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Adaptive prep mapped to the NBME content outline — 18 categories across general principles and organ systems, grounded in ACC/AHA, IDSA and US guideline sources.
16 blocks × 30 minutes · maximum 20 questions per block · one 9-hour Prometric testing session.
Up to 318 items, with at least 55 minutes of break time and a 5-minute optional tutorial from 7 May 2026.
Available year-round at Prometric centres. The new 16-block Step 2 CK software starts on 7 May 2026; the 2026 USMLE exam fee is $695, with a $235 region fee outside the US/Canada.
NBME-published category weightings. Physician task and system splits combine to form the integrated content outline.
Source: official NBME + FSMB blueprint
System weightings from the NBME score report blueprint.
Renal/urinary and reproductive systems (7–13% combined) — AKI, CKD, GU oncology, pregnancy complications, contraception
Cardiovascular system (6–12%) — ACS, heart failure, arrhythmia, valve disease, hypertension management
Gastrointestinal (6–12%) — IBD, GI bleeding, hepatology, pancreatitis, oncology
Respiratory (6–12%) — asthma, COPD, pneumonia, PE, lung cancer screening
Behavioral health (6–10%) — depression and anxiety pharmacotherapy, substance use, suicide risk
Multisystem (6–12%) — sepsis, anaphylaxis, electrolyte emergencies, oncologic emergencies
Themes from US and IMG candidate feedback in 2025–26.
Candidate-reported observations — not official guidance.
Designed for full-time dedicated study after clerkships.
A live item from the iatroX bank. Try it before launching a full session.
A 51-year-old Hispanic woman comes to the urgent care clinic because of changes in mood, behavior, or thinking. History and focused examination are notable for recurrent unexpected panic attacks with persistent worry about additional attacks. Temperature is 98.6°F (37.0°C), blood pressure is 126/78 mmHg, pulse is 84/min, respirations are 16/min, and oxygen saturation is 98% on room air. Physical examination confirms the key finding and shows no unrelated abnormality that would better explain the presentation. There is no evidence of intoxication, delirium, or a primary neurologic disorder unless described in the vignette. Which of the following is the most appropriate next step in management?
Why iatroX is built differently for USMLE Step 2 CK.
Every iatroX item is tagged to a blueprint topic, so your performance dashboard mirrors the structure of the exam itself.
The engine surfaces your weakest topics first, in real time, instead of marching you through a static syllabus.
Incorrect items return at increasing intervals to interrupt the forgetting curve and lock knowledge into long-term memory.
Timed full-length simulations that mirror the official exam structure under realistic conditions.
One iatroX subscription includes the USMLE Step 2 CK bank plus every other premium iatroX exam bank.
Cancel anytime · 30-day money-back guarantee on annual
Since 1 July 2025 the passing standard is 218 on the three-digit scale (raised from 214). The mean score for US/Canadian first-time takers is approximately 250, so 218 sits well below the mean for adequately prepared candidates.
From 7 May 2026 Step 2 CK is delivered as 16 × 30-minute blocks of up to 20 questions each, over a 9-hour testing session. The total number of questions is similar to before; the block structure changed for shorter sustained focus periods.
USMLE performance data for 2023-24 lists Step 2 CK first-taker pass rates of 98% for US/Canadian MD candidates, 96% for DO candidates and 89% for non-US/Canadian candidates. Retaker pass rates are lower, so treat these as cohort-level data, not a personal prediction.
For most US/Canadian graduates a score above the national mean of 250 is good. Above 260 (75th percentile) is competitive for most specialties. IMGs typically need 240s+ to be competitive for residency applications.
Yes. A single iatroX subscription ($29/month or $99/year for non-UK users) includes the Step 2 CK bank alongside every other premium iatroX exam bank.
Other iatroX hubs you may find useful.
see how iatroX compares to UWorld, AMBOSS, Archer Review.
Reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP · Last reviewed 12 May 2026
See our methodology and editorial policy.