Is Step 2 the new Step 1? And, is good Step 2 prep good Step 1 prep?

[TotallyKyle49]

Trying to determine how much time and energy I want to dedicate to board prep v.s. in-house exams. My curriculum is P/F.

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[whataweirdo]

Was also wondering about this. From what I’ve heard, studying hard for Step 1 gives you a solid foundation for Step 2 material as there is some overlap. However, others (such as M3s I spoke with at PSCOM) are completely disregarding Step 1 material and going all in for Step 2. Personally, I’m going to study using solely 3rd party materials for my in-house exams in order to pass Step 1 easily and be better prepared for Step 2 material.

 

[sloop]

I took these exams like 7 years ago, but with that caveat I would say that I recall Step 2 having a significant amount of overlap with Step 1. They are definitely the most similar Steps. Step 3 is different because of heavy clinical emphasis and the weird clinical simulation portion while Step 1/2 are pretty similar. Step 2 definitely tested a lot of Step 1 concepts, just in more of a clinical context.

I did well on both of these exams and I definitely think doing well on Step 1 (or in this case, just learning the material well) is an important foundation for Step 2. I also think that the “focusing on in house material vs boards prep materials” issue is a false dichotomy. Unless your school really sucks, doing well in class should be preparing you for both of these exams.

My experience was that my school’s exams tested on more detail than was provided in any of the board review materials. You have to recognize that almost everybody who studies for these exams uses some combination of the same sources and they all focus on knowing these sources cold. These are standardized exams, so doing this will only get you so far. Like most standardized tests, most people will know the answers to most of the questions. Your ability to distinguish yourself rests on you knowing answers to questions that all of the other people using the same sources won’t. I think this is where the value is in doing well in class. My experience was that most of the people who largely disregarded doing well in class to “focus on Step” were just doing this as a way to rationalize their performance because they found comparing themselves to their peers very stressful.

My school collected internal data on this over several years. They looked at the resources people used to study, etc. along with grades. The only things they found to be significantly correlated with performance on Step 1/Step 2 were Step 1 score (in the case of Step 2) and grades.

 

[Lucca]

I took these exams like 7-8 years ago, but with that caveat I would say that I recall Step 2 having a significant amount of overlap with Step 1. They are definitely the most similar Steps. Step 3 is different because of heavy clinical emphasis and the weird clinical simulation portion while Step 1/2 are pretty similar. Step 2 definitely tested a lot of Step 1 concepts, just in more of a clinical context.

I did well on both of these exams and I definitely think doing well on Step 1 (or in this case, just learning the material well) is an important foundation for Step 2. I also think that the idea of “focusing on in house material vs boards prep materials” issue is a false dichotomy. Unless your school really sucks, doing well in class should be preparing you for both of these exams.

My experience was that my school’s exams tested on more detail than was provided in any of the board review materials. You have to recognize that almost everybody who studies for these exams uses some combination of the same sources and they all focus on knowing these sources cold. These are standardized exams, so doing this will only get you so far. Like most standardized tests, most people will know the answers to most of the questions. Your ability to distinguish yourself rests on you knowing answers to questions that all of the other people using the same sources won’t. I think this is where the value is in doing well in class. My experience was that most of the people who largely disregarded doing well in class to “focus on Step” were just doing this as a way to rationalize their performance because they found comparing themselves to their peers very stressful.

My school collected internal data on this over several years. They looked at the resources people used to study, etc. along with grades. The only thing they found to be significantly correlated with performance on Step 1/Step 2 were Step 1 score (in the case of Step 2) and grades.

very much agree with this.

Also, although this year will be a little weird cuz of timing, based on what graduating students are being told this year we should all fully expect that every single specialty will want a S2CK score prior to ERAS starting not this but next match cycle and onwards. Basically everyone expected this, more or less, but I think its 100% confirmed now. In other words, while in previous years many students would postpone S2CK until post ERAS submission, everyone will need to perform on the exam.

Although it's kind of just semantics, I don't really agree with the "step 2 is the new step 1" phrasing though. It is, in the sense it is a scored exam that will be used to distribute residency interviews. But it isn't for a lot of other reasons, most importantly that you have Step 1 and Step 1 prep as basically a lower-stakes "dry run" for S2CK. Correspondingly, the difference between the Avg S2CK and Max S2CK is much narrower than it was for S1; in other words, people tend to do much better on the test and there is less room for "score screep" as the test exists right now, and finally while it was mixed whether or not people were able to do some clerkships prior to step 1, now everyone will have several shelf exams and clerkships under their belt before they get to S2CK dedicated. These are all opportunities for you to prepare for the test

 

[AzBasRad]

Short answer, yes! As long as there's a scored Step scores, residency programs will continue to use it as convenience metric/ filter.

