There are two major types of USCE: hands-on clinical rotations (electives, externships, sub-internships) and observerships. Hands-on rotations involve direct interaction with patients under supervision. This may include conducting histories and physicals, presenting cases during rounds, writing patient notes, or assisting in procedures where permitted. Observerships are more limited in scope and typically do not involve direct patient care.

Timing the USMLE Step 2 Clinical Knowledge (CK) exam strategically is essential for international medical graduates (IMGs) pursuing U.S. residency. With Step 1 now pass/fail, Step 2 CK has become the key academic metric for program directors evaluating IMG applicants. The timing of your exam can directly impact your ability to receive interviews and successfully match. In this guide, we outline key considerations for determining the best time to sit for Step 2 CK as an IMG