USMLE Step 2 CK's New Exam Format, Effective May 7, 2026
Starting May 7, 2026, USMLE Step 2 CK's exam-day structure changes for the first time in years — same total 9-hour session, but split very differently. Here's exactly what USMLE's own page (https://www.usmle.org/step-exams/step-2-ck) says changes, and what stays the same.
Before May 7, 2026, the exam is divided into eight 60-minute blocks in one 9-hour session, with up to 40 questions per block and a maximum of 318 questions total. Minimum break time is 45 minutes, plus an optional 15-minute tutorial.
On or after May 7, 2026, the same 9-hour session instead divides into sixteen 30-minute blocks, with up to 20 questions per block — USMLE's own materials (https://www.usmle.org/exam-resources/step-2-ck-materials/step-2-ck-content-outline-specifications) don't state a new total question-count cap the way the old format did, so this doesn't invent one. Minimum break time increases to 55 minutes, and the optional tutorial shortens to 5 minutes. Both formats let unused block time roll into break time if you finish a block early.
Study takeaway: the real shift here is pacing granularity, not total content: twice as many blocks means twice as many natural stopping points, so practice should build comfort with shorter, more frequent timed blocks (20 questions in 30 minutes — 90 seconds a question, unchanged) rather than assuming the old 40-question, 60-minute rhythm still applies for a test taken on or after May 7, 2026.