Preparing for the USMLE Step 2 CK [includes a study plan + tips for success]

Today’s inane image of the day:

After I took Step 2 CS, I rewarded myself with a relaxing vacation up in the Bay Area. This is the view from our hotel room.
After I took Step 2 CK/CS, I rewarded myself with a relaxing vacation up in the Bay Area. This was the view from our hotel room.

After I found out my clerkship order for third year, I knew that I would be taking the USMLE Step 2 CK and CS before the start of 4th year. I scored above average on Step 1, but I knew that if I wanted a shot at top-tier residency programs, I needed to improve on Step 2 [I think it all worked out in the end].

My clerkship order was a perfect setup to prepare for the exam – my second to last clinical clerkship was Internal Medicine [the best review for Step 2 CK since I’d estimate that 80% of the exam is medicine-related] and my last clinical clerkship was Psychiatry [which offered a bit more time in the evenings and on the weekends to study]. My track also had 2 weeks at the end of the year dedicated to Capstone [i.e. research], which we could use as we wished. All in all, my schedule appeared to align nicely with taking Step 2 CK before July 1st [the start of M4 year].

By halfway through my second semester of M3, it was clear that something had clicked. Studying for shelf exams became routine and I was doing well on the exams [i.e. honors, which is >80%ile at OUWB]. After also honoring my Internal Medicine shelf exam, I felt confident that I wouldn’t need more than ~2 weeks to study for Step 2 CK. With that, I scheduled CK for June 23, 2014 and CS for June 25, 2014 [CS is a story for another time…].

The best advice I can give on preparing for Step 2 CK is to do well on your third year shelf exams. This is pretty much the same advice everyone gives on studying for Step 1 [i.e. do well on your prelinical coursework], but the caveat is that with Step 2, you need to build your clinical acumen [i.e. what is the next best step]. For some, this comes easier than others, which is why it is important to really understand why. Gone are the days of 1st order questions [e.g. What is the mechanism of X drug?]… get ready to apply all of that knowledge you built up over 3 years of medical school!

I’m a bit advocate for taking Step 2 CK early for the following reasons:

  1. It gets harder to study as 4th year progresses – I promise you.
  2. Unless you’ll be doing a series of Medicine rotations, all of that knowledge you built up during 3rd year will fall out of your head at an exponential rate. And because of what I said in 1., it becomes a losing battle.
  3. Most people do better on Step 2 CK [numerically, at least – remember that the average for Step 2 CK is exorbitantly high… it was 238 my year]. Even if you don’t, at least residency programs have piece of mind that you won’t fail the exam.
  4. Some specialties and residency programs like to see a Step 2 score before they will send you an interview [I know of at least one of my colleagues that received a number of additional interviews when their Step 2 score was released to programs later in the season].
  5. You probably don’t have to buy a new subscription of UWorld because if you take it early enough, you can just reset your 1-year subscription from 3rd year [woot for saving money!].

However, I understand that there are exceptional individuals out there that have super-stellar Step 1 scores and do not want to tarnish this. For those individuals, yes, I agree that it makes sense for you to take it in September or later to ensure that you have a choice on whether or not to release your score. It’s a win-win – if you do better than Step 1, you can release it and blow residency programs away; if you do not improve compared to Step 1, then you don’t have to release the score.

Anyway, let’s get down to the nitty-gritty.

First off, the resources I used [or attempted to, anyway]:

