# Step 2 CK questions from your own material

> Step 2 CK style management questions written from your own rotation notes and assigned chapters, each one carrying the quote and the page it came from.

Markdown copy of https://meduniexam.com/exam/usmle-step-2-ck (the HTML page), published by MedUni Exam. Published September 12, 2026, updated September 22, 2026. Site guide for agents: https://meduniexam.com/llms.txt.

Step 2 CK asks what to do next. Generated from your own rotation notes, the questions keep that shape and print the sentence that settles them.

[Take the ten question sample exam](https://meduniexam.com/#/sample)

No upload and no account, about a minute. Or [upload a chapter](https://meduniexam.com/#/) and get USMLE Step 2 CK style questions from it.

Free: 300 verified questions a month. The Exam Pass is $19.99 once for 90 days on the priority models; [get it here](https://meduniexam.com/#/pricing?buy=exam_pass). 14 day refund, in full before you generate.

## USMLE Step 2 CK passing score, pass rates and percentiles

Step 2 CK passing score: 218 for exams taken on or after July 1, 2025, up from 214. Step 2 CK pass rate 2024 to 2025: 98 percent of examinees from US MD schools, 96 percent from US DO schools, 90 percent of first takers from non-US schools. A Step 2 CK score of 240 is the 23rd percentile among first takers from US MD schools.

| Step 2 CK fact | Number | Applies to |
| --- | --- | --- |
| Questions and time | Approximately 316 questions in sixteen 30 minute blocks, one 9 hour session | Exams from May 7, 2026 |
| Passing score | 218, up from 214 | Exams from July 1, 2025 |
| Percent correct to pass | Approximately 60 percent, varying by form | Every Step exam |
| Pass rate, US MD schools | 98 percent; repeaters 70 percent | Academic year 2024 to 2025 |
| Pass rate, US DO schools | 96 percent; repeaters 69 percent | Academic year 2024 to 2025 |
| Pass rate, non-US schools | 90 percent of first takers; repeaters 64 percent | Academic year 2024 to 2025 |
| Percentile of a 240 | 23rd percentile, first takers from US MD schools | Tests from July 1, 2023 to June 30, 2026 |
| Region fee | USD 235 outside the US and Canada | Current fee schedule |
| Results | Released on Wednesdays, usually within four weeks | Every exam |
| Attempts | Four per Step; no more than three in 12 months | Current rule |

Source: [USMLE examination results and scoring](https://www.usmle.org/scores-transcripts/examination-results-and-scoring), [USMLE performance data](https://www.usmle.org/performance-data), [USMLE score interpretation guidelines](https://www.usmle.org/sites/default/files/2022-05/USMLE%20Step%20Examination%20Score%20Interpretation%20Guidelines_5_24_22_0.pdf), [USMLE attempt limit](https://www.usmle.org/common-questions/attempt-limit), checked on September 21, 2026.

## The exam is about the next step, so the questions are too

Step 2 CK weights its competencies plainly: diagnosis is 16 to 20 percent of items, interpreting laboratory and diagnostic studies is 13 to 17 percent, and mixed management is 12 to 16 percent. Medical knowledge on its own is weighted at zero, because Step 1 tested it. So a set of recall questions from a rotation handbook is the wrong practice, however well written it is.

The recipe below asks for stems that stop at a decision point: the next investigation, the next treatment, the next thing to rule out. Your own notes carry the content for that. What they rarely carry is the systems based practice, patient safety and professionalism block, which runs 10 to 15 percent of the exam between them.

## One question, as it arrives

A 34-year-old woman with a history of asthma presents to the ED with acute shortness of breath. After treatment, her FEV1 is 65% of predicted. She is symptomatic but stable. What is the next best step in management?

