USMLE Vault · Step 2 CK

6 steps to get more than 250 on Step 2 CK

For IMGs who want 250+ on Step 2 CK without spending a year chasing it.

By Dr. Marish Asudani · Published 22 October 2026

How do I score more than 250 on Step 2 CK?

Follow 6 steps in order. Pick your notes on day 1: my notes if you're short on time, the Inner Circle Notes if you have 6+ months. Build a base with the Tzanki deck and 1 question bank, system by system. Practise on CMS forms with the NBME MCQ protocol. Consolidate with Mehlman, then AJmonics. Use Dr. High Yield in the later phases. Then run the final-week and final-day protocols. Underneath all 6, a full notes cycle before every NBME.

Read this firstIn Step 1, everyone knows the answer is First Aid. In Step 2, IMGs are genuinely clueless about what to revise from, and that confusion wastes months. That's why most IMGs get the first of these 6 steps wrong before they've answered a single question.

We've had multiple students score more than 250 using my notes. I scored 254 in 20 weeks, while working. My highest student so far scored 269.

This page isn't the entire Step 2 plan. It's the plan consolidated into 6 steps. Every step links to the page that goes deeper.

Day 1Pick your notes

⭐ MOST IMPORTANT

If you're short on time, use my notes: my Annotated First Aid, 16 to 20 weeks. If you have a lot of time, use the Inner Circle Notes, 6 months minimum. Not sure which track is yours? Choose your track here.

Pick 1 and never switch. Every UWorld correction, every Mehlman line and every NBME mistake goes into that 1 place, so by your final week you're revising notes that feel like your own handwriting.

Months 1 to 3½Build your base: the Tzanki deck and 1 question bank

After selecting your notes, the next step is consolidation. Use the Tzanki deck and 1 question bank to form a good base. That question bank is UWorld, with AMBOSS only for what UWorld can't do.

UWorld, system by system, in tutor mode. It's a learning tool here, not an assessment. Use the read, solve and review method, and every wrong answer goes into your notes in 1 to 2 lines.
If you have time, 10 to 11 days per system. Days 1 and 2: that system in the Tzanki deck plus its Mehlman playlist. Days 3 to 10 or 11: 2 to 3 blocks a day, rotating UWorld → AMBOSS → UWorld, with that system's Anki every morning.
AMBOSS for biostats and ethics at the end of this phase. UWorld's coverage isn't enough.

The questions show you what you didn't know. The notes are where you keep it.

Want a day-by-day schedule that tells you exactly what to study next? The Vault builds it around your exam date. It's built for Step 1, so if Step 1 is still ahead of you, start there, and you reach Step 2 CK with no long break in between.

Build your day-by-day schedule in the Vault →

After UWorldCMS forms, with the NBME MCQ protocol

Use the CMS forms, and run the NBME MCQ protocol on every CMS question, to practise your scores. CMS forms 3 to 10 are the closest thing to the real exam, and they're learning and assessment tools at the same time. 2 rules: review them far harder than you attempt them, and don't touch them until UWorld is finished.

The protocol in 4 lines:

First 3 seconds: labs, a derm image or a simple X-ray? Look at it first, then jump to the last line.
The stem: lock in your diagnosis and your management before you read the last line.
The last line: next best step and not an emergency? Stop the offending drug, then diagnose, then non-invasive, then invasive. Diagnosis before treatment.
The options: whisper your answer first. Switch only when a hard-coded line in the stem rules an option in or out.

Why it works: the CMS forms and the NBMEs are where 240s become 250s. The protocol makes you answer every question the same way, so your score stops depending on the day.

Your NBMEs run alongside the CMS forms, and every one is taken offline, in timed blocks at the real exam's pace, about 90 seconds a question. Online forms are more spacious and inflate your score, so you'd plan on a number that was never real.

After every NBME, run the Step 2 CK NBME Booster Anki (NBME 9 to 16 and the Free 120) to consolidate what that form tested. The form shows you the gap; the deck closes it before the next form.

Run the Step 2 CK NBME Booster Anki after this NBMEEvery pattern from NBME 9 to 16 and the Free 120, as cards, system by system. Opens straight into the Step 2 CK decks.

Open the deck →

Consolidation, then after NBME 12Mehlman and AJmonics

Mehlman in the 2 to 3 weeks of consolidation, before NBME 9: 1 day per system with your notes open, and every line you want goes straight into your primary notes. No separate Mehlman notebook.

▶Mehlman · Internal medicinePlaylist. Also Pediatrics, Surgery and OB/GYN below.

Pediatrics · Surgery · OB/GYN

AJmonics after NBME 12: about 200 questions per system in roughly 2 hours. Screenshot every unknown into a folder by system. That folder is 1 of your 3 final revision resources.

▶AJmonics · COMPLETE Step 2 ReviewPlaylist, 1 video per system

Later phasesDr. High Yield

Use Dr. High Yield during the later phases: concise videos built for rapid recall, plugged into your rotation alongside Mehlman, Divine and AJmonics, system by system. Especially when your score is stuck.

▶Dr. High Yield · Internal MedicinePlaylist ▶Dr. High Yield · All videosPlaylist, including pediatrics. Pick the system you're revising.

The Step 2 high-yield PDFs are also in the University section of the Vault, free.

Free Step 2 PDFs in the Vault UniversityThe high-yield PDFs, free. Opens on the Resources tab.

Open the PDFs →

The endThe final week and the final day

Read what to do in the final week of Step 2 CK, and what to do in the final 24 hours. Put those things into your plan, and run the final-day protocol as well.

In that last week, you revise every card of the Step 2 CK NBME Booster Anki in the Vault.

The rule underneath all 6: a complete notes cycle before every single NBME, and the Step 2 CK NBME Booster Anki after every one. The notes cycle is worth 5 to 10 points, it costs nothing but discipline, and almost nobody does it. And when you read your NBMEs, read the trend across NBME 13, 15 and 16, plus the Free 120, which is the most predictive of all. What I have seen: 80%+ on the Free 120 = a good chance of 250+. If a form goes badly →

Stuck in the 240s?

Send me your NBMEs and your date. I'll tell you which of the 6 you're skipping.

Book a call →

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