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Step 2 CK Advice:
Hello everyone. After posting responses to other people’s questions, getting several private messages asking for advice on how to study for CK, as well as requests for me to post a Step 2 CK Advice thread, I’m going to make a detailed public post about how I did it.
Please note, this thread is not geared for everyone. This is a thread for people looking to do well, but may be pressed for time, are feeling lost, or are just overwhelmed by the number of posts saying you have to do UWorld two or three times to do well. Doing "well" can mean a variety of things - someone who wants to get a 260 may not be happy with a review by someone who was happy to earn a 245. So if you are a person looking for a 260+, this review may not be for you.
If you are someone who is happy to get a 230+, are not a gunner, and are looking for realistic doable study plan, then this article may be of use.
I also made a post about Step 1, which can be found here:
http://forums.studentdoctor.net/threads/step-1-taken-august-2014-used-dit.1128357/#post-16343848
My background:
I am an American-born, English speaking IMG from a reputable Caribbean medical school. When took this test I was near the end of my third year of medical school with three months of rotations to go until fourth year (and no time off to study).
Step 1: 235 (Passing score at the time was 192)
Step 2 CK: 245 (Passing score at the time was 209)
Step 2 CS: Passed on first attempt
Match 2016: Matched on first attempt to my number one choice.
Resources Needed:
So I’m going to keep your resource advice simple. In my humble opinion, I think the only two resources you need for CK are UWorld, and Step 2 Secrets. I’ll tell you what I did and you can make your own opinion from there. At the end of the post is my pre-test day and test-day advice.
Conditions Surrounding my Studying:
When I took my CK I had finished all my core rotations except for Surgery. I started studying for CK at the beginning of my 3-month Internal Medicine rotation, and took CK at the end of internal medicine (the same week as I took my IM shelf). So all the material was pretty much new to me when studying for CK unlike other people who may have had IM at the beginning of 3rd year and so had already done UWorld one time for their shelf. Before starting CK studying I took an NBME. Man – that sucked. I think I got a 176 on it. Not a great way to start out. But not terrible either considering I hadn’t ever done any IM questions. So from there I knew I had my work cut out for me and was determined to stay positive and improve!
My Study Style:
Although I hadn’t done any of the IM or Surgery questions, I did reset my Q-bank at the beginning of IM (because I had already burned up my Peds, OBGYN, and Psych questions). After resetting the Q-bank I did UWorld ONCE through (with about 600 questions left undone and unseen before the exam – oh well). I am slow at questions. But that’s ok! Because that’s MY style. Other people might be able to burn through 150 questions a day, but I can’t do that. I can at most get through 50 questions per day. But I make a point to really KNOW those 50 questions and understand why every answer is right or wrong. Step 2 CK focuses on presentation of diseases and pattern recognition. So if you make a point to really learn from the questions you do have time to do, you will probably be fine. But don’t lie to yourself and say “I did 100 questions today, I’m a boss”, when really you just skimmed through them to be able to feel good about your day. That’s pretty much a waste of your time and questions. Don’t be afraid to go slow and learn at your own pace.
Keeping this in mind, you might wonder how I was able to do this during IM with no time off, and get a 245 while seeing this all for the first time. Well, it helps that I had a strong foundation in Step 1, however this didn’t make Step 2 CK a walk in the park. It only helped with my confidence. To be honest, CK was much harder for me than Step 1. This is because with Step 1 I was able to only do DIT with First Aid, memorize memorize memorize, and do the exam, with basically no question practice. Step 2 CK is more vague, the treatment guidelines are always changing, and there wasn’t ONE good book resource that I could rely on.
Resource Reviews:
So I’ll spare you the agony of trying different resources and tell you what I did, starting with a section on resources I didn't like, followed by a section on resources I loved and how I used them.
**Resources that I did NOT find useful***
Books I hated: I tried Step Up to Step 2 CK, and Master the Boards. I hated both of those books. They were outdated, not comprehensive, a waste of money (in my opinion). You’re better off using Up To Date to look up things you’re confused on from UWorld. UWorld is THE most comprehensive and THE most updated single-study resource for CK. Do not even try to argue this and try to make life more complicated than it needs to be. This is fact. I read both books and they both sucked.