1. **A.** Initiate intravenous corticosteroids
2. **B.** Observe the patient for 30-60 minutes after the most recent dose of bronchodilator
3. **C.** Discharge the patient immediately
4. **D.** Assess the patient individually for suitability for discharge home correct answer
5. **E.** Admit the patient for hospitalization

PAGE 423"Patients who have an incomplete response to therapy (FEV1 or PEF 50-69 percent of predicted or personal best) and with mild symptoms should be assessed individually for their suitability for discharge home, with consideration given to factors listed in figure 5-2a (Evidence C)."

double-checked

Written on September 15, 2026 on the free lane, job 241, question 13570, from [Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma (2007)](https://www.nhlbi.nih.gov/health-topics/guidelines-for-diagnosis-management-of-asthma) (National Heart, Lung, and Blood Institute, US National Institutes of Health), page 423, published under the [Public domain (a work of the United States government)](https://www.usa.gov/government-copyright). The quote is the line the check found on that page, and a second model from a different family picked the same answer from the quote alone. Nothing here was edited by hand.

**54 percent of the questions drafted since counting began on September 14, 2026 failed a check and never reached a student.** Counted from this site's own database, as of September 24, 2026, refreshed twice an hour. A question fails when its quote is not on the page it cites, when a second model picks a different answer, when it breaks a writing rule or when it repeats one already written. [Each check, with its own rate](https://meduniexam.com/stats/rejections.md).

**Exam Pass, $19.99 once.** 90 days of the priority models for your USMLE Step 2 CK block, with the downloads and an unlimited tutor. Nothing renews. [Get the Exam Pass](https://meduniexam.com/#/pricing?buy=exam_pass) Start on the free plan first if you like: 300 verified questions a month with an account, 60 as a guest.

## A practice recipe for USMLE Step 2 CK

Ask for 20 questions from one rotation topic and set a 30 minute timer, because Step 2 CK now runs in 30 minute blocks of no more than 20 questions.

Paste this into the extra instructions box on the generate form, or let the button carry it there:

Write single best answer clinical vignettes with five options. Every stem must end at a decision: the next investigation to order, the next treatment to start, or the result that changes management. Include the vital signs and laboratory values the decision turns on. Do not ask which statement is true, and do not ask for a definition.

[Use this recipe in the generate form](https://meduniexam.com/#/?recipe=usmle-step-2-ck)

The extra instructions box overrides the general guidance the model is given, so the wording above is followed on every question in the set.

## What this cannot do

- This is not the NBME item pool. It writes items in the Step 2 CK style from the file you upload.
- Systems based practice, patient safety and professionalism carry 10 to 15 percent of the real exam and almost never appear in a student's clinical notes, so they will not appear in your questions either.
- Nutrition is coded across 15 to 20 percent of items as a cross cutting discipline. Unless your material covers it, that coding is not reproduced.
- Sixteen blocks across a 9 hour day is an endurance test. Generated blocks match the clock of one block, not the stamina of a full exam day.

## Format facts, and where each one comes from

- Taken on or after May 7, 2026, Step 2 CK is sixteen 30 minute blocks with no more than 20 questions per block.Source: [https://www.usmle.org/step-exams/step-2-ck](https://www.usmle.org/step-exams/step-2-ck)
- The USMLE 2027 Bulletin of Information gives Step 2 CK as approximately 316 multiple choice questions in sixteen 30 minute blocks, a one day exam of approximately 9 hours. The older total of 318 belongs to the eight block format used before May 7, 2026.Source: [https://www.usmle.org/sites/default/files/2026-08/2027Bulletin.pdf](https://www.usmle.org/sites/default/files/2026-08/2027Bulletin.pdf)
- Diagnosis is 16 to 20 percent of items, laboratory and diagnostic studies 13 to 17 percent, and mixed management 12 to 16 percent. Medical knowledge and history and physical exam are weighted at 0 percent.Source: [https://www.usmle.org/exam-resources/step-2-ck-materials/step-2-ck-content-outline-specifications](https://www.usmle.org/exam-resources/step-2-ck-materials/step-2-ck-content-outline-specifications)
- By clinical science, medicine is 55 to 65 percent of items, pediatrics 17 to 27 percent, obstetrics and gynecology 10 to 20 percent, psychiatry 10 to 15 percent and surgery 5 to 15 percent. Items are multi coded, so the totals exceed 100.Source: [https://www.usmle.org/exam-resources/step-2-ck-materials/step-2-ck-content-outline-specifications](https://www.usmle.org/exam-resources/step-2-ck-materials/step-2-ck-content-outline-specifications)
- Nutrition is a cross cutting discipline at 15 to 20 percent: a nutrition coded item is also coded to one of the organ systems.Source: [https://www.usmle.org/exam-resources/step-2-ck-materials/step-2-ck-content-outline-specifications](https://www.usmle.org/exam-resources/step-2-ck-materials/step-2-ck-content-outline-specifications)

