Step 2 Clinical Knowledge (CK)

Step 2 Clinical Knowledge (CK)

USMLE Step 2 is massive nine hour long one day multiple choice question examination. It analyses medical graduate’s ability to apply Clinical Knowledge. The Step 2 examination assesses the ability of Medical graduate to apply clinical science knowledge to patient care in supervised settings emphasising health promotion and diseases prevention. According to the past student’s experience, best time to take up the exam is when your clinical science knowledge from rotations is still fresh. There are many students who opt for the USMLE Step 2 in fourth year also.

Step 2 Clinical Knowledge is a Multiple Choice, computer-based examination administered in nine hours, divided in blocks of 60 minutes. the required information is available on for updated reference. 

What’s on USMLE Step 2 CK Exams

The test items on Step 2 CK examination focus on the principals of Clinical Science that are deemed important for the practice of medicine under supervision in post graduate training. Step 2 Examination covers content related to the traditionally defined disciplines listed below

  • Medicine
  • Surgery
  • Paediatric
  • Obstetrics & Gynecology
  • Psychiatry

The test features an integrated content outline organised in two dimensions:

  1. Physician task (Table 1)
  2. Disease categories. (Table 2)

Let’s breakdown the dimension %wise for better understanding.

Table 1. Physician Tasks

Table 2. Breakdown of the Disease Categories % wise

Note: Not all the topics listed above are included in USMLE Examination. Overall content coverage is comparable in the various examination administered to different examinees for each step.

How to Navigate the Preparation.

IMGs can score decently with 5-6 month of preparation. Further, knowing what system is having what weightage makes it easier for the examinees to decide when they need to start and where to put more efforts while preparing for Step 2 CK. Most Test Items in Step 2 examination describes clinical situations, and examinee needs to provide either

  • Diagnosis
  • Prognosis
  • Indication of underlying disease
  • Succeeding Medical care and Preventive measures

Basic question which haunts most students is how to start preparations, having rotations going, it makes life horrible to take out time for preparations. But knowing super seniors and immediate seniors can relieve stress. Communication with past students is important, more important is not to repeat the mistakes they made while preparation or on the day of the exam.

Practice tests and self-assessment are like mirror for the students doing clerkship/rotations. It assesses the knowledge gained from the rotations and their proper application in the given Medical situation. R&T IMG Village provide required Question banks, Study Materials, Practice videos, Test Videos, video Lectures, etc. for the concrete preparation of USMLE Step 2 for sparkling scores.

Combining revision of old and preparing new disease/system/competency is good strategy to overcome extraneous information overload. Make such a study plan so that while preparing new, you are not forgetting what you have studied last week. One of such plans could be Practice Exams combined with flashcards revision and preparation of new disease/system all settled in daily routine. All the things combine makes preparation effective from the scoring point of view. From the experience of past students, it can be said that if you have gone through all the categories you can pass step 2. But if you want to score more and do not want to take any chances for the resume then one must go for Practice tests and Shelf exams by NBME (National Board of Medical Examiners). Whatever the result of these exams is but they surely increase the level of excellency.

Spare last week for the revision of all the blocks. Make simple and effective flash cards while preparations for faster go through. Do not panic seeing a new question/topic in practice exams because no one can read everything. Give your self-time to analyse the question, sometime gut feelings overpower knowledge which is natural.  Do not worry if you are not able to review all the markings you have done. let your Hard work pay off in your scores.

USMLE – How should one approach?

USMLE – How should one approach?

Medical itself means you must tear off your comfort zone and make hard work your habit. Reaching the stage when USMLE comes in frame, shows your passion and dedication towards the future. Thousands of IMGs enter USA and Canada for the residency or with a dream of practicing Medical in the country. No doubt about the competition in the Medical field for the match making process for the residency. Local students gain advantage on study environment and education systems where IMGs lack a bit. That’s where USMLE makes fair ground for both local students and international students. USMLE basically tests whether student possess the required knowledge prevalent in the USA or not.

Also, hard work is key to pass USMLE, but smartly done hard work is all about great score for the tests. The preparations start with selecting right set of materials for the exams. We all are here to discuss Study Materials.

Basically, one should go with the material they understand, or one which resembles best. But passing with low score in stage 1 is cruel then failing it. Because once you pass, you cannot retake exams to improve your score. And success of residency match making heavily depends on your stage 1 scores. That’s where we need to understand what sets of material one shall go for increased scores.

Great sets of materials and practice question are provided on USMLE website to brief students about the Exam, Topics covered in it and how the exam operates as whole 3 step unit. In our view one shall not overlook the materials and samples test questions provided on the USMLE website for the improved understanding of the examination. We are not suggesting that material on the website is exhaustive, but It is great to have gone through the same.