  • UWorld: I purchased a 1-year subscription during my third year and used it as a study tool for every single shelf exam. Because I bought it sometime in July of 2013, it didn’t expire until sometime in July of 2014 – meaning with my June test date, I just had to reset it to make it a “fresh” question bank.
  • Master the Boards – USMLE Step 2 [New Edition is coming out in June 2015]: [Full Disclosure – I still contribute blog entries for Kaplan Test Prep and actually received this book to use free of charge, so take that information as you wish. I do not get paid by Kaplan for anything that I write in my personal blog, though most of my links are Amazon Affiliate links, so I might get a couple pennies for your purchase.] I was skeptical about Master the Boards [MTB], especially with the mixed reviews on Amazon. However, I gave it a try and actually really liked it as a very fast review source for the most basic high-yield facts I needed to hammer into my brain. I generally did review questions in UWorld and wrote in little notes throughout MTB to ensure I remembered key points. Keep in mind, I stopped using MTB once I was in dedicated time – I primarily used it as a slow review source prior to dedicated time.
  • Step 2 Secrets: I swear Step 1/2 Secrets has a cult following. It’s incredible how many people swear by this series! Anyway, I wasn’t convinced for Step 1, so I never used it for that. But with Step 2, I wanted something during dedicated study time that I knew I could finish. Step 2 Secrets fit the bill exactly. I will caution you that in the 3rd edition (the linked version is the 4th edition), there were a couple of mistakes [which, if you catch, is a good gauge of whether you’re ready for the exam or not!]. I hope that they corrected those!
  • NBME Self-Assessments: Like for Step 1, I used these as a gauge of my process and as a way to predict my score… not as a study aid/tool since you do not get the right answers. I will say, my highest score on these self-assessments actually underestimated my real score, so that was a pleasant surprise!
  • First Aid for USMLE Step 2CK: Ok, I legitimately tried to give the First Aid series a try… but it just isn’t designed the same way as First Aid for Step 1. Keep in mind, the Step 2 version reads more like Organ Systems and not like First Aid for Step 1, which is why I abandoned it… too many words, not enough time!

Now, for the Study Plan [links to a Google Document]:

  • The main gist of my study plan is UWorld. “Study” only implies I was reviewing UWorld questions that I got wrong or looking up a concept I didn’t remember.
  • Every night, I plowed through a bunch of pages of Step 2 Secrets. I had more than enough time to finish the entire book in my ~2 weeks of study time.
  • You’ll also notice that I had a lot of other stuff [“Gateway Exam,” “Assembly Day,” random, “Busy” periods] going on during this time. Yes – this does mean that I wasn’t as serious about Step 2 dedicated time as I was with Step 1 dedicated time.
  • I did a “simulated” full-length exam [i.e. took two practice NBMEs in one sitting]. Definitely do this. It’s hard to sit on your butt for 9 hours to take an exam and still function. It’s good to practice test taking endurance.
  • I did the practice test at the Prometric test center. I go both ways on this one – I actually took Step 2 CK at a different testing site than Step 1, so I wanted to get comfortable with the layout, the bathroom and how to get there. This is why it made sense to me that I would shell out some money to take a practice test there. If you’re comfortable with your testing site, this time could be better used doing UWorld questions.
  • What is not shown in this study plan is that I reviewed areas that I knew I was weak in [because I did those clerkships in the first semester] during my Psychiatry rotation by going through MTB and finishing up any questions I didn’t get to during prior clerkships [this way, when I reset my qbank, I actually had zero unused questions and had seen every single one of them at least once].

Some of my colleagues took a month off to study, while others did something similar to what I did. Some of my colleagues prepared by doing a Medicine Sub-Internship prior to taking Step 2 [they seemed to recommend that as beneficial]. In general, you have to do what’s best for your individual situation.

Current fourth years – did I miss anything? What questions do you lovely readers have for me?

29 thoughts on “Preparing for the USMLE Step 2 CK [includes a study plan + tips for success]

  • April 13, 2015 at 7:21 pm
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    study plan link doesn’t work!

  • April 21, 2015 at 11:59 am
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    Sorry about that! It’s fixed now! =)

  • May 19, 2015 at 5:16 pm
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    thanks for the tips! hope you’re doing well in the transitional year!

  • May 19, 2015 at 10:34 pm
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    Thanks! I’ll be starting my TY on June 29th, so at this point I’m trying to enjoying my time off as much as possible! Let me know if you have any questions about prepping for Step 2. =)

  • June 6, 2015 at 10:57 pm
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    Would you prioritize getting through Uworld a 2nd time or taking NBME practice exams? I will be done with Uworld the first time through before my ~10 days dedicated study time (with other school stuff the other days). I’m not sure whether to try to fit in NBME blocks or just simulate a test with 8 Uworld blocks (though it’ll be my 2nd time through in a relatively short amount of time, so I’m not sure it would be a good representation of the actual test day).

