USMLE Step 2 CK Experience

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. ๐Ÿ™‚ 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. ๐Ÿ˜›

  • 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! ๐Ÿ™‚

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9 Comments
  1. anonymous says

    Thank you for the valuable info! Would you say the UWorld self-assessment was an accurate predictor, and any advice about taking it close to the real exam vs a week before just in case the score isn’t so hot? Thanks!

    1. Rishi says

      Take the UWorld self-assessment (UWSA) a few days before your real exam, relax, and take your score with a grain of salt. It’s not feasible to expect your score to change astronomically with a few more days of preparation. As far as I’m concerned, if you’ve been true to yourself and put forth an honest attempt to prepare for the exam, then you’re ready. The proponents for certain exams (NBME #7, NBME #11, UWSA, etc.) correlating well to the real exam are simply anecdotal and nothing more. Best of luck and thanks for the comment! =D

      1. anonymous says

        Thanks again!! Also a couple other questions about your resources (I’m impressed you still remember down to the specific NBME forms!) – is Secrets something to go through in a couple days for refreshing or does it have a lot of new detail not covered elsewhere? I don’t think I will have time for MTB + Uworld + secrets + my own rotation notes (each about 150 pages) so I am trying to decide if I need to prioritize a new resource (Secrets) and forego 5-6 Uworld sets at the end, or finish uworld entirely/squeeze in the UWSA and skip Secrets. Thanks again and sorry for the nitpicky questions ๐Ÿ™‚

        1. Rishi says

          Not nitpicky at all! Question banks are the top priority above everything else. If you have time, Secrets is a nice “review”, but focus on questions and practice tests above all else. The overwhelming majority of Secrets is already contained in MTB and/or your brain. =D

          1. anonymous says

            Thanks so much again, that really helps! One more question for you (sorry again!), did you find any benefit to doing UWORLD sets in timed mode? I have always used tutor mode because I feel like I need to review the concept immediately so I don’t solidify incorrect reasoning. Unfortunately, this seems to be taking forever and there isn’t as much time as Step 1 to spread out all the sets. Any advice :)?

          2. Rishi says

            Knowing whether or not you got a question right immediately after you answered it provides you with instant positive/negative reinforcement which can indirectly affect your subsequent questions. I did most of my USMLE Step 3 question bank on timed tutor mode and finished sets of 45 questions with nearly half the time remaining; however, whenever I did questions on timed mode, I had far less remaining time.

            Step exams most closely resemble the “timed” mode, so this is what I would stick to whenever possible. That being said, reviewing ALL the questions at the end (both correct and incorrect) is incredibly important to understand the educational objective.

          3. anonymous says

            You have been most helpful, thank you again!! Couple last questions as I approach exam day: any last resources to look through right before the exam, and do you remember what stuff you wrote down on the whiteboard before the exam (if applicable)? Thanks so much again ๐Ÿ™‚

          4. Rishi says

            Maybe review the biostat equations one last time, but other than that, just get plenty of sleep and eat something in the morning. Step 2 CK is and definitely felt longer than Step 1, so test endurance is key. Good luck!!

  2. Jay says

    Hey thanks for sharing your exp. I was wondering what could you suggest one could you use to tackle the next style type questions? Any good book or website?

    Thanks and good luck to you.

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