Study Tips

How to Prepare for & Pass USMLE® Step 2 CK as an IMG

Santiago Callegari
Published on Jan 28, 2021. Updated on Feb 16, 2021.

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. 

Osmosis illustration of a student studying for USMLE® Step 2 CK.

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.

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.

Osmosis illustration of a clinical rotations equipment checklist.

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. 

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! 

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!


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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.