How to best utilize UWorld for USMLE Step 1 and Step 2 CK preparation
- Ash Eighaei Sedeh MD
- Apr 10
- 12 min read
Welcome USMLE candidates!
We hope you find this guide helpful.
Our team at IMG Rotations is very pleased to be a part of your USMLE journey.
Table of contents:
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What Is UWorld for USMLE?
UWorld is the gold standard question bank (Qbank) for preparing for the USMLE exams, Step 1, Step 2 CK, and Step 3. It’s an online platform with thousands of high-quality multiple-choice questions that mimic the style, content, and difficulty of the real USMLE.
Why Is UWorld So Important?
Realistic Practice
UWorld questions look and feel like the actual USMLE exam. The interface even simulates the Prometric exam environment.
Clinical Reasoning Training
Questions are not just fact recall, they train you to think like a doctor, which is essential for passing (and excelling).
High-Yield Explanations
Every question has a detailed explanation that teaches you the why, why not, and how. Includes illustrations, diagrams, tables, and citations from First Aid, UpToDate, and CDC guidelines.
Learning + Assessment Tool
You learn while you practice. The explanations teach you the topics better than many textbooks. You can track your progress, identify weak areas, and analyze performance by subject/system.
What’s Included in UWorld?
Step 1 Qbank
(~3,000+ questions, heavily focused on basic sciences + clinical applications)
Step 2 CK Qbank
(~4,000+ questions, very clinical, similar to shelf exams)
Self-Assessments (UWSAs)
Full-length practice tests scored similarly to the real exam. Very predictive of your actual Step 1/Step 2 score/pass.
IMGs, Listen Up! For international medical graduates (IMGs), UWorld is especially crucial because:
It helps close the clinical thinking gap between your home medical education and US standards.
It gives you confidence in facing the NBME-style questions.
It makes your preparation focused and efficient, no need to study from 10 different sources.
IMG Rotations' Tip: "Don’t just do UWorld! study UWorld."
Each question is a mini-lesson. Use the explanations to build your foundation. Annotate them into First Aid (for Step 1) or your notes.
UWorld Modes: Tutor Mode vs Timed Mode
When using UWorld, you can choose how to practice and review the questions. The two main modes are:
1. Tutor Mode
What it does:
You see the correct answer and full explanation immediately after each question.This mode is great for learning and understanding the material.
When to use it:
Early in your prep, especially during the first pass.
When focusing on learning new systems (e.g., cardiology, microbiology).
When doing subject-specific blocks to build foundational knowledge.
When reviewing incorrect or marked questions.
IMG Rotations' tips!
Take your time with explanations, UWorld explanations are invaluable.
Read why the wrong choices are wrong.
Annotate into First Aid or your study notes as you go.
2. Timed Mode
What it does:
Simulates the real USMLE exam by giving you a set time to complete each question (typically 1 minute and 30 seconds per question).You don’t see the answers or explanations until you finish the entire block of questions.
When to use it:
Later in your prep (second pass or final month).
To build stamina and time management for exam day.
When doing mixed blocks (different topics and systems).
For self-assessment of your performance under time pressure.
IMG Rotations' tips:
Do at least 1–2 blocks in timed mode daily as your exam date approaches.
Treat it like a real test: no interruptions, no checking your phone.
Review thoroughly after finishing the block, you learn just as much during the review.
Comparing Tutor mode VS Timed mode
Mode | Purpose | Best For | When To Use |
Tutor | Learn while doing questions | Deep learning & concept building | Early to mid prep (first pass) |
Timed | Simulate real exam | Speed, stamina, time management | Late prep (final month) |
How Many UWorld Questions Should You Do Per Day?
The ideal target range for most IMGs is 60-80 questions per day if you are serious about mastering the USMLE. However, the exact number depends on where you are in your prep.
Breakdown by Phase:
Early Phase (First Pass - Learning Mode)
Daily Qs: 40 - 60
Do 1 block per day (40 questions) in Tutor Mode.
Take your time reviewing each explanation thoroughly.
Goal: Understand the material, not just answer questions.
Pair with review resources like First Aid, Pathoma, or Boards & Beyond.
Mid Phase (Transition to Mixed, Timed Blocks)
Daily Qs: 60 - 80
Do 1–2 blocks per day (timed or tutor mode).
Start mixing subjects to build integrated knowledge.
Focus on identifying weak areas.
Final Phase (Exam Simulation Mode - Final 4–6 weeks)
Daily Qs: 80 -120
Do 2–3 full timed blocks per day to build test-day stamina.
Treat this phase like training for a marathon.