  • June 7, 2015 at 12:51 am
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    Hey! Thanks for stopping by my blog!

    I actually found that my Step 2 NBME practice exams did not correlate well with my real score, so personally, I would focus on really getting through UWorld for a second time before test day. Definitely try to stimulate the 8 blocks straight at least once just so you can get back into the swing of taking a ridiculously long exam (I would try to do this at least 1/2 way through your study time so you feel like you’ve covered a pretty substantial amount of material and you’re sufficiently far away from the actual test day that it won’t burn you out). Map out how many questions you have to do each day to finish it completely within 8-9 days (I wouldn’t study hard the last day or two and just focus on reviewing questions/concepts you got wrong or know you’re weak in). If possible, try to pick something else up that you can read quickly (e.g. Step 2 Secrets) and highlight key concepts/facts that you feel weak in just so that you can quickly flip through it the day or two before your test. At the end of the day though, UWorld and applying your critical skills to clinical questions are the most important resources for the exam. Good luck!

  • July 14, 2015 at 1:56 pm
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    What was your step 2 ck score? at least the ballpark? without knowing your score, it’s hard to trust the recommended plan, no disrespect to your hard work.

  • July 18, 2015 at 2:36 pm
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    I am willing to say I got 250+ on Step 2.

  • July 18, 2015 at 3:11 pm
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    That’s good enough for me 🙂
    Thanks for sharing your experience.

    Will greatly appreciate if you could comment on this plan for a 2m study.
    I am an IMG:

    Must Read)
    Diagnostic test: Kaplan Diagnostic
    Comprehensive book: MTB 2 CK (main study text)
    Question bank: UWorld + NBME CS Mastery Series
    Self-assessment: UWSA + NBME CCSSA (3,4,6,7) + USMLE practice material

    Should read)
    Comprehensive: USMLE step 2 secrets
    Pathophysiology: Goljan Audio
    Surgery: Pestana’s Surgery Notes
    High yield: Conrad Fischer Comprehensive Cases

    Nice to read (only if weak in a topic after above)
    Medicine: Step-Up to Medicine or Kaplan internal medicine
    Other topics: MTB 3
    Other topics: Kaplan lecture notes
    Ethics: MTB Medical Ethics – 100 cases

  • July 30, 2015 at 5:30 am
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    Hello! I find your blog very interesting. I would like to know what do you think about kaplan bank, so I can do it before UW. I also will like to hear from you a couple advices of how to prepare all areas besides IM (My strength is IM, in the other ones I dont seem to be good according to my recent NBME). Thank you!

  • August 23, 2015 at 11:41 pm
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    I’m currently in the beginning of my third year and I’m done with surgery and halfway through IM. My last two rotations are OB and then peds. I’m worried that by the end I’ll have forgotten all the IM material, be tired from peds (it’s the field I’m planning on going into) and I’ll have to take an exorbitant amount of time to study. Do you think that peds prepares you at all for step 2 or will I be pretty much starting from scratch at the end of 3rd year?

  • September 12, 2015 at 7:48 pm
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    Sorry for the radio silence! I’m responding to this just in case others had a similar question – basically, yes I’d agree with that breakdown of “importance” for materials. I’m not sure how helpful the Kaplan Diagnostic is (could be demoted), however the rest of those resources are definitely required. I am not familiar with a couple of the Kaplan resources you listed (e.g. Kaplan Internal Medicine, Medical Ethics, Conrad Fischer Comprehensive Cases), so I cannot really make a recommendation on those.

    Good luck!

  • September 12, 2015 at 7:51 pm
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    Hi! Thanks for leaving a comment. Kaplan’s Qbank definitely hits on some high-yield topics so if you feel like you need to drill them into your head more, it can be helpful. If you don’t have much time or if doing Kaplan’s Qbank would result in not having enough time to finish UWorld, then it’s not worth it.

    If your last NBME showed that you need some help on the other non-IM subjects, focus on those questions in Kaplan then move on to UWorld.

    Good luck!

