How to Study for USMLE Step 2: 6 Tips for Success

Prepping for your USMLE Step 2 exam? Try 200 free USMLE Step 2 CK practice questions from The Pass Machine to help get your USMLE prep on track.

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Studying for USMLE Step 2

Now that USMLE Step 1 is a pass/fail exam, many residency programs will put greater importance on your USMLE Step 2 CK score. Earning a high score on this national board exam will help set you apart from other students and applicants. This article will focus on six tips on how to study for Step 2.

Tip #1: Start Your Study Preparations at the Start of Clinical Rotations

Many medical students often wonder how to prepare for the Step 2 CK exam to get a competitive score. Although the Step 2 CK exam will test you on some basic science questions, the majority of questions are based on clinical knowledge. This is similar to questions asked on NBME practice exams.

In my opinion, the best way to prepare is to begin at the start of your clinical rotations to develop your study strategy. By starting at that point, you will be able to:

1. Develop a good base knowledge that can be easily added to in the weeks to months leading up to the actual USMLE Step 2 CK exam.
2. Use actual patient encounters to “study up” on internal medicine, particular presentations, and disease states. This type of practical and context-specific learning is associated with increased motivation to master the knowledge and increase retention. What you learn is associated in your memory with that actual patient and how that patient’s entire disease progression, including treatment, transpired.

As you progress during your core clinical rotations, take note of the ways your patients’ illnesses and treatments are relevant to important learning points; that could be a focus of Step 2 CK questions by the medical examiners. Take written notes of high-yield facts and important concepts that can be reviewed quickly during Step 2 preparations. Purchase a comprehensive and high-quality question bank to use during your clinical rotations to supplement your studies.

Additionally, beginning early helps you develop a solid study schedule and avoid the need to cram prior to the Step 2 CK exam. It will also help reduce your stress. It also allows you to develop personalized notes/high-yield notes that you can refer to and make studying for Step 2 more efficient and effective.

Tip #2: Determine the Length of Time Needed for USMLE Step 2 CK by Considering These Factors

One of the most frequently asked questions from medical students when studying for the Step 2 exam is, “How long do I need to study for Step 2 CK to do well?” Unfortunately, no single answer applies to everyone. It depends on a number of variables.

First, your success on Step 1 and the shelf exams provides a good gauge as to how well you have mastered the material needed to succeed on USMLE Step 2 CK. Thus, if you have done well on the prior exams while in medical school, you will likely need less time to prepare. However, if you want to improve your score, then a dedicated study period is, of course, necessary.

Second, you must honestly assess how much dedicated time a day or week you can put towards studying for the USMLE Step 2 CK exam. It is common to have multiple obligations during this time, so balancing your study time and other obligations is necessary. But note that dedicating only two hours a day is not sufficient to successfully execute a study plan.

I would recommend a minimum of four to six hours of study time each day with at least an hour of dedicated Step 2 CK exam question review. This will provide you with sufficient time to review large topics. It also sets aside dedicated time for completing Step 2 CK practice tests.

I also recommend reviewing more challenging topics at the beginning, proceeding to topics you have already mastered to refresh yourself on them, and finishing with a return to the more challenging topics at the end. This “starting early and circling back” approach to challenging topics provides you with two benefits:

1. You tackle hard topics at the start so you can gauge early on just how much time you’ll need to master them. They may turn out to be harder or easier than you initially thought once you get into them.
2. By returning to them, you ensure they are fresher in your brain prior to the exam.

In addition, I recommend devising a study plan to accomplish everything in two months, as longer time frames increase the likelihood of forgetting earlier studied topics before the actual exam.

If you do have more than two months to study, use the “circling back” technique to both continue to better learn the hard topics and to keep them fresh in mind. Studies show that repetitive learning improves both mastery and retention.

Also, if there is a large gap between the time you finished your last core rotation and the time of your planned USMLE Step 2 CK exam, it is advisable to set aside more time to study. There will likely be more material that you have forgotten over the longer time period and your pace of studying may be slower.

Tip #3: Develop a Study Plan and Stick To It

Developing a detailed study plan is essential to maximize your time and ensure you cover all the material over the next few weeks is essential. Take a little time before you start studying to evaluate the scope of all the exam material and set realistic amounts of time needed to study these topics. For example, you do not want to assign four hours to a topic that realistically needs eight hours of study time for adequate review. This type of underestimate will only increase your stress levels.

I recommend you visit the USMLE website to review the allotted time, sections, and break times of the exam, as well as the Step 2 CK exam blueprint or content outline. For example, the cardiovascular system makes up 8–10% of the test questions, whereas biostatistics makes up 3–5% of questions. Thus, dedicating more time to mastering the cardiovascular system is a wiser use of your time, especially if you have a tight exam deadline. However, all topics are important and should be given adequate time.