Pair with NBME practice exams and UWorld Self-Assessments (UWSA 1 & 2).
How Long Should This Take?
On average:
1 UWorld block (40 questions) takes about 1.5 hours to complete in timed mode.
Reviewing that block in-depth takes 2–3 hours (especially early on).
So, 1 full block = 3.5 - 4.5 hours per day.
If doing 2 blocks: Expect 6-8 hours per day, including review.
IMG-Specific Advice
Don’t rush to finish. UWorld is about quality over quantity.
Your focus should be on:
Learning from mistakes
Mastering UWorld-style thinking
Building clinical reasoning
IMG Rotations' Tip: Track Your Progress!
Use UWorld’s built-in performance analytics:
Monitor trends in system-based scores.
Identify weak subjects and review them deeply.
Re-do incorrect or marked questions later on.
Should I review the questions and answers that I get wrong?
Yes! you absolutely should review the questions and answers you got wrong, and not just once. For IMGs, this is one of the most powerful strategies in USMLE prep.
Mistakes are your best teachers
Every wrong question reveals:
A knowledge gap you need to fill
A misunderstanding of the question style
Or a thinking error in clinical reasoning
Instead of avoiding these mistakes, dissect them. They show you exactly what to fix.
USMLE tests how you think, not just what you know
Many wrong answers come from:
Misreading the stem
Missing key clues
Jumping to conclusions
When you review thoroughly, you train yourself to approach questions more carefully and methodically.
UWorld explanations are like mini-lessons
When you get a question wrong:
Read the entire explanation, not just the correct choice.
Study why the other options are incorrect.
Review associated charts, tables, and diagrams—these often reflect high-yield exam content.
If it’s a weak topic, go to your resources (First Aid, Pathoma, etc.) and reinforce it.
Track and revisit your weak areas
Keep a "mistake log" or UWorld notebook where you jot down wrong answers, why you missed them, and key takeaways.
Use that to guide your focused reviews later.
Many high scorers go through all their incorrects and marked questions again before the exam.
It’s not just about getting it right, it’s about understanding
Sometimes you’ll get a question right for the wrong reason. Always ask:
“Did I really know this?”
“Could I explain this concept to someone else?”
If not, review it, even if it was “technically” correct.
IMG Rotations' Tip!
Always review your wrong answers. They are the fastest route to mastery and higher scores. If you're not reviewing them deeply, you're missing one of the most effective tools in your USMLE prep arsenal.
Why Review Correct Answers on Uworld When Preparing for USMLE?
Just because you answered a question correctly doesn't mean you fully understood the concept. Many students, especially during the first pass, get questions right by guessing, partial recall, or lucky associations.
Reviewing correct answers ensures you are:
Solidifying accurate reasoning
Confirming your understanding of all answer choices
Avoiding future errors on similar topics
When and how to review correct answers?
First Pass (Learning Phase)
Review all questions, even the ones you got right.
Focus on:
Why your answer was correct
Why the other choices were incorrect
What new information you can extract from the explanation
This builds depth and reinforces retention.
Second Pass or Final Review
Be more selective:
Focus on correct answers you weren’t confident about
Mark questions you got right but want to revisit later
Skip reviewing questions where you were 100% confident, answered quickly, and confirmed your reasoning on review
What to look for during review?
Concept clarity:
Can you teach the topic to someone else?
Clinical reasoning:
Did you use the right thought process, or was it a guess?
Distractors:
Do you understand why the other choices are wrong? This helps prevent mistakes in similar future questions.
Integration:
Can you connect this question to related material (e.g., pathology, pharmacology, physiology)?
IMG Rotations' Tip:
You don’t need to spend equal time on every correct question. Use your judgment:
Quick check for confident answers
Deeper review for “unsure but got lucky” answers
This helps maintain both efficiency and thoroughness.
Should I finish the whole uworld qbank before sitting for the exam?
Yes, you should finish the entire UWorld Qbank before sitting for the USMLE, especially as an IMG. Completing the full Qbank is one of the most reliable indicators of adequate preparation.
Why you should finish UWorld?
Complete exposure to exam-style content
UWorld is carefully designed to reflect the content, difficulty, and style of the actual USMLE.
By finishing all the questions, you ensure you’ve seen the full range of tested concepts and clinical scenarios.
Identify and fill knowledge gaps
Finishing the Qbank helps uncover all your weak areas, even ones you may not realize are weak.
It allows you to review and correct misunderstandings across every system and subject.
Build stamina and time management
The USMLE is long and mentally demanding. Doing full blocks regularly helps you build test-day endurance and manage your pacing effectively.