  • September 12, 2015 at 7:55 pm
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    Great question! Because the NBME shelf exams tend to be a bit redundant at times, I think that you’ll end up remembering a good amount of IM. However if I were in your position, I would probably give myself a little extra time to make sure that I review Internal Medicine concepts/questions. Since IM is such a substantial part of Step 2, I would be sure that I’m confident in that area before taking the exam. The OB & Peds clerkships really don’t give you exposure to the IM topics that they typically ask on the exam.

    Good luck!

  • October 18, 2015 at 9:13 pm
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    Two quick questions:

    1. Any recommendations on the order to do NBME and UWSA practice exams in?

    2. Any ideas where we can find correct answers for questions we get incorrect on these self-assessment exams?

  • November 1, 2015 at 6:42 am
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    hey,
    I have a very similar study schedule going- love annotating Secrets !
    by chance, what was your UW score average? I cant seem to gauge myself in terms of what is a good UW percentile. Currently, i’m averaging 70-73% but I’m only half way through my first round. I’ve heard we should hit 80% to be comfortable for the real exam…any thoughts? much appreciated!

  • November 8, 2015 at 3:02 am
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    Hey! Thanks for stopping by and leaving a comment!

    Unfortunately, I really don’t remember what my UWorld average was. I primarily went off of my practice NBME scores to gauge my progress, which I believe to be a relatively accurate predictor of your score. Wish I could be more helpful there – sorry!

    Amanda

  • November 8, 2015 at 1:36 pm
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    Hey Katie!

    Sorry for the delay – I’m answering just in case you were curious or if future readers are.

    1. The smaller the NBME number, the older it is. The older it is, the less representative it is of the real exam. So for NBMEs, make sure that if you’re using them to gauge your progress that the newer ones are done closer to your test date. UWSA practice exams are really just extra questions for you to use – don’t use them as a prediction of how you’re doing. Personally, I would take the newest NBME closest to your test date and do UWSA when you run out of questions.

    2. I tried to find correct answers earlier on in my studying and found it to be futile because I’d just run into discussion boards or question the validity of the answers I found. Hours of valuable study time passed and I still didn’t learn anything – so, I recommend *not* buying the extended version NBMEs and just taking them, looking at your strengths and weaknesses and move on. Unless you have months on end of time to study, this is not a good use of your limited time.

    Amanda

  • November 19, 2015 at 2:37 pm
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    Hello .. i want ur advice .. Can i finish preparing for step 2 ck in 2 months. . i Had step 1 2 months ago and i want to take the exam on January ..

  • November 22, 2015 at 11:42 pm
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    Thanks for stopping by the blog!

    Depending on your clinical experience, Step 2 CK is definitely doable in 2 months. If you haven’t had much exposure to NBME-styled clinical questions, I would make sure to do plenty of practice tests and focus on UWorld. With clinical experience, it’s much easier to tackle Step 2 – you’ll find that the questions are much easier than Step 1 since it isn’t verbatim memorization.

    Good luck!

  • January 19, 2016 at 7:05 am
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    Any suggestions regarding USMLERX Qbank? Is it worth going through for step 2? Or is it just a waste of time?

    Thanks in advance for all of your excellent advice!!!

  • February 6, 2016 at 12:24 pm
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    Hey Karen,

    Thank you for your comment! I did not personally use USMLERx Qbank at all for Step 2 and haven’t heard too many people that have. I used Kaplan’s Step 2 Qbank a little bit… but it didn’t feel like a great use of my time so I stopped. Most of Step 2 is internal medicine, so make sure that you’re solid there (open Step Up to Medicine if you need to!) and you should be all set for the exam. =)

    Good luck!
    Amanda

  • April 12, 2016 at 7:14 pm
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    Amanda,
    would you recommend studying 8-10 hours a day or more 12-14 hours
    i’m looking at 10 weeks to write step 2 ck

    thank you

  • April 12, 2016 at 7:16 pm
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    also, the FA you’ve mentioned in the study plan
    is that first aid for step 1?
    How do u recommend going through the step 1 first aid material

    is it mandatory , and some changes have been made to step 2 this year

    how do u recommend a student prepares for this

  • June 11, 2016 at 9:37 am
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    Hey Karen,

    My apologies that intern year got the best of me! I’ll respond to this in case anyone else has a similar question – for Step 2 CK, I used Master the Boards (Step 2) primarily but I know that First Aid for Step 2 is comparable if you like the format. I did not review much Step 1 material since CK is mostly clinical. I know that every year they say they are making “changes” to incorporate more basic science/translational material, however I do still believe that using the question banks and at least one book is enough (assuming you did well on clinical clerkships and really understand the material you studied).

