One of the perils of taking standardized medical exams is the stark contrast between “textbook” and “clinical” medicine. Physicians try to abide by the latest guidelines and evidence-based practices, but this doesn’t always translate to test questions which may have been written months/years in the past. Some of the questions and answer choices on USMLE Step 2 CK certaintly casted doubt on my level of preparation, but oh well, at least it’s over. :-) Similar to my reflection on USMLE Step 1, I wanted to share my experience with this monstrous exam.
PREPARATION
I spent roughly three weeks preparing for this exam by first going through Master the Boards (MTB) for USMLE 2 CK and highlighting things. Then I went through USMLE Step 2 Secrets and annotated MTB with lots of info that wasn’t covered. I proceeded to do all of USMLE World’s question bank (scored 80%) and also annotated key concepts into MTB. My exam was on a Sunday, so two days beforehand, I did UWorld’s self-assessment and the questions posted on the USMLE website. I never did any NBME exams.
TIMING
Each of the test sections are an hour in length regardless of how many questions happen to be in that section. There’s a 15 minute introduction section which demonstrates how to navigate questions, highlight, mark, etc. One can easily skip this and add the extra time to the 45 minute break!
- Introduction: Skipped this section entirely.
- Section 1 (45 questions): Slap – in – the – face. This section was by far the hardest. Took me the full hour. Couldn’t even go back to the questions I flagged.
- Section 2 (41 questions): Another tough section. Another full hour.
Took a 5 minute break to stretch, eat a protein bar, drink some water, and laugh at the kid cramming for his exam in the break room. :-P
- Section 3 (44 questions): Much better! My confidence was renewed. Took the full hour because of two different abstracts.
- Section 4 (44 questions): Practically half this section was neurology. And I learned a lot while doing it. Lots of buzzword-related questions. Took 50 minutes.
Took a 10 minute break to drink more water and walk outside for a minute or two. I needed the sun.
- Section 5 (45 questions): Better. Took 50 minutes.
- Section 6 (44 questions): Best. Took 45 minutes.
Took a 15 minute break. I had developed a pretty nasty headache at this point, so I took some Advil, ate another protein bar, checked the Texans score (because that was way more important), and tweeted the following:
- Section 7 (44 questions): Bestest. Took 45 minutes. My ego pushed me to start the last section without a break.
- Section 8 (45 questions): “It was aight.” Took 55 minutes.
CONCLUSION
Personally, I thought Step 2 CK was harder than Step 1. Maybe because it’s longer? Maybe because I spent less time preparing for it? Many questions placed emphasis on prioritizing steps in a workup. For example, every answer choice was right, except only one was the best “initial” step. I found this difficult at times. That being said, out of the 352 questions, only a handful were topics totally out of left field.
Buzzwords saved me a few times. I found the longer vignettes to typically be easier questions. The multimedia-based questions were very straightforward. And I had an unusual number of questions at the extremes of age (newborns and geriatrics).
If I had one piece of advice – focus on studying less materials but mastering them. Some people want to have a book for each subject, but I really think that’s overkill. Master MTB, First Aid, Step Up, or whatever prep book you prefer. And do tons of practice questions!
Overall, I’m just glad this exam… my last exam in medical school… is finally over. Please let me know if you have any questions! :-)
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