Programs I tried:
I don’t feel like getting a “background” with a study program really helped me all that much. My score only increased 30 points in the first 5 or 6 weeks of studying with a program, whereas it jumped 40 points with questions in less time. I think my score would have increased even more if I had started just with questions. I gained SO much from questions it isn’t even funny.
--DIT (useless). You might be surprised, since I absolutely loved DIT for Step 1. I had read many reviews about how sucky it was, but was convinced by another student I knew to try it. However, as I suspected based on the reviews I’d read, it was pretty much useless (even as someone who was seeing the material for the first time). The style of the program isn’t helpful for test day. I’m the type of person that when I see something I know on a test, I remember where I learned it from. On Step 1, I felt like everything I saw was from DIT. On Step 2 CK, I felt maybe two questions were from DIT. Not hyperbole, that was my experience.
--I also tried Kaplan High Yield based on another’s suggestion – which SUCKED EVEN MORE than DIT. Absolute waste of time and money – DON’T DO IT. They just skim over topics, with outdated information. It is by no means comprehensive and you will waste your valuable study time with it. I think zero questions I answered were answered from this resource.
****Resources worth your time and money****
--UWorld -
First off is my question-reading technique. When I get a question, I read the last sentence of the vignette, and go from there. Sometimes the last sentence is all you need to answer the question, and the previous 10 sentences are a total waste. So do yourself a favor and save yourself some time and energy and start with the last sentence. Also, reading the last sentence first allows you to understand what they're looking for so that when you read the vignette your mind is searching for pertinent details instead of getting lost in the fluff and having to read vignettes twice which is a colossal waste of time if you don't HAVE to do it. Not saying I didn't read some vignettes twice, but if you can avoid it on the majority of questions that's awesome. And if you can save a minute by only reading the last sentence and answering on that, then that really adds up - and you WILL need the time. I did this for every practice question, as well as for every question on the real test.
If you read my Step 1 Study advice, you’d know that for Step 1 I wasn’t about the UWorld show. But for CK, UWorld was legit and is the only reason I got a 245. If I could do it over again, I would ONLY do UWorld, on timed-tutor-random or even tutor-random. Why not use a book? Because this test is about pattern recognition, so if you get really good at understanding HOW diseases present, you will be at an advantage. And diseases can present differently so the questions help you recognize these subtle differences. Another main point is that this test isn’t really asking “what disease is this?” It’s asking “what is the first line/second line/ third line treatment or test for this?”. Meaning you need to know what disease it is without them flat-out telling you, and you also need to be good at knowing what is the gold standard treatment or test, and when other non-first line treatments or tests would be indicated.
Something I liked to do while using UWorld. For very complex and hard to understand concepts, I would take notes within the program, which was helpful in my last days of studying. I would make a briefs summary in my own words, and then when you’re ready you can generate a list of all your comments. If you really keep it to things you struggle with, it will be a nice concise review of tricky topics.
Other than that, I did not take notes. UWorld has many redundant questions. Plus I figured if I spent the time trying to understand the topics rather than writing my own textbook, I’d get through more material and more questions which worked well for me.
I get asked: Why tutor mode and not just timed non-tutor blocks of 44?
Well I varied between timed tutor vs untimed tutor depending on the day, but I always did it on tutor. For me, tutor was great because the immediate emotional response of yes, I got that right, or crap I got that wrong, helped me really focus on the answers and figure out why things were the way they are. That style helped things stick and that’s why I did well on CK. And even though I didn’t get through the last 600+ questions, it didn’t matter because I still got a 245 and felt prepared on test day.
I also get asked why I chose random mode (and not systems-based) when seeing things for the first time.
On my first few sets, I had initially started with systems-based (i.e. respiratory) but I wasn’t retaining well. So I switched to random and voila things started sticking and making more sense. Considering the test is not systems-based blocks (i.e. not 44 questions of respiratory in a row), it can’t hurt to learn on random mode too. But to each is own and I have to say things connect in ways you’d be surprised. The body is connected so you need to look at the body that way, and approach this test as a doctor and not just a test-taker. Something that affects the lungs may very well have a renal component, and learning to recognize these things outside of a systems-based approach worked well for me.
