Hi every one, i recently scored 266 on USMLE Step 2 CK, preparing in approximately 150 days alongside a full-time job. I graduated from medical school more than 15 years ago and currently work full-time in healthcare.

I wanted to share my experience, especially for older graduates and people wondering whether they can prepare while working.

My background

I cleared Step 1 in June 2025. My Step 2 preparation began in mid-March 2026, and I took the exam on August 31.

I had a strong foundation from my earlier training, but returning to exam preparation after years of clinical practice meant revisiting many subjects outside my daily work.

How I managed preparation with work

My working hours were approximately 8:30 am to 4 pm. I usually studied:

• 4–5 hours on weekdays
• 10–12 hours on weekendsThe principles that have worked for me over the years

About 15 years ago, I secured a top rank in my country’s highly competitive postgraduate medical entrance examination. The principles I learned then have continued to work for me:

1. Know how badly you want it. Be clear about your goal and why it matters to you. That sense of purpose helps you keep going on difficult days.
2. Consistency beats talent. Showing up every day and doing the work matters more than occasional bursts of intense study.
3. Make the process enjoyable. Find satisfaction in understanding concepts, solving questions, and improving. Preparation becomes sustainable when you enjoy the daily work.
4. Think of preparation like bodybuilding. You exercise every day, but visible muscle growth takes months. Learning works similarly: progress builds gradually, even when you cannot see it immediately.
5. Use MCQs as your guides from day one. Questions show you what matters, how concepts are tested, and where your understanding needs improvement. Start solving them early.
6. Understand the exam before going deep into preparation. Work through at least two representative papers—for example, NBME 11 and 12 for Step 2 CK—to familiarize yourself with the question style and prime your mind for what you need to learn.
7. Spend the first half of your daily study time building concepts systematically. Choose a topic within a subject or system, such as asthma. Study it, make concise notes, and solve the available MCQs on that topic, refining your understanding as you go. Then move to the next topic, such as COPD, and repeat the process.
8. Spend the other half learning through mixed questions. Use previous examination papers or representative assessments, such as NBMEs. Let each question guide a focused review. For example, if a question tests PPD interpretation in tuberculosis, review that concept, make brief notes, and solve related MCQs. If the next question is about angina, repeat the same process for angina. This helps you build knowledge across subjects while practising how the exam actually tests you .

My routine

1. Morning practice before work: I started the day with 25 questions from a CMS form before my job began.
2. First study session: 4–8 pm: I studied systematically, topic by topic within a subject—for example, respiratory medicine. I built concepts using UWorld and reinforced them with topic-specific MCQs from AMBOSS.
3. Second study session: 8–11:30 pm: I worked through NBME questions sequentially. For each question, I reviewed the underlying concept and reinforced it with related MCQs from AMBOSS.
4. Consistency during the first 3.5 months: I followed this routine every day without a break. Within the first three weeks, I completed NBME 11, 12, and 13 to understand what the exam expected me to know and how it tested that knowledge.
5. Weekend study: On weekends, I studied for 10–12 hours using the same combination of systematic topic review and mixed-question practice.
6. My approach to each topic: First, I understood the concept. Then, I made concise notes and tackled MCQs testing it from multiple angles. I repeated this until recognizing the patterns became almost automatic.
7. Total question practice: I solved approximately 14,000 MCQs during my preparation using this approach.
8. What I believe is possible: This experience convinced me that a score of 275 can be an achievable goal with the right guidance, consistent effort, and an effective strategy. Individual outcomes will vary, but I believe many students underestimate their potential.
9. Build reflexes through practice. This exam tests more than memory—it requires you to recognize patterns and apply concepts quickly. Make mistakes during preparation, understand why you made them, and learn from them so you can approach test day with fewer surprises and greater confidence.

I’m sharing this post as a gesture of gratitude to this awesome community, which was a valuable source of guidance throughout my preparation. I hope my experience helps someone else on their journey