USMLE Step 2 CK Preparation Course

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From American Doctors; USMLE Step 2 Course


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USMLE Step 2 CK Exam Overview

Opportunity to Become a Doctor in America

Step 2 CK assesses the examinee’s ability to apply medical knowledge, skills and understanding of clinical science necessary to provide supervised patient care and focuses on health promotion and disease prevention. Step 2 CK provides due attention to the principles of the clinical sciences and basic patient-centered skills that provide the foundation for the safe and competent practice of medicine under supervision.

Step 2 CK is a one-day exam. It is divided into 8 blocks of 60 minutes and administered over a 9 hour test session. The number of questions per block will not exceed 40. The total number of questions in the general exam will not exceed 318.

The exam also includes a break period of at least 45 minutes.

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USMLE Step 2 CK Exam Detailed Information

The content of all USMLE exams is organized according to general principles and individual organ systems. Test questions fall into 18 main categories, depending on whether they focus on concepts and principles that apply across organ systems or within individual organ systems.

Step 2 The Clinical Information (CK) content weight for these topics is indicated in the next heading. Chapters focusing on individual organ systems are divided into normal and abnormal processes, including principles of therapy. In most cases, knowledge of normal processes is evaluated in the context of a disease process or specific pathology.

While not all topics listed in the content outline are included in every USMLE Step exam, general content coverage may be included in all steps.

General Principles of Foundational Science2-4
Immune System3-5
Blood & Lymphoreticular System4-6
Behavioral Health6-8
Nervous System & Special Senses6-8
Musculoskeletal System/Skin & Subcutaneous Tissue6-10
Cardiovascular System8-10
Respiratory System7-9
Gastrointestinal System7-9
Renal & Urinary System & Male Reproductive4-6
Pregnancy, Childbirth & the Puerperium4-6
Female Reproductive System & Breast4-6
Endocrine System4-6
Multisystem Processes & Disorders4-6
Biostatistics & Epidemiology/Population Health/Interpretation of Medical Literature3-5
Social Sciences: Legal/Ethical Issues & Professionalism/Systems-based Practice & Patient Safety10-15
Step 2 CK Test Content Specifications
Medical Knowledge: Applying Foundational Science Concepts0
Patient Care: History and Physical Exam0
Patient Care: Laboratory/Diagnostic Studies13-17
Patient Care: Diagnosis16-20
Patient Care: Prognosis/Outcome5-9
Patient Care: Health Maintenance/Disease Prevention8-12
Patient Care: Pharmacotherapy8-12
Patient Care: Clinical Interventions6-10
Patient Care: Mixed Management12-16
Practice-based Learning & Improvement3-5
Systems-based Practice & Patient Safety5-7
Step 2 Competencies Required in CK Doctors
Obstetrics & Gynecology10-20
Step 2 Weights of CK Sections

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USMLE Step 2 CK Sample Test Questions

A 21-year-old woman comes to the office for counseling prior to conception. She is recently married and would like to conceive within the next year. She does not eat meat, fish, or dairy products and wishes to decrease the risks of her diet on her baby. Menses occur at regular 28-day intervals and last 5 days. She does not smoke or drink alcohol. She takes no medications. She is 157 cm (5 ft 2 in) tall and weighs 50 kg (110 lb); BMI is 20 kg/m2. Physical examination shows no abnormalities. Pelvic examination shows a normal appearing vagina, cervix, uterus, and adnexa. Which of the following is most likely to decrease the risk of fetal anomalies in this patient?

(A) Adjusting diet to include more sources of protein during the first trimester

(B) Beginning folic acid supplementation prior to conception

(C) Calcium supplementation during the first trimester

(D) Iron supplementation during the first trimester

(E) Soy protein shakes throughout pregnancy and lactation

(F) Randomized clinical trial

(Answer: B)

A 10-year-old boy is brought for a follow-up examination 2 days after he was seen in the emergency department because of hives, hoarseness, and light-headedness. His symptoms began 15 minutes after he was stung by a bee and lasted approximately 60 minutes; they resolved before he was treated. He has been stung by bees three times over the past year, and each reaction has been more severe. Examination shows no abnormalities. Which of the following is the most appropriate recommendation to prevent future morbidity and mortality from this condition?

(A) Avoid areas known to have bees

(B) Avoid wearing colorful clothing outside

(C) Carrying diphenhydramine tablets

(D) Carrying self-injectable epinephrine

(E) Seek immediate medical attention following any future sting

(Answer: D)

A cohort study is conducted to compare the incidence of adverse effects of a recently approved antihypertensive pharmacotherapy with that of conventional therapy. A total of 20,000 patients are enrolled. Twelve thousand are prescribed the recently approved therapy, and 8,000 are prescribed conventional therapy. Patients in the study and control groups are matched for baseline blood pressure, age, and gender. Data are collected from the records of the patients’ ongoing clinical care. Results show that those receiving the newly approved treatment have twice the incidence of fatigue compared with those receiving the conventional treatment. The results are statistically significant (P=0.01). Which of the following potential flaws is most likely to invalidate this study?

(A) Publication bias

(B) Selection bias

(C) Type I error

(D) Type II error

(Answer: B)

Three days after hospitalization for diabetic ketoacidosis, an 87-year-old woman refuses insulin injections. She says that her medical condition has declined so much that she no longer wishes to go on living; she is nearly blind and will likely require bilateral leg amputations. She reports that she has always been an active person and does not see how her life will be of value anymore. She has no family and most of her friends are sick or deceased. On mental status examination, she is alert and cooperative. She accurately describes her medical history and understands the consequences of refusing insulin. There is no evidence of depression. She dismisses any attempts by the physician to change her mind, saying that the physician is too young to understand her situation. She says, “I know I will die, and this is what I want.” Which of the following is the most appropriate next step in management?

(A) Discharge the patient after she has signed an “against medical advice” form

(B) Seek a court order to appoint a legal guardian

(C) Offer insulin but allow the patient to refuse it

(D) Admit to the psychiatric unit

(E) Administer insulin against the patient’s wishes

(Answer: C)

A 45-year-old woman is hospitalized for management of Staphylococcus aureus endocarditis with persistent bacteremia. The patient is discussed during interdisciplinary rounds, which includes physicians, nurses, pharmacists, and social workers. During rounds, a pharmacy student notices that the patient missed two doses of her scheduled antibiotic last week but is unsure why. The physician and nurse are unaware of these missed doses, and the student does not mention her observation. Which of the following measures is most likely to improve communication within this interdisciplinary health care team?

(A) Conduct interdisciplinary rounds in a quieter location

(B) Encourage questions from all team members

(C) Implement a checklist for standardizing patient rounds

(D) Use computers during rounds to review medications

(Answer: B)

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