How Long is USMLE Step 2? Questions and Time Limits for Step 2

USMLE Step 2 is often compared to running a marathon. While I would argue that one could run two marathons (and perhaps even start a third) in the time it takes to sit for Step 2, the analogy nonetheless starts to capture the endurance required to sit for such an exam. Just as one might enter a marathon after having already reviewed the route, you can prepare yourself for test day by understanding how the exam is structured. Here you can find some information on the layout of Step 2 CK, pass rates, and score interpretation. 

How Long is USMLE Step 2? 

USMLE Step 2 CK takes a total of 9 hours to complete. It includes eight 60-minute question blocks and one hour of break time. Test takers have control over how they use the break time, allowing flexibility to divide it between sections as needed or take longer breaks when necessary.

How many questions are on USMLE Step 2? 

The number of questions per block can vary, however it will not exceed 40 questions. The total number of questions on the exam will not exceed 318. You can generally anticipate between 38-40 questions per block, which equates to about 90 seconds per question. 

If you complete a block before the hour is complete, you can either proceed to the next block or use that remaining time to review or change your answers for questions within that block. You cannot return to previous blocks of questions. 

Once your time for a block is up, you’ll have a brief transition period to choose between taking an authorized break or starting the next block. If you take a break, the time will count down from your one-hour break allowance until you return. Be mindful: if you exceed the allotted break time, any additional breaks will reduce your remaining exam time.

Can I request accommodations on test day?

You can apply for testing accommodations, which may affect your block or break times. More information can be found in our step-by-step USMLE test accommodations guide.

How many questions do you need to get right to pass Step 2? 

As of July 2022, the USMLE Management Committee increased the passing threshold for Step 2 from 209 to 214. This means you need to answer about 60% of USMLE Step 2 questions correctly to pass.

What is the pass rate for Step 2? 

According to 2022-2023 data from the USMLE which considered the scores of 28,212 examinees from US/Canadian medical schools (528 of whom were repeating the exam), 97% of individuals passed. Among the 15,806 examinees from non-US/non-Canadian medical schools (1,411 of whom were repeating the exam), 86% passed. 

Interpreting Step 2 Scores

For the 2023-2024 academic year, the average score for USMLE Step 2 among first-time test takers from LCME-accredited US/Canadian medical schools was a 249 (standard deviation: 15) according to USMLE score data. Many students cite 240 as a desired score, which would place them at the 26th percentile of first-time test takers. 

As tutors, we’re often asked questions like “How hard is it to score a 240?” In many ways, this is like asking how hard it is to run a marathon. A first-time runner needs more preparation than a seasoned athlete. The difficulty depends on your goal. A race might be much easier for the runners who opt to take their time finishing compared to those who want to qualify for the Olympics.

Your target score may depend on the specialty you’re applying to and how competitive you want your application to be. And like any marathon runner who needs to be diligent about maintaining a solid training plan, so too can test-takers greatly benefit from a structured and effective study schedule. Elite Medical Prep offers a team of tutors who can help with both schedule building and effective resource utilization. There is no one-size-fits-all formula for success, nor is there a prescriptive definition of a “good” score; schedule your complimentary consultation with Elite Medical Prep to learn more about how our team can help individualize the test preparation experience to best suit you and your goals.