| Category | USMLE Step 1 | USMLE Step 2 CK |
|---|---|---|
| Format | 7 blocks × 40 questions = 280 MCQs | 8 blocks × ~40 questions = 318 MCQs |
| Duration | 9 hours total with breaks | 9 hours total with breaks |
| Passing standard | Pass/Fail since January 2022 (no numeric score reported to residencies) | 3-digit numeric score (mean ~249, passing ~214) |
| Focus | Basic sciences: pathophysiology, pharmacology, microbiology, biochemistry, anatomy, behavioral science | Clinical medicine: diagnosis, management, patient care across all specialties |
| Pass rate | ~96% first attempt (US MD graduates) | ~97% first attempt (US MD graduates) |
Test yourself
1. USMLE Step 1 changed its scoring format in 2022. What is the current format?
2. A medical student is planning their residency application strategy. Which exam score now carries the most weight for differentiation among competitive residency applicants?
Passing is required, but the score no longer differentiates applicants. Step 2 CK has absorbed much of that differentiating role. Research letters, clinical grades, and Step 2 CK scores have all grown in relative importance since January 2022.
Most students find Step 2 CK harder to prepare for because it requires integrating clinical knowledge across all specialties in realistic patient scenarios. Step 1 demands pure memorization depth; Step 2 CK demands clinical reasoning breadth. Both are genuinely challenging.
Most program directors recommend taking Step 2 CK in time to submit scores with your ERAS application (typically by mid-September of MS4 year). Many competitive applicants now take Step 2 CK at the end of MS3 or early MS4 to have maximum time for strong scores.
Apply what you know
Progress Note adapts to your knowledge gaps — so you spend time on what actually moves the needle.
Start practicing freeContinue the curriculum