Stepping Up to Step 2CK

In a previous post “How and When to Study for Step CK” we discussed preliminary information about developing a study plan for Step 2CK, based on the LAS Medical Coaching Model™. This post continues the discussion and provides specifics about a two-phase test prep plan for the USMLE Step 2CK.    

The USMLE Step 2CK

The USMLE Step 2 CK is a one-day, 9-hour digital exam that assesses the application of medical knowledge and clinical reasoning skills. Emphasis is placed on the content associated with health promotion, disease prevention, principles of clinical sciences, and basic patient-centered skills. There is a maximum of 318 questions divided into 8 question blocks. Each block has up to 40 questions and 60 minutes allotted for completion. A minimum of 45 minutes is available for self-directed break time between blocks. Break time may be increased by accruing time in two ways: finishing a question block before the allotted time expires and completing the optional tutorial at home before the exam. This exam requires stamina, pacing, accuracy, and efficiency during recall. Preparation necessitates a plan. For updates and more specific information about Step 2CK, visit

LAS Test Prep Overview

LAS test prep plans are empirically based and designed to deepen knowledge, hone test-taking skills, increase accuracy and efficiency of recall, and enhance achievement outcomes. They incorporate principles of mastery learning and therefore, progress as achievement is attained within specified learning goals.

Sample workflow: Implement your learning or review process for hypertension and coronary heart disease. Complete the associated cardiovascular questions from your Q-Bank (timed and in test mode) in blocks of 10-25Qs (these questions are targeted to the specific topics studied and used to assess comprehension and immediate recall). The achievement goal for these blocks is 75% or above.

After achieving 75% or above, these same questions will be reused until the exam date. They are added to another type of practice block (a maintenance block) comprised of 30-40 used questions to maintain knowledge and enhance achievement outcomes. This block is a priority.

Implement maintenance blocks 2-5 times per week depending on lengthier or shorter timelines. As the remaining questions are completed at 75% or above, they are added to the maintenance block. During your test preparation, the number of daily targeted blocks decreases while the number of daily maintenance blocks increases. The process of targeted learning, recall practice, and maintenance is repeated until all cardiovascular questions are completed at 75% or above and then restarts with the next organ system.

This plan is intended to be an adaptive roadmap for learning and achievement. Each plan involves a significant study and practice commitment (typically 6 of 7 times per week) and is defined by the content outline from the USMLE Step 2CK, your personal learning goals, maintenance of knowledge, recall practice with spaced repetition, and weekly self-assessments for progress tracking. Based on a 6-week timeline, this plan emphasizes accuracy and achievement and the use of daily practice questions by subject (specialty + system) and comprehensively (all specialties + all systems).

Phase I

Phase 2

Whether or not you begin preparing for Step 2CK during clerkships, use your Q-Bank to maintain your knowledge after completing each shelf exam. Since study timelines often vary, this plan is designed to be flexible. It incorporates practice questions from day one but if you haven’t started using them, now is the time to begin!





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