 256.

Is 3 months enough for Step 2? ›

4-6 months is all you need for your USMLE step 2 CK. If you read it right after USMLE step 1, it can be done is lesser time. But don't rush things if you think you are not prepared, the scores are the most important thing for your CV.

How long should I study for Step 2 CK? ›

Overall, study time usually ranges from 1-4 weeks with most students taking 2-3 weeks. Students who take the exam during a vacation will often need less time since they have more time each day to study.

What is the most predictive exam for Step 2 CK? ›

There are two UWorld self-assessments available for Step 2 CK, and it is recommended that UWSA 1 should be given 1 month before the exam, and UWSA 2 in the last week before the exam as it is also a very predictive assessment. These are also the assessment forms available on the NBME website.

Is 6 months enough for Step 2? ›

How long does it take to prepare for each USMLE exam? Based on our experience working with IMGs, preparing for the USMLE Step 1 takes 6 to 12 months, and Step 2 CK (clinical knowledge) takes between 4 and 7 months.

How hard is it for IMG to get residency? ›

It is no secret that getting into a residency program as an IMG is harder than as a non-international applicant. When it comes to matching a residency program, it is only logical that success rates will be slightly lower for IMGs, especially in the most competitive residencies.

What percentile is 260 on Step 2? ›

Percentiles for Step 1, Step 2 CK, and Step 3 in 2022
ScoreStep 1 PercentileStep 2 CK Percentile
20 more rows

What is the average Usmle score for IMG? ›

IMGs: Average Step 1 Scores by Specialty (2022 Match)
Step 1, US IMG (Matched)Step 1, Non-US IMG (Matched)
Internal Medicine225238
Internal Medicine/Pediatrics220230
Interventional Radiology261250
Neurological SurgeryN/A246
18 more rows

What are the high yield topics for Step 2 CK? ›

You should know how to evaluate and manage adnexal masses, vaginal bleeding, abnormal uterine bleeding, and primary/secondary amenorrhea. Risks, workup, and treatment of cervical, endometrial, ovarian, and vaginal cancers are heavily tested, high-yield Step 2 CK content.

What is a good baseline score for Step 2? ›

Defining Your USMLE Step 2CK Score Goal

The average USMLE Step 2CK score is approximately 242, mean is 245 with a standard deviation of 15, meaning that 68% of students who take the exam will fall between 230 and 260, 95% will fall between 215 and 275, 2.5% greater than 275 and 2.5% less than 215.

What is a competitive Step 2 CK score? ›

If you get a score of around 240-250, you would be able to apply for any medical specialty and have a great chance of getting in. A score of at least 248 can allow you to compete for highly competitive specialties or locations.

What is the average Step 2 CK score? ›

What's the Average Step 2 Score? Data provided by the National Board of Medical Examiners, which administers the USMLE, indicate that the average score for Step 2 CK for U.S. medical graduates hovers just above 240. Generally, it's been 242 to 243 over the past few years.

Is 5 months enough for Step 2? ›

Given that clinical experiences are so key to Step 2 CK-relevant knowledge, if at all possible, you should aim to take Step 2 within 6 months of finishing your core clinical rotations.

How long does it take to study for Step 1 IMG? ›

For IMGs who have just completed second year of medical school, 4-6 weeks of dedicated preparation time will be enough. However, for those who start late, 4-6 months of dedicated preparation will allow them to do well on the exam.

How long should IMG study for Step 1? ›

Most USMLE Step 1 test-takers suggest you should begin studying at least 3 months before the exam to get the best results, but 6 months is optimal.

How long does it take to study for Step 3 IMG? ›

Generally, students take between 2 to 8 weeks to prepare for Step 3. However, the time to prepare for USMLE STEP 3 varies based on your prior knowledge but. For me, I had a good foundation from my STEP 1 and STEP 2CK; therefore, it took me around four weeks to prepare for this exam.


1. How I scored a 256 on USMLE step 1 ...( detailed guide with a timetable)
2. How to Study for USMLE Step 1 as an IMG - Only 4 Resources!
(Chris Quelch)
3. Best All In One MedSchool Study Tool? AMBOSS Walkthrough
(Santiago AQ)
4. USMLE Study Plan: How to Make a Step 1 Dedicated Study Schedule in 5 Steps
5. STEP 1 in 4 months | USMLE STEP 1 Study Schedule and Plan
(Malke Asaad, M.D.)
6. Pass USMLE Step 1 In A Hurry


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