The USMLE Exam Guide for Step 1, Step 2 CK and Step 3
The USMLE is the three-exam sequence you have to clear to practise medicine in the United States. Step 1 comes first, Step 2 CK follows, and Step 3 usually lands during residency. Below is what each one asks of you, and where students most often get stuck!
We tutor Step 1 and Step 2 CK one to one, with medical students who sat these exams recently. If your practice scores have flattened and you want somebody to look at the work with you, that is what we are here for!
USMLE Step 1
Step 1 covers the basic sciences and the mechanisms behind disease. Since January 2022 it has reported pass or fail and nothing else, so there is no score to improve toward and no credit for a near miss. A whole year of work resolves into one word, which is its own kind of pressure.
Here is where first-time takers landed in 2025, from the official USMLE performance data at usmle.org.
- 93% of students at US and Canadian MD schools passed
- 89% of students at US DO schools passed
- 75% of international medical graduates passed
That last row is why international graduates make up so much of who we are asked to help, because one in four does not clear it on the first attempt. If that is you, you are in good company and it is a fixable problem!
Most people who come to us for Step 1 are not short on content. They have finished a first pass and their NBME scores have stopped climbing, and nothing in their study plan explains why. Step 1 tutoring starts by finding the reason.
USMLE Step 2 CK
Our full USMLE Step 2 CK guide covers the 2026 format, the 218 passing score and the content weightings.
Step 2 CK tests clinical knowledge, and unlike Step 1 it still reports a three-digit score. Since Step 1 went pass or fail, Step 2 CK carries the numerical weight in residency applications, which has changed how seriously people take it and when they sit it.
We tutor Step 2 CK at the same price as Step 1, and hours bought for one carry across to the other, so nothing you buy goes to waste!
USMLE Step 3
Our full USMLE Step 3 guide covers both days, the CCS cases and what passing takes.
Step 3 is the last of the three and is usually taken during residency rather than medical school. It is scored, and it runs across two days.
We do not tutor Step 3 yet. If you have hours left over from Step 1 or Step 2 CK you can put them toward med-school application coaching instead.
Everything we have written on the USMLE
Ten pages, all checked against usmle.org this month, because a great deal of what is published about these exams describes a format that changed in 2026!
The exams themselves
- What is the USMLE, the three Steps, formats, costs and attempt limits
- USMLE Step 2 CK, the 2026 format, the 218 line and the weightings
- USMLE Step 3, both days, the CCS cases and the 200 line
- USMLE pass rates, all three Steps by examinee group, with the four-year trend
- USMLE cost, every published fee including surcharges and rescheduling
- USMLE vs COMLEX, which one you sit and whether you sit both
- USMLE scoring, what each Step reports and what passing takes
- USMLE score invalidation, what triggers it and what stays on your record
- USMLE eligibility, who can sit each Step and the four-attempt rule
- How hard is the USMLE, measured against the published pass rates
Step 1 in detail
- The complete Step 1 guide, what it tests and what passing takes
- How long is Step 1, the eight-hour day block by block
- Step 1 dates, eligibility periods, booking and the 2029 testing-dates change
- Step 1 pass/fail, what changed in 2022 and where the weight went
- Step 1 content outline, every published weighting and how to use it
Preparing for Step 1
- Step 1 study schedule, 3 weeks to 6 months, phase by phase
- Step 1 practice questions, where to get them and how to review them
- 8 best Step 1 tutors, and the three times tutoring is the wrong call
- Best Step 1 prep course, seven compared and what each one fixes
How the USMLE compares to other exams
If you are still premed, or deciding between routes, start with these two comparisons.
Getting help with the USMLE
Our mentors are medical students who cleared these exams recently rather than attending physicians who sat them a decade ago. They remember which questions felt unfair and what they cut when time ran short, and that turns out to matter more than seniority for this particular job.
Packages run from five hours to forty, one to one, 60 minutes a session, at one price for Step 1 and Step 2 CK. You are matched with your mentor inside 24 hours and there is no consultation call to sit through first.
Not sure whether tutoring is even the right call? Tell us where you are and we will tell you straight, including when the answer is no! You can send us a question any time 🙂