Strongly agree with the above - good step 1 prep sets the foundation for good Step 2 CK prep. This means understanding physiology/ pathology, micro, immuno well enough to understand dx/clinical questions CK tests on. However, also note that now you don't have to know the basic science minutiae like paroxysmal storage disease etc.

If your inhouse exams have shadow grades used for AOA determination, then it will be important to do well in them. Otherwise, concentrate on passing comfortable, and focus on research/making connections w/i your preferred field.

 

[voxveritatisetlucis]

There is less variance in step 2 scores

Hopefully they try to get more variance

 

[aldol16]

Step 2 will be the next Step 1 in the coming cycles. Step 2 prep will become more intense and scores will get pushed higher/it will be harder to achieve the same scores with the same amount of work.

 

[bGMx]

I've noticed that many of my AnKing step2 questions are common sense because I studied for step 1 hard. It wouldn't work the other way around i.e. the foundations learned for step 1 allow you to answer higher order step 2 questions. Answering step 2 questions wouldn't allow you to understand the foundations.

Unfortunately, step1 pass/fail doesn't mean you get to work less hard. I think it's quite the opposite (rat race is now during clerkships where you must study AND perform clinically). It does take off the pressure during step1 dedicated, which is huge.

 

[Ho0v-man]

I took these exams like 7 years ago, but with that caveat I would say that I recall Step 2 having a significant amount of overlap with Step 1. They are definitely the most similar Steps. Step 3 is different because of heavy clinical emphasis and the weird clinical simulation portion while Step 1/2 are pretty similar. Step 2 definitely tested a lot of Step 1 concepts, just in more of a clinical context.

I did well on both of these exams and I definitely think doing well on Step 1 (or in this case, just learning the material well) is an important foundation for Step 2. I also think that the “focusing on in house material vs boards prep materials” issue is a false dichotomy. Unless your school really sucks, doing well in class should be preparing you for both of these exams.

My experience was that my school’s exams tested on more detail than was provided in any of the board review materials. You have to recognize that almost everybody who studies for these exams uses some combination of the same sources and they all focus on knowing these sources cold. These are standardized exams, so doing this will only get you so far. Like most standardized tests, most people will know the answers to most of the questions. Your ability to distinguish yourself rests on you knowing answers to questions that all of the other people using the same sources won’t. I think this is where the value is in doing well in class. My experience was that most of the people who largely disregarded doing well in class to “focus on Step” were just doing this as a way to rationalize their performance because they found comparing themselves to their peers very stressful.

My school collected internal data on this over several years. They looked at the resources people used to study, etc. along with grades. The only things they found to be significantly correlated with performance on Step 1/Step 2 were Step 1 score (in the case of Step 2) and grades.

Agree with one caveat.

A lot of the “focus on Step” crew who lets grades slide are not necessarily the types who are grinding through all of relevant BUFAPS for each block, doing a question bank, and keeping up with all of their anki reviews from previous blocks. That group typically watched sketchy micro and pathoma the week before the test and carried around a copy of FA they bought at orientation but never opened until January of second year. They did mediocre in class because they weren’t grinding hard at either class or boards. No surprise their meh grades correlated to a meh board score.

The folks who did all of the above and just crammed the school specific minutiae right before the exam typically did really well on both.


It’s pretty hilarious that the people who just took this exam p/f probably think the above is insane. It was the norm two years ago.

 

[Captain_Falcon]

Agree with one caveat.

A lot of the “focus on Step” crew who lets grades slide are not necessarily the types who are grinding through all of relevant BUFAPS for each block, doing a question bank, and keeping up with all of their anki reviews from previous blocks. That group typically watched sketchy micro and pathoma the week before the test and carried around a copy of FA they bought at orientation but never opened until January of second year. They did mediocre in class because they weren’t grinding hard at either class or boards. No surprise their meh grades correlated to a meh board score.

The folks who did all of the above and just crammed the school specific minutiae right before the exam typically did really well on both.


It’s pretty hilarious that the people who just took this exam p/f probably think the above is insane. It was the norm two years ago.

