About this time last year, I was wrapping up my third year rotations and beginning to think about studying for my second Step exam. There are three Step exams that every doctor-in-training in the US takes – creatively titled Step 1, Step 2 and Step 3. The first is taken between second and third year. The second, divided into two parts, is taken between the third and fourth year of school. The third is taken after graduation.
The two parts of the Step 2 exam are the Clinical Knowledge (CK) portion, a multiple-choice exam, and the Clinical Skills (CS) portion, a practical-style exam where you are filmed interacting with standardized patients.
Now let me say this first (and I’ve told every third year student who will listen) – I feel like I took the exams wayyyy too far apart! I took CK in early July and then CS in early October. I wish I would have taken CS in August sometime.
The next important thing to know is that Step 2 CK studying is nothing like Step 1 studying. For starters, you’ve been prepping all year by taking shelf exams. You’ve seen patients and scenarios played out in real life, so this makes the exam easier to prepare to take. You’re used to the question format and style. Passing all of the shelf exams sets you up for great success with Step 2 CK. Want further proof it’s more chill? I had an elaborate, color-coded Excel spreadsheet for Step 1 study and a handwritten, partially followed calendar for Step 2 CK.
I was fortunate to end my third year on my psychiatry rotation, which is fairly non-demanding. There are no night shifts and you only work one weekend. This left me time to start my studying during this rotation and then take the exam shortly after the end of the rotation. I was on a “study month” for all of July, so this gave me three bonus weeks of travel (and ain’t nobody mad about that).
Resources: UWorld was the primary resource. I used it throughout third year and reset it approximately six weeks before my exam. I figured out the reset date by dividing the number of questions by 80 (the amount I would do each day), then counted back from the exam. My other resources were Master the Boards and USMLE Step 2 Secrets. MTB is just okay, but I had already used it for my internal medicine shelf, so I was familiar with the content and format. Secrets is GOLD and I highly recommend it. I also took two practice tests from NBME, the people who make the test. They were pretty close to the score I got on the actual exam.
Here’s my schedule! I was still on rotations through June 16, and then we had a three day in-person toxicology course the following week.
As you can see (hopefully; I’m not sure how much sense my calendar makes), I did two sets of forty questions each day from UWorld, spending time going through each one. I did 22 pages (or one to two chapters) from Master the Boards each day. For Secrets, I started to read some each day, and then decided it was best done closer to the exam. I read it all in the five – six days leading up to my test.
This schedule left me plenty of room to do other things! If there was a day I didn’t get two question sets in, I could do it the next day. I took my birthday off, as well as three days for a bachelorette party. Studying certainly could have been condensed into about two and a half to three weeks if needed.
How about the actual test? Well, I came down with a raging case of strep pharyngitis the day before the exam and still did the expected 15-20 points better than Step 1. Maybe because it was less pressure or I had done it all before, but this felt easier than the first time.
For Step 2 CS, which I had to take in Houston, there was much less structure in regards to studying. I read through First Aid for USMLE Step 2 CS in the two weeks before the exam. I’m pretty sure my class only owned a few copies as a whole, and we kept passing them around until we all took the test. My school also does a mock exam and gives us feedback. We’ve also been talking to patients and creating plans and workup all year long, so this is just a standardized version of that.
My advice for success:
-Take the two exams closer together than I did! I felt like I had to review diagnostics and differential diagnoses more since I waited so long.
-The Secrets book is GOLD. That and UWorld could really be all you need for CK study.
-Take a deep breath – you’ve got this! You’ve been preparing for it all year long. It’s just one more step on the way to being a docta.