United States Medical Licensing Examination Step 2 Clinical Knowledge
Administered by National Board of Medical Examiners (NBME) and FSMB
Tests your clinical knowledge and ability to provide patient care under supervision. Step 2 CK is now the most important USMLE score for residency applications, as Step 1 has moved to pass/fail.
Quick Facts
Format
Up to 318 multiple-choice questions across 8 blocks of 40 questions each
Duration
1 day (9 hours of testing time with breaks)
Passing Score
Minimum passing score of 209 (three-digit score reported)
Valid For
No expiry, but all Steps should ideally be completed within 7 years
Cost
USD 645
Cost in Naira
Approximately N1,000,000
Test Centres in Nigeria
- Prometric Test Centre Lagos (Victoria Island)
What is Tested
Internal Medicine
Diagnosis and management of adult medical conditions including cardiology, pulmonology, endocrinology, and more.
Surgery
Pre-operative evaluation, surgical indications, post-operative care, and emergency surgical conditions.
Obstetrics and Gynaecology
Antenatal care, labour management, gynaecological conditions, and reproductive health.
Paediatrics
Child development, paediatric diseases, neonatal conditions, and immunisation schedules.
Psychiatry
Psychiatric disorders, pharmacotherapy, psychotherapy indications, and emergency psychiatry.
Preventive Medicine and Ethics
Screening guidelines, epidemiology, bioethics, patient safety, and quality improvement.
How to Register
- 1
Ensure your ECFMG certification is active.
- 2
Apply for Step 2 CK through your ECFMG account.
- 3
Pay the USD 645 exam fee.
- 4
Receive your scheduling permit (3-month eligibility window).
- 5
Schedule at Prometric Lagos through prometric.com.
- 6
Sit the exam. Results typically arrive within 3 to 4 weeks.
Tips for Nigerian Candidates
Step 2 CK is now more important than Step 1 for matching into US residency. Prioritise a high score.
Book the Prometric Lagos centre well in advance, especially during peak testing seasons (June to September).
Consider completing clinical observerships or electives in the US before writing Step 2 CK.
Nigerian doctors who score 240+ on Step 2 CK significantly improve their residency match chances.
The exam is long (9 hours). Practise stamina by doing full-length timed practice tests.
Join USMLE study groups on Telegram for shared resources and accountability.
Factor in the cost of ECFMG pathway requirements (such as clinical experience verification) alongside the exam fee.
Preparation Tips
Step 2 CK is now the key differentiator for residency. Aim for the highest score possible.
Complete UWorld Step 2 CK question bank thoroughly. Review every explanation.
Use AMBOSS as a supplementary question bank and reference.
Study UpToDate for evidence-based management guidelines.
Focus heavily on internal medicine, as it makes up the largest portion of the exam.
Practise clinical vignette-style questions under timed conditions.
Plan for 2 to 4 months of dedicated study after completing clinical rotations.
Recommended Resources
Cost Breakdown
Exam Fee
USD 645
In Naira
Approximately N1,000,000
Who Needs This Exam
Medical graduates who have passed Step 1 and are pursuing US residency
Related Exams
Check your readiness score
Find out how prepared you are for this exam and get personalised recommendations for your career path.
Take the assessmentJoin CadreHealth
Connect with other healthcare professionals preparing for exams. Access salary data, hospital reviews, and career guidance.
Join freeVerify before you act
Exam fees, visa costs, and requirements change frequently. The information on this page was last reviewed in April 2026. Always confirm fees and requirements directly with the official body before making payments or decisions.
Exchange rates are approximate and fluctuate daily.