--UWSA (self-assessment) – I took this 5 days before my exam. Got a 252 (just like I got on Step 1 UWSA). Ended up with a 245 on the real deal CK. This is a good practice test because you get the answers to the questions which is great if you have the time to go through them. I personally didn’t have the time, so I didn’t get to do that but I would have liked to, and I think it would be very helpful when you get close to your real test.
--Step 2 Secrets – this is a great resource for the last few days before your test. It is a relatively small book but VERY high yield. I only had time to read about 40 pages and had at least 10 questions from it. It has some minor errors here and there, but if you’re noticing those errors, it means you’re ready for the test. Keep in mind this book isn’t to teach you or act like a textbook, it’s to remind you of all the thousands of little details you may have forgotten on the way to understanding the “big picture”. This book is also all you need for the Statistics questions. This is not an exaggeration. I was able to answer all the stats questions with this. It’s all you need for that. And it’s also great for Acid-Base. I wish I’d had more time to read it since I know I could have done even better if I had. To have 10 questions from 40 tiny pages is awesome. I only had one or two days to read it and 40 pages was the best I could do. You can buy the book on Amazon.
Summary:
I’d just do UWorld and Step 2 Secrets, which was my initial plan anyway.
If I could do it over again, I would not waste my time with ANY study programs or books (other than Step 2 Secrets). I would immediately start with UWorld on tutor mode, random order. The real questions are VERY similar to UWorld and I felt well prepared. The software is identical as well.
I would have stopped UWorld a week before my exam, in order to take my UWSA a week before my test, and have time to review those questions.
I would read Step 2 Secrets in its entirety (probably would take me 4 days to really absorb it) in the days leading up to the exam. I would take that book to my rotations as well and read it in your spare time.
I have no doubt if I had only done these things, my score would have easily been 250+ on the real deal. Unfortunately I wasted about the first month and a half on resources and study plans that I was convinced to try (by people who ended up scoring less than me), until I finally returned to my original plan, which worked well for me and improved my score immensely. Start with UWorld, understand the content, and you will do great. Don’t get spooked by people who try to convince you to do things that you aren’t comfortable with. Which includes this advice. If you feel like you absolutely need additional resources, then go ahead and do that! You are in control of your studying and you have your own unique brain. So use it to make your life and your studying the best they can be!
Day Before Exam and Test Day Advice:
I took a full day off before the exam. Taking a full day off was immensely helpful to me on both Step 1 and 2CK. Having the rest at that point is far more valuable than any neurotic last-minute cramming you will get done. This test is LONG. You will want to be rested. Avoid YOLOing the day before. You have the night after the test to celebrate.
One thing you should definitely do before the exam if you can manage it, is to watch the tutorial about how the software works on the USMLE website. You get 15 minutes on test day to do this, but if you don’t use up these 15 minutes, they get added to your break time which is FANTASTIC. You can access this tutorial on the actual USMLE website, but you have to use a PC so if you don’t personally have a PC, watch it at the hospital or something.
On test day, be sure to bring water, Gatorade, easy to eat snacks (my food of choice was Balance Bars), and ibuprofen for the headache you may get. Earplugs, extra coffee, Tums in case you get a rumbly tumbly. I tried to space my breaks out to one after every two blocks. I had to pee SO bad after the first block from all the coffee and water I’d had that morning so my breakdown went like this:
Block 1
Break
Blocks 2 and 3
Break
Blocks 4 and 5
Break
Blocks 6 and 7
Break
Block 8
DONE
Side note, when I didn’t take a break between blocks, I still gave myself a mental rest and sat for a good minute or two at my computer desk. I’d close my eyes, breathe, and refocus before moving on to the next block. Make sure if you had a rough block, you don’t let that anxiety follow you into the next block. You have to tell yourself that you are 100% correct 100% of the time. Negativity will not get you ANYWHERE on this exam! Don’t give up!
I was seriously pressed for time on almost every block, but I was able to answer every question. On my last block I think I had about 12 questions left with 10 minutes to go so I had to go rapid fire and I think I still answered them pretty well. When in a pinch, read the last sentence of the vignette, and see if you can answer from that. Work with what you’ve got! Better than leaving things blank or literally randomly guessing.
So there you go. Those are my Step 2 CK study opinions. I hope my review will help some of you! Please feel free to comment/PM me with any questions you may have. Best of luck!
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And I didn't feel that using a book along with UWorld was helping me to be more efficient. I felt that it was slowing me down.