It is important to include review time in each study session/day to look over high-yield topics and your personal notes. In addition, picking one high-yield book can help reduce overlap in studying and prevent wasting time looking through multiple books on each topic.

Finally, do not let yourself fall behind by taking unscheduled study breaks or skipping study sessions. If you find yourself needing more time while studying a topic, rearrange your study plan to accommodate this instead of hastily studying the topic. Also, it is sometimes better to delay taking the exam if you feel you need more time rather than trying to cram the material and go into the Step 2 CK exam half-prepared.

Tip #4: Take Step 2 Shortly after Finishing Your Core Rotations

Taking the Step 2 CK exam within six months of your core clinical rotations is ideal so your clinical knowledge is fresh. This helps minimize the amount of material forgotten.

However, if you are experiencing burnout or exhaustion after finishing your core rotations, take some time to rest and reset your brain. This will ensure that the time spent studying will be more effective and productive. It will also reduce the number of distractions, as it is easier to become distracted if you are not fully engaged in the study session.

Tip #5: Complete as Many USMLE Step 2 CK Practice Questions as Possible

The single most helpful and proven technique to do well on the USMLE Step 2 CK exam is to complete as many practice questions as possible. Picking a large question bank and using it during your core rotations will ensure you complete a sufficient number of questions. Purchasing a second QBank (if your finances allow) to provide you with enough questions is an area where “more is better” is a valid approach.

When answering practice questions, it is not sufficient to just answer a question and move on to the next one. Regardless of whether you answer the question correctly, you should always read and ensure you understand the explanation. If you are not 100% clear on the topic after reading the explanation, turn to other resources to help improve your understanding.

Also, understand why each question’s “distractors” are not the best choice when answering the question. In case you’re not familiar, “distractors” or “response distractors” are the wrong response options provided for each question. When studying for Step 2, reviewing the distractors as well as the correct answers increases the material covered and further enhances your understanding. And remember that practice questions will never be identical to the Step 2 CK exam questions, so memorizing correct questions is an inadequate strategy. You must strive to understand the concept or learning point that the question is assessing you on.

Next, identify the key learning points in the question and explanation and include these in your high-yield personal notes. Note that important learning points include how certain disease presentations, lab results, and prevalence rates differ among different age groups, genders, and ethnicities of patients.

Tip #6: Take Timed Practice Exams

In the tip above, I discussed the importance of focusing on doing practice questions. The approach recommended was to do the questions while in study mode, during a dedicated study period. This means that each question was read and answered, its explanation was reviewed, and relevant notes were taken.

A related but different approach is to complete actual and time practice exams. This is done in a QBank that allows both study mode and exam mode. A practice test is when the series of multiple-choice questions are done in as an exam simulation. In this case you proceed through the series of questions without looking at explanations and while pacing yourself to complete all the questions in the allotted time.

There are many benefits to exam mode. In fact, most students consider the approach “first aid” for USMLE Step 2 CK prep. To summarize:

• Exam mode, by simulating the actual Step 2 CK experience, can trigger the same type of stress and anxiety that often occurs on the real exam. By taking practice tests, you can gradually desensitize to that stress and anxiety.
• Exam mode, especially when it includes the same number of questions as the real exam, can help you gauge your physical and mental fatigue vs. remaining acuity and focus.
• Exam mode, by including the time constraints, helps you gauge your question-answering pace. You can then adjust it if necessary to help you prepare for exam day.

And last, completing a practice exam in exam mode helps you assess your overall preparedness. For example, if you score significantly lower (by greater than 20 points) than your target score, it may be advisable to delay the exam to give yourself additional time to prepare. Then, of course, you have to use that additional time well, so you don’t face the same dilemma as your new date is approaching.

Given the above, it makes clear that the QBank study mode and exam mode are both crucial to your exam preparation. I recommend that before purchasing a question bank you confirm that it provides both modes of exam preparation. (Note that The Pass Machine USMLE Step 2 CK is a question bank that does provide both study mode and exam mode with the click of a button.)

Studying for the USMLE Step 2 CK Exam

The two most important components of studying for the Step 2 exam are to start early and do as many questions as possible, both in study mode (initially) and in exam mode (later in your studies). In the last few weeks leading up to the USMLE Step 2 CK exam, taking self-assessment exams as practice is essential in providing you with a good knowledge base. Developing your own study schedule with high-yield notes can help you better remember these topics, as well as provide you with an excellent resource during your Step 2 CK review. Finally, stick to your plan, with all its components, to ensure more than adequate preparation and get a passing score.

All the best in your studies and on test day.

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