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The Increasing Importance of Step 2 CK: Reasons and Outcomes

  • by Michael Stephens
  • May 16, 2022

The old adage goes, “Two months for Step 1, two weeks for Step 2 CK.” This may not have been the best advice in the past, and it’s even less so nowadays. How long you budget to study for Step 2 Clinical Knowledge (CK) is an individualized decision, but Step 2 has been gaining importance over time. We’re going to discuss how Step 2 CK works in medical education, how it’s changed recently, and how these changes may affect your preparation for this exam.

A “Level Playing Field” Way To Evaluate Residency Applications

When processing residency applications, reviewers rely on certain metrics, one of them being standardized exam scores. Since almost every applicant took USMLE Step 1 by the time applications were due, its score historically functioned as the main comparison point. Now that Step 1 has become Pass/Fail, however, it no longer will really serve this purpose. That’s where Step 2 CK comes in. Step 2 CK tests the clinical knowledge you gain after completing your rotations and before graduating from medical school and is now the first test in the USMLE sequence that provides a three-digit score. You’re not required to take this exam before you submit your residency applications, but it may be a useful tool for you as an applicant, as we explain below.

Step 2 Is More Clinically Relevant Than Step 1

Even before Step 1 became a Pass/Fail exam, Step 2 CK was arguably a more useful metric of practical medical knowledge. Step 1 emphasizes basic science underlying clinical medicine, whereas Step 2 CK highlights the actual clinical knowledge upon which patient care is based.  These exams complement each other, but during a typical day at work, a physician uses more knowledge he or she learned for Step 2 CK than for Step 1. As a result, Step 2 is the more clinically relevant of the two exams. 

When Should You Take The Exam And How Should You Study?

The timing of your exam is a personal choice. It depends on when you will be able to study and take the test. Make sure to budget enough time to make at least one pass through a high quality question bank, many of which have close to four thousand questions. One single “tried and tested” textbook or video resource for Step 2 CK does not exist, but a number of good options are available to supplement question banks as needed. Practice tests are one more useful tool. Some question banks provide self-assessments and the National Board of Medical Examiners (NBME) has three forms composed of retired board exam questions. They are available online for a fee of $60.

Another component in your decision-making is whether you plan to include your score in your initial residency application submission. If you passed Step 1 on the first attempt and feel that your application will be robust without a three-digit test score, you can submit your application without a Step 2 CK score. Just keep in mind that most programs will require you to have taken Step 2 CK by the time rank lists are due, so the evaluators will eventually be aware of how you performed on that test.

On the other hand, if you are looking for an opportunity to  bolster your application further, you may wish to take Step 2 CK beforehand. The test is a great way for you to stand out,  showcase your firm knowledge base, and demonstrate your strong work ethic. You should plan to spend more than a few days studying for Step 2 CK. Historically, the test may have not taken a front row seat, but it is quickly becoming the most important board exam in your medical training.

It goes without saying that the key to prepping for any exam is a good study plan! You can use Cram Fighter to create study schedules for each of your Shelf exams and then add a dedicated study block to pull it all together for Step 2. See how easy it is to create a detailed study schedule with the resources you want to use with a free 7 day trial for Cram Fighter!