USMLE Step 2 CK Advice
The United States Medical Licensing Examination (USMLE) Step 2 CK (Clinical Knowledge) is a 318-question, 9-hour test that medical students take some time after they’ve completed their third year of medical school. [Yes it’s even longer than Step 1.] With the recent announcement that Step 1 will be transitioning to a pass/fail test rather than a numerical score in the future, many are hypothesizing that residency program directors will be placing even more emphasis on your Step 2 CK score. I personally think this might be a good thing for medical students’ sake, because Step 2 CK is much more patient-oriented and clinically applicable compared to Step 1 which is mostly basic science knowledge.
Some of the study advice I shared about Step 1 applies to Step 2 CK as well. There are still a lot of resources available to medical students to study for Step 2 CK, though not quite as many as Step 1 in my opinion. My number one piece of advice still stands: your priority should be doing what works best for YOU, and it won’t be the exact same as what works for your peers.
For me personally, due to the COVID-19 pandemic, Step 2 CK ended up getting cancelled and rescheduled 3 times, which was extremely stressful. I wasn’t alone, medical students all over the country were facing the same thing, but it definitely didn’t minimize how taxing that was. That being said, in reality my study schedule had a few more pauses in it than I initially planned, but I’ll share my advice leaving that aside.
How studying for Step 2 CK is different than studying for Step 1
First and foremost, I’d like to try to comfort medical students by saying that studying for Step 2 CK, and even taking the exam, is much more tolerable than Step 1. Studying basic science facts that aren’t always immediately applicable to patient care was extremely difficult for me on Step 1. However, the questions for Step 2 CK are always clinical, always centered around a patient and the decisions a physician should be making, and for many students including myself that is much easier to focus on.
Second, an important thing to note is that Step 2 CK definitely builds directly off of the content from Step 1. You’re still being tested on microbiology, pharmacology, etc., the difference is that now you’re expected to take things one step further and apply decision making directly to a patient case.
Step 2 CK generally requires less “dedicated study time”, and most medical school curriculums reflect that. For me, the biggest chunk of studying the material found on Step 2 CK truly happened on my rotations during third year. I was happy to find that the knowledge stuck much better than I expected as I got to learn around real patients. There were multiple times as I took Step 2 CK where I knew an answer, not based on flash cards or practice questions I had done, but because I had seen a patient with the disease in the question stem. I outlined how I studied during rotations in a previous post, so if you’re still going through your third-year rotations I’d suggest checking that out in addition to this post.
My Resources
Resources from Step 1 studying:
In my opinion, there are less resources for medical students for Step 2 CK compared to Step 1, but this is a good thing. It also makes sense because arguably, if you wanted to review some of the things found on Step 1 you could refer back to your Step 1 resources. That being said, one of my resources was my own notes from Step 1 studying.
During the first 18 months of medical school, as I was learning all of this information for the first time, I created personal study guides in Notability for each organ system. I definitely referred back to those often as I studied for Step 2 CK, and even still I’ll look back on them during rotations. I also referred back to my old Sketchy notes (those cartoons truly stick in your brain so well).
TZanki Step 2 CK Deck:
I completed this deck of flashcards during my rotations in third year and this helped immensely in getting a foundation of important concepts for Step 2. I honestly didn’t keep up on my “reviews” throughout my dedicated study weeks, but if you can I would definitely advise staying on top of the reviews.
UWorld Question Bank:
This was by far the most important and useful resource for Step 2 CK studying. The UWorld practice test I took less than 2 weeks before my exam ended up being within 5 points of my actual score. This varies by person, but overall I think their practice test has good reviews on being a good predictive tool.
Before COVID messed up my schedule, I had planned to complete the UWorld question bank by the end of my third year rotations, or about a week after. Since my schedule got changed, I also had time to go through a good chunk of the questions I had gotten wrong on the first pass (approximately 700-800). Many people are able to do 2 passes of the questions, as UWorld will allow you to reset your progress once. My advice if you’re doing some of the questions you got wrong previously is to treat them like brand new questions. Don’t try to think about what answer you might have chosen last time, because then it quickly gets confusing and you’re not truly treating it like a new set.
I studied from UWorld in a similar way as I did with Step 1.
My general approach: Reading the last sentence of the question stem, and skimming the answer choices will help set you up for focusing on the right information as you read the rest of the stem. I used the highlight function pretty heavily, and also the strike-out function for crossing out answer choices I knew were wrong right away. The highlights and strike-outs would help me know later if I was focusing on the right information/had the right thought process when I initially saw the question.
The thing that makes UWorld so valuable in addition to the questions themselves are the explanations that follow every question. I would definitely spend the most time reviewing questions that I got wrong, but I at least briefly reviewed all of the questions to be sure I also focused on questions that I might have gotten right by guessing.
I used Notability to take hand-written notes from the UWorld Descriptions, which I organized by specialty. UWorld also has a flashcard function, so making flashcards in their program of the facts that you get wrong or with their really useful tables/images is also a great idea.
Amboss:
I used Amboss after I had completed UWorld and I wanted to practice with additional questions. I did like their set up because you can click on different topics within the questions and a summary page would pop up right next to it. For example, if I got a question on one of the Parkinsonian-related disorders, I could click on the term Parkinson’s within the description, and Amboss’ summary page on Parkinson’s would pop up right next to the question. This feature made Amboss unique and very useful. I know many students utilize their other functions such as flashcards, I just personally didn’t get experience with those.
High Yield Review Videos:
One of the last things I did before test day was watch high yield review videos from YouTube. I used both Dr High Yield’s Videos and the famous Emma Holiday Videos.
The last few days
The last few days are often a little weird to plan. At least for me, I always feel like I know what I’m going to know at that point so close to the test. So here’s a picture of my schedule the last couple of weeks leading up to the exam:
The day before the exam, definitely don’t study! I think it’s useful to get up early so you’re tired that night, and for me getting outside and hiking is always perfect before something stressful.
I hope this was helpful! Please feel free reach out and ask questions, and good luck in your studies!