Step 1 vs. Step 2 Comparison – Difficulty, Scoring & Knowledge

Guide to USMLE Step 1 vs Step 2 CK

Guide to USMLE: Step 1 vs. Step 2 CK

If you’re preparing to take the United States Medical Licensing Examination (USMLE), you may have several questions about how the test is designed. While Step 1 and Step 2 are a part of the USMLE, they’re two different tests. Each has its own importance, so you’ll want to know what sets them apart beforehand.

Keep reading to learn more about the differences between USMLE Step 1 and Step 2.

Knowledge Needed for Tests

When it comes down to it, USMLE Step 1 and Step 2 gauge various areas of the student’s medical knowledge to determine whether they’re ready to obtain a medical license.

Knowledge Needed for USMLE Step 1

Many experts and past test-takers note that Step 1 of the USMLE is the most important test. This portion of the exam is designed to test students on basic sciences, including understanding and memorizing facts, and requires in-depth knowledge to adequately answer the questions. Topics include pathology, physiology, pharmacology, biochemistry, microbiology, anatomy and more.

When you’re preparing to take Step 1, be sure to spend time focusing on the broad range of facts that could come up on the test. Further your studying by testing yourself on how much information you know regarding each section within the question bank.

Knowledge Needed for USMLE Step 2

Step 2 is designed to test your knowledge and skills regarding clinical medicine. Here, you’ll be tested both through traditional testing methods on paper and physical demonstrations to gauge your clinical abilities. These are broken up into two portions — Step 2 and Step 2 CK (clinical knowledge).

Step 2 ultimately determines whether the student is ready to interact with patients in a clinical setting. It’s a good idea to study the aspects of successfully applying patient care and health maintenance, diagnosis and management.

If you plan on becoming a neurologist, achieving close to or above a 230 and a 240 will ensure you're keeping pace with your peers

Test Scoring Differences

Although they’re part of the same exam, USMLE Step 1 and Step 2 are scored differently. Though the USMLE program doesn’t disclose how they score Step 1 or Step 2, you’ll want to take a closer look at the minimum and average scores so you can prepare as you study. The USMLE helps determine your residency match, and higher scores often mean a higher chance of being matched.

The required minimum score to pass Step 1 is 194. However, you’ll find varying average Step 1 and Step 2 test scores depending on specialty. For example, residents testing for neurology in the 2020-21 school year scored an average of 229.5 with a standard deviation of 17.1. Step 2 CK is graded based on a competitive numerical scale, and the minimum score to pass is 209. For neurology residents in the 2020-21 school year, the average score was 239.4 with a standard deviation of 15.4.

Note that USMLE Step 1 and Step 2 scores vary widely among residents and in specialties. If you plan on becoming a neurologist, achieving close to or above a 230 and a 240 will ensure you’re keeping pace with your peers. Be sure to keep that in mind as you prepare to take the tests.

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USMLE Step 1 vs. Step 2 Difficulty

Each Step’s difficulty will depend on your knowledge and abilities, so wondering how hard Step 1 or Step 2 is may not get you anywhere. Step 1 tests a broad range of basic science knowledge and Step 2 focuses on a smaller range of content that directly applies to practicing medicine. For some, passing Step 1 may take longer than Step 2, and vice versa.

How Difficult Is USMLE Step 1?

This portion of the exam is eight hours long, broken into seven one-hour blocks including breaks. It can contain up to 280 questions broken down into up to 40 questions per section. Step 1 only involves multiple-choice questions. Check out the USMLE’s official content outline to learn more about Step 1’s specifics.

How Difficult Is USMLE Step 2 CK?

This portion of the USMLE turns the focus to high-yield concepts that ensure you’re ready to safely practice medicine under supervision. Step 2 is nine hours long, taking place in eight one-hour blocks with breaks. It may feature up to 318 questions with up to 40 questions per block. Explore USMLE’s official content outline for Step 2 to learn more.

Importance for Medical Career

Both exams are crucial for takers’ future medical careers. Though it may take several tries for you to pass each one, you must complete them to advance down the path to becoming a practicing medical doctor in the United States. Step 1 and Step 2 are required for entry into most residency programs.

Many residency programs instate a scoring cutoff for Step 1, meaning you must obtain a certain Step 1 score for entry. That said, you don’t have to do particularly well on Step 1 to join a residency program — it’s your Step 2 score that mainly determines whether you’ll be matched with a program. Still, having a good Step 1 score and a bad Step 2 score isn’t the end of the world.

By obtaining strong letters of recommendation and improving your applications in other ways, you can still obtain the best match for you. In some cases, students will choose to take only one of the exams for a variety of reasons. Doing so will depend on which type of medicine you want to practice and the residency program you want to join.

Overall, Step 1 and Step 2 are equally as important for most medical students.

medlearnity has helped hundreds of medical students prepare to take their USMLE, and our services prove to help them even after the exam. Sign up for a free trial

Prepare for the USMLE With Medlearnity Tutoring

Congratulations on preparing to take your USMLE! This is a significant step in your medical career and we understand that preparing properly matters. That’s why Medlearnity is dedicated to providing only the highest quality USMLE Step 1 tutoring and USMLE Step 2 tutoring.

At Medlearnity, we offer personalized learning experiences, and we do our absolute best to pair you with a tutor that will best fit your schedule and learning needs. All of our tutors test astonishingly high on their exams, which means that with their compassion and knowledge, they can help you get to where you need to be. By using a combination of practice drills, test-taking advice and studying assignments, you’ll be more than ready when it comes time to take your USMLE.

Medlearnity has helped hundreds of medical students prepare to take their USMLE, and our services prove to help them even after the exam. If you want to put our tutoring services to good use, sign up for a free trial with one of our USMLE Step 1 and Step 2 online tutors today!

About the author 

Akshay Goel MD

Dr. Goel is a body-trained radiologist and an expert in medical education and imaging informatics. He completed his Radiology Residency at Columbia University Medical Center and his fellowship at Weill Cornell Medicine. Dr. Goel has guided several students and doctors into successful careers over the past decade. He continues to help Medlearnity tutors optimize their educational methodology to drive the highest tutoring and admissions impact possible.

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