Above all, ensure you are in a good state of mind. This post is late for people in this current step taking cycle, but hopefully may prove useful for next year. This is a very personal post, but I hope my story might help one or two people and give hope to anyone who may find themselves in a similar situation in the future. I took my step two exam in October hoping to get it out of the way early in the year. The only problem was that when I had scheduled my date, my sister who had been diagnosed with grade 4 liver cancer, had been doing well. The month prior to my scheduled date, she had been admitted for what we all knew was probably the last time. To cut to the chase, she died four days after I sat for the exam. In retrospect I realized how completely unable I had been to concentrate on anything, much less sit for an 8 hour exam. But I took it in a fog and promptly failed. After getting the results I knew were coming I spoke to our dean of students and set up a strategy to study for my next go around. I knew I was capable and not as "dumb" as my score seemed to show. I studied my butt off for four weeks and then waited for what seemed an eternity... Then last week, I got my results: 241/97! I had gone from failing miserably to doing quite well. The take home messages are 1. ensure you are emotionally ready, and 2. if the worst happens, take heart and talk to people you trust to help steer your next effort. Good luck to anyone who may have had a similar experience.