Keys to Acing The USMLE Step 2 CK Exam Tips and Tricks to Get You Through Medical School





Overview

You’re inching your way toward your goal. You’ve completed Step 1 already. Congratulations! Let that small victory take you miles forward. But there is no rest for the weary; Step 2 CK is around the corner. We understand how you must feel which is why we’ve assembled this guide with some of the tactics that worked for us. The Step 2 component of the USMLE is a two-day test, usually taken in the fourth year of medical school. The test is divided into two parts. The first is the Clinical Knowledge or CK section. It is a nine-hour test divided into eight blocks that each take about an hour to complete. One block has 44 questions. These questions test your knowledge about clinical sciences such as surgery, internal medicine, pediatrics, obstetrics and gynecology. The second part is the Clinical Skills or CS section, which requires you to examine and diagnose actors posing as patients is covered in a separate guide.

Study Guidelines It always helps to get an idea of your strengths and weaknesses before you start studying. This can be done either through classes and rotations or by taking an NBME (National Board of Medical Examiners)

self-assessment test online. You can get a breakdown of your score and then start with your weaknesses. Start by reading and learning material; you don’t have to read the entire chapter, instead do questions simultaneously. Remember that learning occurs by thinking through the question, looking at the explanations, reading and digesting explanations, and trying to remember explanations when you go back to the question. Annotating your textbook with notes from the UWorld or other question bank questions is always a good idea.

Essential Resources Textbooks/Online Resources The USMLE Step 2 CK is a culmination of everything you learn throughout the clinical year of medical school, including the knowledge that you learned for the USMLE Step1. There are many good books that you can study to go through the outline of topics covered in medical school but we recommend a maximum of just four resources to remain focused. One key resource is Uworld. The best way to utilize this resource, according to our advisors, is to constantly do questions from UWorld for your shelf exams as well. Because there is a long enough gap

between your Step 1 and Step 2 exams, you can repeat the questions for Step 1 exams. You could either do the questions on tutor mode first, then read explanations, think through the things you got wrong and look at topics you got wrong in other books and on the internet to be able to understand the topics better. Another resource is Step Up for Medicine for Internal Medicine. It does a great job breaking down topics and gives a comprehensive overview of medicine replete with nice diagrams, although it may go into a little detail. For surgery, pediatrics and other areas, Mastering The Boards is a good resource to study from. Some students may feel that OB Gyn is not covered well in Mastering The Boards. If you don’t feel confident enough to study for OB Gyn from here, then for a detailed overview use case files for specific topics. Focus on Step Up To Medicine because internal medicine is more than 60% of the questions. Make sure you brush up on all internal medicine and then brush up on psychiatry, pediatrics and surgery etc.

Mock tests Practice taking tests so you can get more familiar with the structure of the test as well as constantly work on improving your time management skills. Several resources for mock tests exist: • In all, there are 4 NBMEs that cost about $50 each. These can be purchased online and taken in a timed environment. You will also get a score at the end and can then analyze your strengths, and weaknesses again. • Unofficial NBMEs are available online but you don’t get a score for these tests. You will be able to answer questions and go through answers. These tools will not calculate a score automatically so you may have to calculate a score manually. • There is also an official resource put up by the USMLE called the 131 step 2 questions. This pdf can be found online and contains 131 sample CK questions and answers.



Scheduling the test When you’re applying for residency, many programs will want to see the results by the time the rank lists are submitted, in February. Bear in mind that it will take one to two months for the results to come, so plan accordingly. International students need to have their Step 2 score by the time they submit their application to ERAS (Electronic Residency Application Service). In this case, you will need your score back by September 15 instead of February. The kind of study regime to follow depends very much on the type of schedule you already have. There is no specific schedule that suits everyone. The study routine you follow depends on how you are already doing and how far you are. That said, take at least one month to study, depending on your goal score and how you did in the USMLE Step 1 exam.



Key Strategies Time Management: When reading the questions, actively think of differential diagnoses; before you look at the answer choices, you should already have an answer in your head. Train yourself to have a clear diagnosis by the time you reach the answer choices. This helps immensely with time management. Prepare wisely: Be familiar with lab values- You lose a lot of time deciding whether this is a normal value, high or low. In order to save time, learn the normal lab values, and know what it means to have hypernatremia, what are the specific diseases that cause that, what elevated bilirubin levels indicate etc. Many times you can get the diagnosis from the labs, which are very helpful. Don’t ignore Chest X-rays and EKGs- don’t forget about these while you’re preparing. These are often overlooked but note the test checks whether you can identify abnormalities in Chest X-rays, and Step 2 will test whether you can read EKGs.

Practice Find active learning resources; test yourself with questions. The more familiar you get with the format of the test, the better. You should know how the questions are asked, how many questions you will have to answer in 8 hours, and be prepared to manage your time well.



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