How I passed the USMLE Step 2 CK while working full-time as a UK Foundation Doctor
- Jessica
- Oct 12
- 6 min read
Preparing for the USMLE exams is never easy. Doing it while working full-time adds a whole new level of complexity, but it is possible—with the right approach, consistency, and flexibility. Here’s how I balanced clinical duties and Step 2 CK prep.
Why I chose to take Step 2 CK during foundation years
After finishing my medical degree and having passed Step 1, I knew that sitting Step 2 CK was the next necessary step. I preferred to get Step 2 done as close as possible to finishing medical school and it made sense for me to complete it while the content from ward work was still fresh — even if that meant juggling shifts, on-calls, and study blocks, and so my later years could focus on career development rather than exam stress.
I wanted both Step 1 and Step 2 CK completed early so that I could make informed decisions about my next career steps — not applying blindly to U.S. programs without knowing where I realistically stood (as now a lot of weighting is given to Step 2). Having both scores would allow me to plan future observerships strategically, and consider sitting Step 3 during F2 or F3 if the timing worked.
My study materials & tools
I decided that instead of trying to carve out huge study blocks, I’d build something sustainable: small, consistent study sessions around my work, using mobile tools and adapting to interruptions. I leaned heavily on several resources that fit into my existing schedule.
I took an Amboss free self-assessment in April the year before I eventually took the test (they tend to promote these around the Spring time from late January to April).
Here’s what else I used:
Resource | How I Used It |
UWorld (Step 2 CK Qbank + app) [PAID] | Did blocks while commuting (train, tube), sometimes on lunch breaks. I used the app version extensively. I highly recommend buying the Q bank with the Medical Library (Affiliate code: JESSICA10) |
The CMS (Clinical Mastery Series) forms are 50 question exams on each specific specialty. I sat these in timed conditions in the evenings and marked them immediately after, making flashcards on my incorrects and plotting my score. On weekends I would sit the 5-hour NBME exams (downloaded offline here) and simulate exam conditions. I would spend the next day marking these exams and meticulously going through incorrect questions and concepts (using Anki for flashcards and making notes/using Mehlman Medical guides and the UWorld Medical Library to help). I plotted scores on my Notion dashboard. | |
Mehlman Medical guides [FREE] | Helpful for quick topic reviews; used as topic review and helped me find quick reasons and answers for questions I kept getting wrong on the simulated exams. |
Free 120 [FREE] | I saved this until last. It is free and 120 questions (to be taken in 3 hrs and represents the real exam platform). I found this a bit easier than the real thing - in reality, questions are slightly longer and more varied in complexity and scope (of course, because the real thing is 3x as long as this practice exam). |
I watched his concise videos on ethics and QI during commutes or while cooking around 2 weeks before my exam date. | |
Randy Neil, MD [FREE] | Great Youtube videos for working through biostatistics questions that commonly come up in the USMLE Step 2 - good for you to get used to the way questions are asked and how to memorise equations. Recapped about 1 week before my exam date. |
Amboss [PAID] | Ethics, QI and doing the respective questions for these topics. |
My timeline & strategy
Initial plan (December 2024): I first booked Step 2 CK for December 2024 — overly optimistic, as I soon learned that full-time NHS work leaves little sustained study time.
First extension (to March 2025): I paid to extend my exam, thinking three more months would be enough — the same mistake I made with Step 1.
Second extension (to July 2025): By March, I realised I still wasn’t consistent across all systems. Extending again gave me the time I needed for consolidation and more full-length practice.
Micro-study routine:
Commutes: aimed for 20 UWorld questions on my phone
Between shifts: short Mehlman topic reviews / CMS forms and Anki flashcards
Gym sessions: flashcards or Mehlman online Qbank (Youtube)
Weekends: NBME full-length forms and error log review
Tip: Tracking my progress kept me accountable. Once my performance was consistently at or above 70% across multiple sources, I booked the test and stuck to the date.
Challenges, pitfalls & lessons learned
Underestimating full-time work: I repeatedly overestimated how much I could study after busy shifts. Building a realistic schedule from the start would’ve helped.
Mental fatigue: Working and studying simultaneously is draining. I learned that quality rest improved recall and performance more than pushing through exhaustion.
Consistency over perfection: Even 10 questions a day added up. I treated every commute or break as an opportunity.
Be flexible: Some rotations were heavier than others. I adjusted goals weekly instead of forcing rigid routines.
Buffer time matters: Leave space for unexpected rota changes or burnout — they will happen.
Exam day
I sat my USMLE Step 2 CK in July 2025 after months of preparation and two extensions. By that point, I felt ready — not perfect, but consistent and calm.
The exam itself was long but fair. The questions were challenging yet straightforward, testing reasoning more than obscure recall. There was also more statistics, ethics, and communication-based material than I had anticipated.
In terms of pacing, I structured my breaks carefully:
5-minute breaks after Blocks 1 and 2, just to reset and refocus.
5-minute breaks between most other blocks to stretch and sip water.
A 20-minute lunch break after Block 5 and another 15-minute break after Block 6 before finishing the final section.
You have a total of 1 hr for your breaks and 8 hrs to complete 8 blocks of 40 questions.
Those small breaks made a huge difference to my concentration. Even with them, I remember feeling completely drained by the final block — mentally and physically exhausted — but also relieved that I’d given it everything.
When the results came, I had passed, and honestly, that was enough. The relief was immense — not only from months of juggling full-time work and revision, but also from knowing that I could finally move forward with my long-term plans.
My Total Step 2 CK Costs (Transparent Breakdown)
I provided the specific study materials I used earlier on in this post, but there is an abundance of information available online. The best approach is to find resources that work for you personally as the costs can really add up.
This included:
£967.18 ($1,240) – booking the Step 2 CK exam
£346.34 ($449) – UWorld 3-month subscription
$299 (£233) – extending UWorld to 6 months
$139 (£108) – one additional month of UWorld access
$135 (£105) – extending and rebooking the exam date
Anki – Free – my go-to for spaced repetition and review
Estimated Total: ≈ £1,760 ($2,260)
I definitely underestimated how these costs would add up — especially the extensions. Between subscriptions, rebooking fees, and the exam itself, it became a much bigger financial commitment than I’d expected. Still, I see it as an investment in flexibility and peace of mind. Paying to extend meant I could sit the exam confidently rather than underprepared. If you’re planning your own Step 2 journey, set aside a small “extension buffer” fund — because when you’re working full-time, life (and the rota) will almost always get in the way.
Final thoughts & advice
If you’re a Foundation Doctor preparing for the USMLEs, here’s what I’d say:
Don’t underestimate how draining full-time work can be — plan your prep around it, not against it.
Use every pocket of time: commutes, breaks, and workouts add up.
Focus on trends, not single test scores.
Extend your exam if you need to; it’s better to move the date than to sit unprepared.
Make sure you read up on and practice questions on ethics (it is very different to the UK way of practicing medicine) and biostatistics!
Good luck! I hope this helped.
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