    For your earlier question – the number of hours you study depends on your strengths. If you do better with less hours, then do that and spread it over more days. If you think you can focus for 12-14 hours then lucky you! I definitely could not focus for that many hours, so I made my plan as reasonable as possible to try to account for what I was actually capable of.

    Good luck!
    Amanda

  • June 25, 2016 at 10:02 am
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    Hello Amanda,

    I think my original post didn’t post properly so I apologize if you receive two of these. But I just wanted to ask if you could clarify when you read mtb? Was that during your dedicated two weeks of study time? Or before then? I have about 3.5 weeks of study time and I was planning to read mtb, secrets, and do uworld questions. If I find myself tight on time, which of the two books would you recommend dropping? Thanks so much! Also, did you read by sections and do mixed question sets or did you do questions by topic?

  • July 25, 2016 at 5:20 am
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    Hey!

    My apologies for the delay – I’m pretty sure you’ve taken Step 2 by now (if so, congrats on being done) so I’m answering this for historical purposes. I read Master the Boards primarily during my dedicated time (I might have started a bit earlier just to try to catch up on topics I had covered earlier in the year), however some of my colleagues annotated it throughout the year with UWorld. With 3.5 weeks of dedicated study time (and truly just focusing on studying), you should be able to get through both books. I recommend dropping the book you’re least likely to finish – the reality is, most of these books have the same information so as long as you get through an entire resource, you will do well.

    I did sections and tried to do some questions by topic in the beginning. I started randomizing the blocks as I got closer to my exam.

    Good luck!
    Amanda

  • January 10, 2017 at 9:57 am
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    Hi Amanda, thanks so much for your blog. It’s very helpful!

    I’m an IMG from Spain and I want to take the USMLE next year.
    Right now I’m finishing my 6th year (we do 3y of Basics and 3y of Clinics). Since after my 3rd year I hadn’t decided on taking the USMLE, I didn’t do back then the Step 1. Right now I have the feeling that all that is too far in my brain and I need more time to study for Step1. That’s why I’ve decided on taking first the Step 2CK + 2CS, since it’s more fresh in my mind. I also thought that Step 2CK counts “less” for residency application (theoretically??) and doing that one first, will allow me to be more familiar with USMLE-style, and therefore, do Step 1 better & more comfortable.

    1. Do you think this is a good idea?
    2. Do you know any source/website where I could download any of the study material / QBanks you’ve recommended?
    3. Would you mind telling me how long did you study for Step 1?
    4. Do you know any IMG that has gone through the same process that I will go, and could give me some advice?

    Thanks again so much!!

  • August 7, 2017 at 1:51 pm
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    Hi Ines!

    Thanks for stopping by the blog and my sincerest apologies that it has been over half a year since I had a chance to reply to comments. I’m going to answer your question in case anyone else is in a similar situation.

    1. Taking Step 2CK + CS makes sense if you have done well on shelf exams (or if you’ve purchased the NBME ones to simulate our shelf exams – I highly suggest saving the Internal Medicine ones as practice for the real thing since a substantial majority of Step 2 is Internal Medicine).
    2. I purchased all of my resources, however I know that if you speak to your classmates or make very targeted Google searches, you can sometimes find PDFs of resources. I do not personally condone this strategy as it is stealing from the authors that spent a lot of time and energy to create the resource in the first place.
    3. You can visit my Step 1 study plan page to get details on how long I studied for Step 1.
    4. I’m sorry, I’m not close to any IMGs that have gone through a similar process but do believe that if you stumble across any via Student Doctor Network or other blogs, you may find a few to reach out to.

    I hope this helps and good luck!

    Amanda

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