How to Score a 270 on USMLE Step 2 CK

12 min



Unicorns. Sasquatch. Leprechauns. A 270 on Step 2 CK. What do these things have in common? They’re all imaginary. Or… are they?

Believe it or not, scoring greater than the 99th percentile on Step 2 CK is possible for a select few who prepare well, take care of themselves, and get a little lucky. In this brief article, I’ve included eight steps I personally used to score a 270+ on Step 2 CK.


1. Create a solid foundation of Step 2 CK knowledge

Creating and maintaining a solid foundation of knowledge is the most crucial part of any study plan for Step 2 CK especially if you’re shooting for a score of 270+. In other words, your preparation for Step 2 CK begins at the beginning of medical school by way of doing everything you can to thoroughly learn and retain the material being taught in your classes. The second prong of creating a solid foundation is learning how to effectively study for a standardized exam like Step 2 CK. Lucky enough, you get to take USMLE Step 1 and your shelf exams before you take Step 2 CK! Learning to study effectively for these will create a strong knowledge base that will carry through into your Step 2 CK preparation.


2. Make a Step 2 CK study plan

It doesn’t matter so much how you do it, but that you do it! Especially after Step 1 becomes a pass/fail exam, it may be tempting to leisurely study for USMLE Step 2 CK. This is not a good idea for anyone but will specifically be detrimental to those looking to score over 270. So, make a plan to conquer Step 2 CK. The exam features a wide range of material and is daunting in both length and depth. However, it’s not unmanageable. If you approach Step 2 CK as simply another exam and create a realistic but ambitious study plan, you will be able to cover all the material.


3. Study during your third year

How does someone study everything for Step 2 CK in one month? Trick question: you don’t. However, by preparing for your shelf exams, you’re simultaneously preparing for Step 2 CK. I personally did one pass of UWorld during my third year for shelf/clerkship exams and a second pass during my dedicated period in the month leading up to my exam. This proved to be extremely helpful and allowed me not only to succeed on my shelf exams but also to score a 275 on Step 2 CK. In my opinion, using Step 2 study materials to prepare for your shelf exams is the most effective way to actually squeeze in USMLE studying during 3rd year. Trying to set aside time in your busy schedule to study only exclusively for USMLE Step 2 CK during your 3rd year outside of dedicated is going to be very difficult.


4. Acquire knowledge with practice questions

Practice questions are vital to any study plan. I’ve used many question banks, but UWorld was the most comprehensive and the most like the actual exam when I was studying for Step 2. As you progress through whatever question bank you decide to use, start by testing yourself untimed and in tutor mode. Untimed questions will help you slow down and force you to take your time as you learn. As you get closer to your test date, start testing yourself in timed test mode to simulate the exam experience. Complete and review at least one NBME practice exam and both of the UWorld assessments– that is what worked for me. I recommend practicing your pattern recognition for each of the diseases discussed in UWorld and the diagnostic criteria for the ones that just won’t stick in your brain.


5. Retain knowledge with spaced repetition

Retaining knowledge is just as important as acquiring knowledge in the first place. You might be saying, “that’s obvious!” However, it’s easier said than done. The only way to score a 270+ on Step 2 CK is to be a super genius (which I do not consider myself, and I assume you are not either) or to be efficient with your time. Since you can’t learn everything in one month (see step 3), you must plan to retain and review it. The most efficient way to review high yield information is via spaced repetition.


The most popular application for spaced repetition flashcards is Anki. Anki was the backbone of my studying throughout medical school and dedicated for Step 2 CK. I used premade decks and supplemented them with my cards and other trusted premade decks for specific diagnostic criteria and minutiae. I made my cards for concepts included in CMS forms and UWorld that weren’t in pre-made decks. I kept up with all my cards throughout my third year of medical school. At times, this was brutal (looking at you, surgery rotation), but ultimately my dedication paid off.


6. Take a dedicated period

If you can take time off before your Step 2 CK exam, use that time to go back through your question bank and review all the content you’ve been studying for the past year. I took a month off before taking Step 2 CK. This dedicated study period was how I managed to complete all 3300 UWorld questions (there are even more now!) and hone my test-taking abilities before my test day.


7. Test-taking strategy

Good study habits and a strong knowledge base alone won’t get you to a 270 on Step 2 CK; you will need great test-taking strategies to surpass a 270. Personally, anytime I got confused or mixed up, I decided to take a step back and ask myself the following questions:

– What is common? When in doubt, the most common or least expensive treatment option is the correct choice.
– What is the concept that the exam-writers are trying to test?
– What are the common pitfalls? How might someone fall into an incorrect line of thinking, especially if they’re rushing through the test or lack a comprehensive knowledge base?


8. Self-care; know thyself

Most importantly (in my opinion), take care of yourself. A little hard work never hurt anyone, but medical students, residents, and doctors tend to push themselves past their limits in pursuit of their goals. This kind of pressure works occasionally, but it’s not sustainable. I did four to six UWorld blocks and reviewed Anki cards per day in the month leading up to my Step 2 CK, but doing that for a year would have destroyed me. If you’re sick, rest. If you need a mental health day or time with your loved ones, take it. Your brain (and your patients) will thank you later.


Finally, the best piece of advice I ever received in medical school was, “don’t listen to anyone’s advice about how to study, including my advice.” While these study strategies worked well for me, I always caution my students not to completely revamp their study strategies based on what someone else says they should do. Still, these practices are tried and true and have helped me and many others reach our Step 2 CK score goals. I believe they can help you do the same.


Oh, and if 270 isn’t enough for you, here’s how to score a 280 on Step 2 CK!

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