There are many programs available in form of books, video lectures, practice questions, Question Banks, practice exams, i.e. First Aid, Kaplans medicals, pass program, becker professionals, broad vitals, etc.

Having heterogeneous courses for USMLE, most common mistakes made by student is selecting material which is good for their colleagues, and not analysing their potential worth on their studies collectively. One must not blindly go for the material just because it has great reviews. No doubt that such materials are made in a way that helps students score more but every single student has different specialities and Capabilities. Some can adapt well new things; some find it difficult to overcome old methods and applying new materials.

Select the study program considering your strengths and weakness and available time one has for the preparations.

Question Banks Given the exhaustive nature of the examination one may overlook some topics which amounts to lower marks or worse, failure in exams. To overcome, students must include Question bank in their study plan. Also, it is great way of revising what you know and realizing where you need to put in more efforts.

Flashcards, another great way of revising the whole nut. Flash cards saves time and make the revision faster and improve retention.

There is a misconception that one cannot go memorising the content without understanding the whole concept. We bag to differ here; we firmly believe that understanding concepts is basic and foremost requirement. Concepts are most important, without practical knowledge students will feel destroyed in Residency or clerkship. But that comes after you clear exam. So, to get there one has to score impressively. Given amount of time student have, they need to categorise the topics according to their % share in the blocks. More time given to topics having lesser % share will unnecessarily waste time off in your scores.

Aisle to the USA Medical Practice for the IMGs

Aisle to the USA Medical Practice for the IMGs

Norms have getting tougher with passing time. New government in USA has already shown that not all who apply for medical residency will get visa.

Let’s get things in chronology.

Complete Medical graduation in a Medical School of your home country which appears in the World Dictionary of Medical School. Each county and city wise medical schools accredited are listed at. Also apply for the MCAT or GRE.

Then comes United States Medical Licensing Examination. step 1 is critically important for the National Residents Matching Program.  Passing score in the step 1 is 194, getting the same with step 1 will put you out of the league of matching program because average score of USA medical graduates comes around 229.

Apply for Certification of Education Commission for Foreign Medical Graduates (ECFMG). ECFMG tests IMGs Medical knowledge and ability to speak/understand English. Affirmation from ECFMG makes you eligible for the step 2 tests Namely Step 2 CK & Step 2 CS. Scores of Step 2 CK are also considered for residency program where passing scores are 209.

After appearing for the USMLE and comes step 2 CS (Clinical Skills). These tests are conducted only in USA. Travel to USA and appear for the step 2 CS.

After completing Step 1 and Step 2, IMGs has to apply  for the paid Residency program. Here if you have great scores and Professors recommendation latter one can match with the speciality or critical care. But as IMGs doesn’t have recommendation latter, they rely on their USMLE scores. And to be honest not all IMGs get residency in their preferred program. The residency positions are assigned by National Residency matching program. Many IMGs go unmatched. IMGs only gets matched to the program where they have applied. Also interviews are being conducted for the same. one hard fact for the IMGs is that if they have had not any experience in the Clinical experience, they are highly unlikely to get accepted for the residency program. Here they must go first for the Externship which is not paid, in some you have to pay them.

Now comes Visa part. If you have matched to any program, then visa will be granted to you. Usually J1 and H-1B are common work visas for residents. Here comes IMGs supervised Residency or clerkship in USA in the state they want to practice medical. Time of residency differs state to state for IMGs, usually it is 3 years. (it is 1 year for USA medical graduates).

In the last six month of the Residency program one may apply for USMLE step 3.  Minimum score for the final step is 198.

Once IMGs are done with the whole process, there comes licencing stage. It varies from state to state. Generally, one gets licence of the state in which he/she has been trained. Further, one has to undergo fellowship of 2 years for the additional speciality.

There is also another route for the residency is to apply for the Master’s Degree and get F1 visa stamping. Many foreign doctors get full time job for their master’s degree. And if he/she is comfortable for their future then they can make living with the same.

5 Ways for IMGs to Interview Successfully for Residency

5 Ways for IMGs to Interview Successfully for Residency

Residency application season is here! It is a time of great excitement, but also the source of a considerable amount of anxiety among applicants. Particularly, for International Medical Graduates (IMGs), preparing for residency interviews presents additional logistical and cultural challenges- with having not had primary medical education in the US. So while it is key to make a memorable impression, you also have to sell your ability to thrive in a system that is new to you. Your interview is your opportunity to show the programs that you are even more impressive in person than you are on your application. After all, your application is what got you the interview, so there must have been things they liked about you from your personal statement and curriculum vitae! You are interviewing to illustrate how you are a hard-worker, resilient, dependable and a great future resident to work with, train and deliver great care to their patient population. Here are foundational methods for IMGs to interview well for residency positions.