Maximize the value of UWorld’s analytics
UWorld’s performance tracking becomes much more meaningful when you’ve completed most or all of the Qbank.
You’ll get a clearer picture of your readiness and can focus review on your lowest-performing areas.
Exceptions or modifications
In rare cases, some students do not finish 100% of the QBank, usually if they:
Are scoring very high consistently (e.g., 85 - 90%+ on UWorld and >250 on self-assessments)
Are very short on time (less than 2–3 weeks before the exam)
Even then, it’s critical to at least:
Finish 90 - 95% of the Qbank
Focus on the most missed, marked, and incorrect questions
Review all major systems and high-yield topics
IMG Rotations' tips:
Finishing UWorld should be a priority. For IMGs especially, it’s one of the best ways to level the playing field and build the clinical reasoning skills expected on the USMLE.
What Is Considered a Good UWorld Average Score?
For USMLE Step 1 (Pass/Fail)
65–75%:
Strong range for passing with confidence and mastering key concepts.
>75%:
Excellent, typically indicates strong understanding and high readiness.
<55%:
At risk, usually requires review of fundamentals and additional time.
Even though Step 1 is now pass/fail, a high UWorld average is still important because it correlates with:
Success on Step 2 CK
Clinical reasoning skills
Your ability to pass Step 1 on the first attempt
For USMLE Step 2 CK (Numerical Score)
70–80%:
Very good. Often correlates with Step 2 CK scores in the 240–260 range.
>80%:
Excellent. May align with scores >260.
60–70%:
Satisfactory but needs consistent review and targeted improvement.
<60%:
Caution, consider delaying exam to strengthen weak areas.
Important Notes About UWorld Averages
It’s cumulative:
Your average includes your earliest (often weaker) blocks. If your recent performance is significantly higher than your overall average, that’s a good sign of improvement.
Score alone isn’t enough:
What matters more is how well you review and retain the content.
UWorld is harder than the real exam:
So a 70% on UWorld often translates to a much stronger performance on test day.
IMG Rotations' tip on interpreting your performance
Always pair your UWorld average with NBME practice exams and UWSA scores to get a more complete picture.
Focus on consistency across systems and disciplines, not just your total average.
What is the UWSA?
There are two self-assessments for each step:
Step 1
UWSA 1
UWSA 2
Step 2 CK
UWSA 1
UWSA 2
Each exam contains:
4 blocks of 40 questions (160 total), just like the real exam.
Must be done in a timed setting, there’s no tutor mode.
Provides a predictive score report, including a 3-digit score estimate and percentile.
Why is UWSA Important?
Highly Predictive
UWSA 2 (especially) is considered one of the most accurate predictors of your real USMLE score, especially when taken 1 - 3 weeks before your actual exam.
Real Exam Simulation
The format, timing, and difficulty mimic the actual exam, helping you practice under test-like conditions.
Performance Feedback
You get a breakdown of your performance by subject/system, helping guide final review and identify weak areas.
How Should You Use the UWSA?
Use UWSA 1 midway through your dedicated prep (usually after completing 50 - 75% of the UWorld Qbank).
Use UWSA 2 in the final 1 - 2 weeks before your actual exam to confirm readiness and fine-tune your review.
UWorld Qbank Average → Real Exam Score
This correlation is imprecise but can offer a general idea:
UWorld Average | Estimated Step 2 CK Score |
85–90% | 260+ |
75–85% | 240–260 |
65–75% | 230–240 |
55–65% | 210–230 |
<55% | <210 (risk of failing Step 1 or low Step 2 CK score) |
IMG Rotations' Tip: This estimate works best after you've completed 75-100% of the Qbank with a good review process. Early averages are often misleading.
UWSA → Real Exam Score Prediction
The UWSAs are more accurate for score prediction than just the Qbank average.
Step 1:
UWSA 1: May underpredict slightly for some students.
UWSA 2: Strongly predictive of passing Step 1 if taken 7–14 days before the exam.
Step 2 CK:
UWSA 1: Fairly predictive but slightly less reliable than UWSA 2.
UWSA 2: Considered the most accurate predictor of your real Step 2 CK score.
Most students find their real score within ±5–10 points of their UWSA 2 score, especially if taken under realistic conditions.
How to use this in your planning
Track your Qbank performance, but base final readiness more on UWSA + NBME practice exams.
Take UWSA 1 midway through your dedicated prep.
Take UWSA 2 7-10 days before the exam as a dress rehearsal.
