USMLE Step 2 CK exam guide
How the Step 2 CK day is built, what it costs and what changed in 2026, all in one place.
Step 2 CK at a glance
| Detail | Step 2 CK |
|---|---|
| Result | Score from 1 to 300, with a passing standard of 218 |
| Test day | One day, a 9-hour testing session |
| Blocks | 16 blocks of 30 minutes each |
| Questions | Up to 20 per block, up to 318 in total (unchanged by the new software) |
| Breaks | At least 55 minutes in total, plus a 5-minute optional tutorial |
| Exam fee | US$ 695, plus a US$ 235 surcharge outside the US and Canada |
How the 9 hours add up
16 blocks × 30 minutes = 8 hours of question time. Add at least 55 minutes of break time and the 5-minute optional tutorial, and the session is 9 hours. Before 7 May 2026, Step 2 CK used eight 60-minute blocks. The total number of questions did not change.
Sources: usmle.org Step 2 CK and the software update notice, checked October 2026. Fees: fsmb.org and the ECFMG surcharge page.
Your day, hour by hour
- Optional 5-minute tutorialLearn the screen before the clock starts.
- 16 blocks of 30 minutesAnswer up to 20 questions in each block, about 90 seconds a question.
- At least 55 minutes of breaksPlan where you will take them, because the day is long.
- Stamina mattersRehearse long sessions in your last weeks so the ninth hour feels familiar.
Registering and fees
| Item | Amount |
|---|---|
| Exam fee | US$ 695 |
| International test delivery surcharge | US$ 235 (outside the United States and Canada) |
| Total outside the US and Canada | US$ 930 |
Sources: fsmb.org and the ECFMG surcharge page, checked October 2026. India adds its own tax; see the South Asia guide.
Try the official samples
USMLE sample questions
The exam makers publish sample questions for Step 2 CK, so you can see the real interface before test day.
Open on usmle.orgWhat changed in 2026
New software, shorter blocks, FSMB registration and higher surcharges, explained on one page.
Read the 2026 changesPast papers and syllabus
USMLE publishes no past papers, so prepare from the official content outline. It shows how the exam divides questions between systems and tasks.
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