What is USMLE Step 2?
The USMLE Step 2 Examination is the national medical licensing exam to become a certified physician in the United States of America. It must be passed by all MD/DO candidates. It is the second of three medical licensing exams required in the United States to become a practicing physician.
Content
The USMLE Step 2 exam focuses on the scientific foundations of medicine. It consists of multiple categories including internal medicine, pediatrics, surgery, obstetrics, gynecology, and psychiatry. These disciplines are subdivided into their relevant systems such as cardiology, hematology, endocrinology, gastrointestinal, musculoskeletal, neurology, psychiatry, reproductive, renal, and respiratory.
For a full outline on the USMLE Step 2 exam, check out the USMLE Step 2 official outline.
Length
The USMLE Step 2 exam is a 9-hour exam. The exam allocates 8 hours for questions, 45 minutes for break time, and 15 minutes for a tutorial that can be skipped (time is added to break if skipped).
Question Time
The exam consists of 318 questions divided into eight blocks. Each block is allocated 60 minutes to complete. Once the 60 minutes finish, the block is automatically submitted and the student can no longer return to that block of questions. However, if the block is submitted early, any remaining time will be added to your break time.
Break Time
The 45 minutes of break can be divided in any way between the question blocks. It is completely up to the test-taker to decide how to divide up their break time. However, an important note is that breaks can only be taken between blocks; breaks cannot be taken during a block.
Tutorial Time
The exam begins with an optional 15-minute tutorial. If you have done the tutorial before, you can skip it. The remaining tutorial time will be added to your break time. It is recommended to try the tutorial prior to your actual exam.
Tutorial Time
The exam begins with an optional 15-minute tutorial. If you have done the tutorial before, you can skip it. The remaining tutorial time will be added to your break time. It is recommended to try the tutorial prior to your actual exam.
Questions
The exam contains 318 multiple choice questions in a clinical vignette format. A clinical vignette is a long patient description with associated labs that is followed by a question regarding the case. Each question will have at least five multiple-choice options to pick from. In addition, some questions will have two or three parts.
Sample Clinical Vignette
Sample Clinical Vignette Question
A 22-year-old college student that is confused and lethargic is brought to the emergency room. His roommates say he was complaining of a severe headache and neck stiffness last night. Vital signs are remarkable for a temperature of 104.3F, blood pressure of 80/60, and heart rate of 120. Physical exam reveals a purpuric rash on the patient’s chest. Lumbar puncture reveals a high neutrophil count. What treatment should be given to his roommates as prophylaxis?
A. Acyclovir
B. Ceftriaxone
C. Doxycycline
D. Rifampin
E. Vancomycin
Correct Answer: D
Scoring
The score of the USMLE Step 2 exam ranges to 300 with a minimum passing score of 209. The average score in 2018-2019 was 243 with a standard deviation of 16 points. Although the exam is technically pass/fail, students are expected to score high because residency programs receive USMLE Step 2 scores.
Release Dates
USMLE Step 2 scores are released about 2-4 weeks after the exam. Students receive an email once the score has been released.
Scheduling
All scheduling of the exam is done through the Prometric website. Dates are only available up to 6 months in advance.
Fees
USMLE Step 2 exam fees vary depending on the region. The following fees are based on US and Canada testing centers.
Registration
The registration fee for the USMLE Step 2 exam is currently $645.
Rescheduling
The rescheduling fee for the USMLE Step 2 exam depends on when the student reschedules.
If 31 days or more from the exam day: $0
If less than 31 days: $50
If less than 5 days: $136