Use the results to:
Confirm exam readiness
Delay the test if necessary
Focus your final days of review
Example for Step 2
If you're scoring:
68% average on UWorld, and
UWSA 2 score: 242 taken 10 days before the examYou’re likely to score between 235 - 250 on the real Step 2.
Why 65-75% is Considered Safe for Passing Step 1
Mastering Core Concepts:
This score range usually means you are consistently getting the major systems and clinical concepts right.
Step 1 tests your basic medical sciences knowledge as well as clinical reasoning, and this range indicates you’ve seen a broad enough set of questions to handle both.
Preparation for Integrated Clinical Questions:
UWorld mirrors the integration required on the exam. A score in this range reflects good exposure to integrated clinical cases and physiological concepts.
Room for Improvement:
A 75% average on UWorld is considered excellent and generally correlates with a high pass (usually above 240 if it were still scored numerically).
With a 65-75% range, you still have room for review and targeted improvement, especially in weaker areas.
Below 65% Average:
If your UWorld average is consistently below 65%, it indicates potential areas of weakness. You may struggle with:
Basic scientific concepts
Applying knowledge to clinical cases
Understanding the reasoning behind multiple-choice questions
In such cases, it’s recommended to spend more time reviewing weak areas, strengthen foundational knowledge, and consider taking more time before the exam if possible.
What to Do if Your Average is Below 65%:
If you're scoring under 65%:
Revisit basic concepts using resources like First Aid, Pathoma, and Sketchy Micro.
Identify patterns in the types of questions you’re missing and focus on those systems or topics.
Review UWorld explanations deeply to understand why your answer was wrong.
How Long Should Your Dedicated Study Period Be?
For most IMGs, the ideal length of a dedicated study period depends on several factors:
Current baseline knowledge:
If you're already strong in basic sciences and clinical knowledge, a 6-week dedicated period might be enough. If you feel less prepared, you might need 10-12 weeks.
Time before exam:
Ideally, you should have at least 2-3 months before your exam to allow time for UWorld, review, and final practice exams.
For a Step 1 preparation timeline, here’s a rough guideline:
6-8 weeks:
If you’ve been studying part-time or have already done a lot of prep, this timeframe can be sufficient.
8-12 weeks:
If you need more time to solidify foundational knowledge or feel less confident, consider extending this period.
How Many UWorld Questions Should You Aim to Do?
Your UWorld question goal during the dedicated period will depend on your study strategy and timeline, but here are general recommendations:
Step 1:
Target UWorld questions:
Around 2,000-2,500 questions in total.
First pass:
Aim for 1,500-2,000 questions to complete during your dedicated study time.
Second pass:
You can aim for 500-700 questions during the last few weeks, especially your weak areas and marked questions.
How many per day:
If you have 8-10 weeks, aim for about 40-50 questions per day.
If you have 6 weeks, aim for 50-60 questions per day.
Take full practice blocks (4 blocks of 40 questions) at least 2-3 times a week to build stamina and simulate real exam conditions.
Step 2 CK:
Target UWorld questions:
Around 2,200-2,500 questions.
The first pass should cover about 2,000 questions, and the second pass should cover your weak spots.
How many per day:
Aim for 50-60 questions per day with a focus on completing timed blocks.
Structure of Dedicated Period
1. UWorld for First Pass
Start with timed mode:
This simulates the real exam and helps with time management.
Review every question in depth, even if you got it right. Understand the reasoning behind each option.
2. Second Pass
In the final weeks, you should do a second pass of all the questions you got wrong or flagged during your first pass.
Focus on weak areas, high-yield topics, and incorrect answers.
3. Practice Exams and Self-Assessments
Schedule UWSA, NBME exams, and UWorld self-assessments (UWSA 1 and 2) to track your progress.
Take practice exams every 7–10 days during the last 2 weeks of your study period to simulate real exam conditions and assess your readiness.
IMG Rotations' tips for a successful dedicated period
Follow a Schedule:
Create a detailed study schedule to ensure you’re staying on track and hitting all necessary content.
Active Recall and Spaced Repetition:
Don’t just passively read answers. Use tools like Anki to reinforce important information and active recall techniques to boost memory retention.
Rest and Recovery:
Don’t forget to incorporate regular breaks to prevent burnout. Quality rest is as important as studying.
Revisit Weak Areas:
After each UWorld block, spend time focusing on weak systems and topics to boost your performance in those areas.
Here it is again,
You made it all the way to the end of this blog post!
We hope you have found the information offered here by IMG Rotations useful in your USMLE journey.
Don't forget to check our blog post on the ERAS residency match 2026 HERE.
Any questions? Email us: info@imgrotations.com
