USMLE Step 2 CK: How to Ace the Test. Advice from an Expert

We sat down with Dr. Amy Chen, a MedSchoolCoach tutor and expert on the USMLE Step 1 and 2 exams. We asked her for some advice for students who are currently preparing for the USMLE Step 2, specifically how students could ace the exam! Included below are also very helpful USMLE Step 2 CK references for our students.

How should someone best prepare for the USMLE Step 2 CK exam? Are there any resources that you suggest? Is there any schedule that one should follow?

In terms of resources, I don’t think it’s necessary to have too many resources. There’s a lot out there. You could potentially study from 5-7 different resources. I’d suggest keeping your number of resources down to 3-4 just because it can focus your concentration.  I’d say UWorld is definitely the #1 Resource. That is 100% necessary and definitely key to really learning a lot of information. Another resource I really like is Step Up to Medicine. This has a detailed overview of Step 2 CK for internal medicine topics. I think it does a really great job of breaking down the topics and the key information you need to know for each different disease. It also has a lot of nice diagrams and information. It does go into a little bit of detail but I do think it gives you a comprehensive overview of internal medicine. For the other topics like surgery or pediatrics, I think Master the Boards is a good resource to use. I would use Step Up to Medicine for internal medicine topics. Some people find OB-GYN is not covered very well on Master the Boards. If you’re struggling with OB-GYN and you would like a more detailed overview of the subject, I would recommend Case Files’ OB- GYN for that particular topic.

Alright. Is there any specific way you suggest studying from these resources? Would you suggest looking at the topics first and then answering questions? Or is there another way? 

Yes, I think before you start studying, it’s good to get a sense of your own weaknesses and strengths and to kind of start studying from your weaknesses. You can identify those multiple ways. Some people already have a handle just from their classes and their rotations, about what they maybe strong in or what they don’t do so well in. Or you can take an NBME and kind of get a break down of your score. So I would say, start with your weaknesses and start with kind of reading and learning the material. I actually like to do the questions simultaneously with the material. I don’t think you need to finish reading a chapter before you start doing the questions. I think there’s a lot of learning that occurs just from looking at the question and looking at the explanation and really kind of reading and digesting and trying to remember the explanations; then go back and annotate on your textbook the notes from the UWorld questions.

“I think before you start studying, it’s good to get a sense of your own weaknesses and strengths and to kind of start studying from your weaknesses.”

Is that the same way you studied?

Yes. That’s the same way I studied for them. I would focus on Step Up to Medicine because internal medicine is such a big part of the exam. It’s more than 60% of the questions. So I would start there. Make sure you brush up on all your internal medicine topics. Feel comfortable with that and then you can go on and branch out to other topics like pediatrics, psychiatry and surgery and so on.

Great! Then, are there any other mock tests you suggest taking?

Yes definitely. There are 4 NBMEs available. You can buy them – I think they’re like $50 each to buy them online. That way, you can take them in a timed environment and it gives you a score at the end. Otherwise, if you don’t want to buy them, try googling to see unofficial NBMEs. You can get the questions and the answers but the disadvantage is you don’t really get a score at the end. It doesn’t score automatically. You have to score it yourself. But NBMEs are a must. They’re great at assessing your progress. There’s also the 131 Step 2 Questions booklet. It’s a PDF that can be found online. It’s an official resource put out by the USMLE with 131 sample CK questions. Those are also good to go through for practice and they give you the answers as well.

Is there anything one should keep in mind while scheduling the test? 

I don’t think there is anything in particular you have to keep in mind. I think it depends on when you’re applying for residency. Many residency programs will want to see that CK score back by the time you rank in February; by the time you submit your rank lists. Keep in mind though that it can take a month or two for those results to come back. You want to take it with enough time that your results are back by the time your rank list is due in the year you’re applying to residency. Other than that, there isn’t too much scheduling consideration you need to do. It depends on the individual person and when they’re freest in their schedule. I want to say you want to give yourself at least a month to study, but ideally more than that. But it depends on what your goal score is and how well you did on Step 1. But ideally, you’d have some time where you wouldn’t be studying as well with an intense rotation.  Also, if you’re an international medical student or foreign medical student, you do need to have your Step 2 score by the time you apply; so by the time you submit your application. For that you would need your score back by September 15, instead of February.

That’s good information. Would you suggest any schedule that students should follow? 

I think it really is student-dependent. I think it really depends on how they are already doing and how far they are away from their goal score in terms of studying. But as I said, you need at least a month to prepare for it and ideally more time.

That makes sense. What’s the best advice you got for the USMLE Step 2 CK? After taking it, what do you think you could have done better? And what would your suggestions be based off of that?

I have a couple of ideas of what’s helpful to keep in mind while studying for Step 2. One of the things that’s really challenging for many people is time management. You only have a certain amount of time to answer each block of questions and it’s very easy to get bogged down and then run out of time by the end of each block. The way I encourage people to approach their questions is, when you’re reading the question, you should be actively thinking of differential diagnoses. By the time you reach the end of the question stem, you should already have a most likely diagnosis in your mind before you even look at the answer choices. I don’t think it’s advantageous to look at the answer choices first or read the question and look at the answers and think about the diagnosis. I think you end up using a lot of time in trying to go back and reread the question and so on. Be able to train yourself to have a clear diagnosis by the end of every question because that helps a lot with time management. Also, be very familiar with the lab values. You can lose a lot of time if you always have to go and check if this value is a normal value, if it’s high, or if it’s low. If you can do a good job of learning the normal lab values, that will also save a lot of time. You should know what does it mean when someone has hypernatremia, what are the specific diseases that could cause that? What does it mean when someone has elevated gluten levels? A lot of the times you can get the diagnosis just from the labs. They’re very very helpful. Being sure that you feel comfortable with EKGs and chest X-rays – those are often overlooked but Step 2 will test you on whether you know how to read an EKG and can identify abnormalities in X-Rays. Don’t forget about those as well while you’re studying.

Is there any other advice you’d like to give?

Practice is really important. So just practice as much as possible. Practice with the UWorld Question Bank, practice with your NBME exam. Try to find resources out there that encourage active learning so that you can test yourself with some questions. I think that’s really the key. Get used to the format of the test and used to how the questions are asked; get used to time management and just get used to answering this many questions in 8 hours essentially.

 



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