Yup I was the guy who studied everyday for all of preclinical with keeping up on all of my Anki reviews. Eventually i stopped paying attention to all of class material even if it meant dropping a question or two on an in house exam. We eventually switched to NBME tests so once that happened I never looked back.

The grind has continued m3 year for Step 2

 

[sloop]

The folks who did all of the above and just crammed the school specific minutiae right before the exam typically did really well on both.

This probably depends on your school and their exams. This wouldn’t have worked well for many of the exams at my school, for instance, because all of our first year exams had an essay portion that composed a significant portion of your overall grade. Most of the boards resources are geared toward recognition rather than rote recall. That is, if you do questions and get the right answer, for the most part that is good enough. Yes you can and should review the answers to make sure you know the concepts but the strategy is different.

For my first year exams, a lot of my prep was drawing out pathways from memory and drilling down concepts to the point that I could teach them to my study partners without referencing notes. This is kind of what you need to do when you might have to write an essay explaining immunity complete with every relevant cytokine or explain what would happen in cardiac physiology given certain parameters.

Even though the essay questions were obviously not at all like boards questions and required a different strategy, I actually think they really helped to form a great foundation for boards. When you have learned concepts so solid that you can explain them coherently in granular detail, you’re basically golden when it comes to multiple choice. If there was a question about a concept that came up on an essay question, there was no uncertainty or hesitation and I was able to just pick the correct answer immediately, completely forget about that question, and move on. Had I not done that type of prep, even if I might have gotten the right answer on the multiple choice question, I might have spent more time, I might have felt the need to flag the question, and I might have spent precious time reviewing a question I actually got right rather than spending that time on the questions I actually got wrong.

 

[MDMechEngr]

Do schools with 1 to 1.5 year preclinical curriculum have an advantage because they start clinical rotations early and will have taken all their shelf exams before taking S2? I heard they bumped the passing score for S2 by 5 points. It will probably get harder for stratification and eventually go pass/fail too, but not for a while.

 

[Captain_Falcon]

Do schools with 1 to 1.5 year preclinical curriculum have an advantage because they start clinical rotations early and will have taken all their shelf exams before taking S2? I heard they bumped the passing score for S2 by 5 points. It will probably get harder for stratification and eventually go pass/fail too, but not for a while.

Most students regardless of preclinical length take all of their shelves before step 2

 

[Lawpy]

Trying to determine how much time and energy I want to dedicate to board prep v.s. in-house exams. My curriculum is P/F.

Focusing on in house exams is the ideal move

 

[voxveritatisetlucis]

Especially if the school does junior AOA

AOA > Step

 

[TotallyKyle49]

Focusing on in house exams is the ideal move

Just found out my school does not have NBME exams, has internal rankings, and Junior AOA. So it seems like doing well on in-house exams would be more beneficial than grinding hard for a P/F exam. I can't help but be a little disappointed because I think the workflow of watching BNB/Pathoma, unsuspending AnKing cards, and using qbanks would be ideal for me. Would I still be able to incorporate these resources somehow? I'm not a huge fan of making my own Anki cards.

 

[Billiam95]

Just found out my school does not have NBME exams, has internal rankings, and Junior AOA. So it seems like doing well on in-house exams would be more beneficial than grinding hard for a P/F exam. I can't help but be a little disappointed because I think the workflow of watching BNB/Pathoma, unsuspending AnKing cards, and using qbanks would be ideal for me. Would I still be able to incorporate these resources somehow? I'm not a huge fan of making my own Anki cards.

Use 3rd party resources to figure out the big picture and what's NBME important, then fill in details with in-house lectures.

I would posit that it is incredible important to keep up with AnKing, as there is just too much NBME information to learn in a dedicated period that is not covered in in-house lectures. The greatest gift you can give yourself is to be passing NBMEs at the start of dedicated. Although step1 is now P/F, it is not easy to pass! A lot of my classmates cruised through MS1/MS2 due to pass/fail step1 and are now struggling to pass practice exams even at the end of dedicated.

 

[Hzreio]

Focusing on in house exams is the ideal move

Why?

 

[aldol16]

Step 2 is just different from Step 1. It's not even only the content. It's that your experience going into those exams is so drastically different. People take Step 2 after completing most of their clinical rotations. People take Step 1 after completing none of their clinical rotations (some exceptions exist). So when you take Step 1, you're relying on your memory of what you've read or seen in UWorld only. When you take Step 2, you also have the benefit of having seen patients being managed and perhaps even managing some patients yourself. That sort of experiential learning does wonders for your memory.

So you can't really compare them directly like that.