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The CCSE is NBME’s Comprehensive Clinical Science Examination: a 200-question exam your school gives near the end of the core clerkships to judge whether you are ready for USMLE Step 2 CK. It runs 5 hours 15 minutes including a 15-minute break (NBME timing chart) and is scored on the same 1-300 scale as Step 2 CK (NBME guidance).
You cannot buy it yourself: it is a secure exam that NBME sells only to schools, and NBME says it is not meant for practice (NBME). Its twin for individual students is the CCSSA. This page covers what the CCSE tests, how to read the score and what to do next.
CCSE at a glance
| Topic | Official rule | Source |
|---|---|---|
| Score scale | Reported on the same 1-300 scale as Step 2 CK, with a likely score range (within 8 points two-thirds of the time) and an estimated probability of passing Step 2 CK within a week. | NBME: CCSSA and CCSE guidance (March 2025) |
| What it is | A Comprehensive Subject Exam that schools give to check readiness for USMLE Step 2. It must be given securely and is not meant for practice; faculty order it through NBME. | NBME: Comprehensive Subject Exams |
| Step 2 CK passing score | 218, for exams taken on or after July 1, 2025. The CCSE itself has no pass mark from NBME. | USMLE: results and scoring |
| Results | Often posted to the school in the MyNBME portal the day after the testing window ends; can take up to three business days. You see results in the examinee portal. | NBME: Subject Exam Program Guide |
What the CCSE covers
NBME describes the CCSE as a general, integrated test of what you learn in the core clerkships, built to reflect Step 2 content (NBME outline). The physician-task split tells you how to study:
| Physician task | Share of exam |
|---|---|
| Diagnosis, diagnostic studies and outcomes | 40–50% |
| Pharmacotherapy, intervention and management | 40–50% |
| Health maintenance | 10–20% |
By system, most areas sit at 5–10% each. The two to watch are social sciences, medical ethics, professionalism and patient safety at 10–15%, larger than any single organ system, and biostatistics at 1–5% (NBME). Students who prepare only by organ system tend to lose points on the ethics and safety questions.
Reading your CCSE score
NBME’s guidance treats CCSE and CCSSA the same way and asks you to look at three numbers together (NBME guidance):
- Your total score, on the 1-300 Step 2 CK scale and equated across forms, so you can compare one CCSE with a later CCSSA.
- Your likely score range. Retested with the same knowledge, your score would land within 8 points of the reported one two-thirds of the time. NBME compares that range with the Step 2 CK low-pass range, the band just above the passing score.
- Your estimated probability of passing Step 2 CK within a week, from 1% to 99%.
The guidance sorts results into four cases. A range completely below the low-pass band means you are at risk of failing. A range partly below it is borderline, and more preparation is strongly advised. A range partly inside and partly above is still close to the minimum. Only a range completely above the band suggests you are likely ready. The Step 2 CK passing score itself is 218 (USMLE scoring).
Why your result may not match Step 2 CK
NBME lists the reasons a CCSE result can drift from your real score: the longer the gap before Step 2 CK, the more you can learn or forget; a probability estimate is not the same as mastering that share of the content; and testing under different conditions, or retaking the same form, makes the numbers less reliable (NBME guidance). A CCSE taken months before your exam is a snapshot, not a forecast.
Your school may also use the CCSE for its own decisions, such as when you may sit Step 2 CK. Ask your dean’s office what score or probability they require, because NBME does not set one.
CCSE vs CCSSA
| CCSE | CCSSA | |
|---|---|---|
| Who buys it | Your school | You |
| Where you sit it | School or Prometric, proctored | Online, at home |
| Questions | 200 | 200 in four sections of 50 |
| Score scale | 1-300, Step 2 CK scale | 1-300, Step 2 CK scale |
| Price | $62 at school, $152 at Prometric | From $62 per form |
Sources: NBME fees, NBME CCSSA. Because both share a scale and the same guidance, a CCSE result and later CCSSA forms make one trend line. Space them out and sit each under exam conditions in one sitting.
After a low or borderline CCSE
Start from the score report, not a new resource. Sort your weak content areas into the three physician tasks: missed diagnoses point to reading and pattern recognition, missed management points to next-step algorithms, and missed ethics and safety questions point to a short, focused review. Then set a date for your next scored check, usually a CCSSA form two to four weeks later.
For a full plan see the Step 2 CK study plan, and for which practice forms to use in what order see which NBME to take first.
Working with a tutor before Step 2 CK
Our Step 2 CK tutors start with your CCSE or CCSSA report and your question-bank data, then build sessions on the weakest task and system areas. You work live questions while the tutor checks your reasoning, and the plan is adjusted after every scored form.
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