Format checked on September 12, 2026. These pages are reviewed once a quarter by the person who runs MedUni Exam, and the review is what moves the date above. If a number here is out of date, write to [support@meduniexam.com](mailto:support@meduniexam.com) and it gets fixed.

## What it costs in USMLE Step 2 CK units

With a free account the allowance is 300 verified questions a month, which in this exam's units is 15 runs of a 30 minute block of 20 questions, or about 95 percent of a full Step 2 CK exam of approximately 316 questions, every month, at no cost. A guest workspace with no account gets 60 questions a month, which is 3 such runs.

The Exam Pass, $19.99 once, is one payment that puts the priority models on your jobs for 90 days and then stops on its own.

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Paid through Stripe, which shows the total before you pay. One payment, nothing renews, and the [refund policy](https://meduniexam.com/refund-policy.md) gives you 14 days, in full before you generate. A 500 question pack at $5.99 and the Pro subscription are on the [pricing page](https://meduniexam.com/pricing.md).

Works in any language, and quality varies by language: the questions come out in the language of your document, or in the one you pick from a list of every living language. [What works in your language, and what does not](https://meduniexam.com/for/any-language.md).

## Questions students ask

### Will it write management questions or recall questions?

Whatever you ask for. The recipe on this page asks for stems that end at a decision, which is the shape Step 2 CK uses. Without that instruction the generator writes a mix.

### What material works best?

A rotation handbook chapter, the department protocol you were given, or your own notes from the ward. Prose with reasoning in it produces better vignettes than a bullet list of diagnoses.

### Is this enough on its own?

No. It drills your own material in the exam's format. The blueprint areas your notes do not cover stay uncovered, and this page says which ones those usually are.

### Does it grade written answers?

Yes. Ask for short answer questions and a grading model scores your wording against the source and the key points, in the language the question is written in.

[Upload a chapter](https://meduniexam.com/#/)

[How the checks work](https://meduniexam.com/how-it-works.md)

No account needed to try it. Registering keeps your library, grades and review queue across devices.

[All ten exams](https://meduniexam.com/exam.md) · [USMLE Step 1](https://meduniexam.com/exam/usmle-step-1.md) · [Real generated questions](https://meduniexam.com/sample.md)

## Related pages

- [Step 2 CK Percentiles Table and 218 Pass Score](https://meduniexam.com/blog/step-2-ck-percentiles-and-passing-score.md): Every Step 2 CK percentile from a score of 205 up to 280 in one table, with the national mean by academic year, the passing score of 218 and the pass rate for each examinee group, all checked on September 21, 2026.
- [USMLE Step 1 questions from your own file](https://meduniexam.com/exam/usmle-step-1.md): Step 1 style single best answer questions generated from a student's own pathology and physiology material, with the format facts and the limits stated.
- [COMLEX Level 1 practice from your notes](https://meduniexam.com/exam/comlex-level-1.md): COMLEX-USA Level 1 practice generated from a DO student's own material, including OMM, with the post May 2026 item count.
- [For medical students](https://meduniexam.com/for/medical-students.md): Why questions generated from your own syllabus beat a generic question bank.
- [PowerPoint slides into exam questions](https://meduniexam.com/for/lecture-slides.md): Uploading PowerPoint decks: what is read, what is not, and why the questions cite slide numbers.