You must dress appropriately for the interview. In choosing your interview attire, please be conservative. Below are gender-specific recommendations, but overall understand that this is not the time for experimenting with a new look. You want to be memorable, just not for the wrong reasons! For Women: Choose suits that are black or blue ideally, with a solid colored professional blouse underneath. Whether you choose to wear a skirt suit or pants suit is at your discretion. It is unlikely that you will be judged negatively for wearing pants. You can also choose to wear a dress suit that is accompanied with a suit jacket.  You can wear heels or flats, however, you should keep your heels no taller than 2- 3 inches, with 2 inches or less being the best measure. Please do not choose this time to wear heels if you normally don’t. If you normally wear makeup, then wear makeup, however, make sure that it is more of a natural look- no dramatic, stage-worthy looks. If you do not normally wear makeup, now is not the time to start. Unless you plan to have your makeup applied professionally by a makeup artist with the clear specification that this is for a professional job interview. This is probably not a feasible option, considering that your interview day typically starts at 8am. For Men: Choose suits that are black or dark blue, with a collared dress shirt underneath and a conservative tie. Your shoes should be business dress shoes that compliment your suit.


This is incredibly important! I know that some candidates choose to use “consultants” and/or “personal statement writing services” to write their personal statements. If you are not a strong writer, I understand the motivation to make that choice. If that is an approach you choose to employ, know that it is extremely important for you to know every inch of your personal statement like the back of your hand! If it is in there, it is fair game for us to ask you about. So please do not put anything in your personal statement that you cannot address fully and accurately! You should be able to explain any conditions that you mention (the patient I had once with Schinzel-Giedion syndrome), because if you thought it was significant enough to include in your personal statement, then you should have thought it was significant enough to learn the disease process well enough to have a basic discussion about it. If you have any research listed, please be prepared to discuss the research at-length! One candidate was being interviewed by THE research guru in our department and failed miserably at explaining his own work.


Don’t try to be friends with the interviewer. You should be pleasant, easy to talk to, and personable, but we don’t need to be friends. This is a professional job interview at all times. Yes- we may discuss great recipes if you mention a culinary hobby, yes-we may discuss the recent trades and lineup drama if you are a sports fan, but either way, no, I do not want to see pictures of your dogs, or kids, or hang out after the interview. It’s inappropriate. Oftentimes, programs will have a candidate/resident meet and greet the night before your interview day. Even if the event is at a bar and/or there is alcohol available, please remember that these are not your colleagues…yet! Drink in moderation, do NOT ask anyone on a date, or make any sexually charged, flirtatious innuendos. Often, the chief resident or more senior resident will make their contact information available. If another resident offers you their contact information, feel free to take it, but please do not interpret this as a doorway to a date. All of these incidents are brought up when discussing candidates during the recruitment/ranking meetings and you do not want any unfavorable statements associated with your name.


Don’t be weird. While this is an important time to highlight some of your unique qualities because you want to be remembered, please make sure that it is positive, pleasant, good-work-ethic memories that you are trying to leave behind. This is a great time to highlight your hobbies of photography, love for a particular sport, or your culinary genius. You want to appear as a well-rounded person and trust me, all of the “I volunteer in an orphanage for fun” comes off as disingenuous- we are all doctors and we love medicine, but we do other things to unwind- don’t act as if you don’t!


Some programs offer an informal meet-and-greet with the current residents the evening prior to the interview day. Definitely plan to attend if you can! This is a valuable opportunity to truly see how well the residents interact with each other and get honest answers about the culture of the program. These may be the people you will be working with in a few months, so you get an idea if there is any “professional chemistry” that is present. Residency is a grueling process and you will spend more high-intensity, emotionally charged experiences with these people than your own family during the duration of your residency, so it is important to be able to connect with at least a few of your fellow residents. You can use this opportunity to find out what their daily routine is like, what are the strengths of the program, as well as its weaknesses. Also, observe your fellow interview candidates, it is possible that you may end up in the same program as 1 or 2 of them that you’ve met on the interview trail. However, still remember that this is a professional event and part of your interview! There may be alcohol available depending on the venue.

It is probably best not to drink alcohol, however if you choose to please DO NOT GET INTOXICATED! Do not make any inappropriate comments or statements! DO NOT make any sexual advances, comments or flirtations with any of the residents (or fellow candidates)! These things are ALWAYS reported back to the committee. One candidate asked a resident for her telephone number at one of these events and one of the residents relayed it back to the program director and the recruitment committee and he was not considered for the rank list.


Remember, your interview is your opportunity for us to get to know you, as well as for you to get to know our program. We are all interviewing to see if the candidate is a good fit for our program. You need to also assess if the program is a good fit for you!