Anxious about studying for Step 2 without dedicated time

[Latteandaprayer]

My school is a 1 year preclinical. As an M3 now, I have completed my core clerkships. I am taking Step 1 early this December, and Step 2 early February. I was stupid (please don’t just focus on this) and took all my dedicated time for Step 1 only, because our deans and counselors strongly encouraged this, because a lot more students failed last year after taking less dedicated time for Step 1. I got scared and did what they suggested (6 weeks dedicated for just Step 1, none for Step 2). Too late to do anything now except control what I can.

January I will need to do some clinical rotation. I can choose an elective, a SubI, or do my Emergency Medicine rotation. I’m thinking I might do EM in January and use whatever time I have to study for Step 2, as well as study for it in December after Step 1. For reference, my Shelf scores ranged from 70s (FM and surgery) to low 90s (Psych, OBGYN). IM, Peds, and Neuro were in the mid 80s. Not stellar but also not terrible since all my scores were well above my cohort’s averages.

Do you have any recommendations of how else to do this? I wish I split up my dedicated times, but again I can’t change the past and I acted on the advice of counselors and the deans.

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[GoSpursGo]

The answer is choose a very light elective. For example, at my med school back in the day it was well known that you could leave certain electives around noon if you weren't going into that specialty, and people would strategically put that elective either right before step 2 and/or use it as a chance to get research in. Surely there is something that would fit the bill at your school, or even an explicit research elective where you can ostensibly be working on some crappy retrospective chart review for a few hours a day and then study the rest of the time. The answer is definitely NOT to do a subI. While the idea of shift work like EM may be tempting you're not going to get any studying done DURING your shifts and your studying may not be best if you're moving between day and night shifts so I would also find that to be non-ideal.

As an aside, it's not clear that you were stupid to follow their advice. Failing step 1 is much, much worse than scoring below your goal for step 2. And as you said, you can't change the past, so it does you no good to continually beat yourself up over the decision--you weighed the risks and benefits and arrived at a reasonable choice, so own that choice and figure out how to succeed for step 2.

 

[Latteandaprayer]

The answer is choose a very light elective. For example, at my med school back in the day it was well known that you could leave certain electives around noon if you weren't going into that specialty, and people would strategically put that elective either right before step 2 and/or use it as a chance to get research in. Surely there is something that would fit the bill at your school, or even an explicit research elective where you can ostensibly be working on some crappy retrospective chart review for a few hours a day and then study the rest of the time. The answer is definitely NOT to do a subI. While the idea of shift work like EM may be tempting you're not going to get any studying done DURING your shifts and your studying may not be best if you're moving between day and night shifts so I would also find that to be non-ideal.

As an aside, it's not clear that you were stupid to follow their advice. Failing step 1 is much, much worse than scoring below your goal for step 2. And as you said, you can't change the past, so it does you no good to continually beat yourself up over the decision--you weighed the risks and benefits and arrived at a reasonable choice, so own that choice and figure out how to succeed for step 2.

Thanks for that advice, I’ll see what electives might be “easier” and go from there.

I actually posted this question on Reddit first and literally all the comments were about how stupid I was to not allocate time for Step 2 dedicated, how I shouldn’t have listened to my advisor, and that I set myself up for failure. Not a single response actually had advice… So I just wanted to get it out of the way that I recognize maybe I should’ve done something else and maybe I am an idiot, and maybe I should’ve posted on here before deciding my schedule, but there is literally nothing I can do about it now at all. Just wanted to make sure the discussion could stay focused on advice rather than “shoulds” and calling me stupid lol

 

[Billiam95]

How have you been doing on shelf exams?

 

[Angler]

a lot more students failed last year after taking less dedicated time for Step 1

It really is amazing how much the MD pass rate for step 1 fell from 2021 to 2022 (the first year for P/F). The pass rate went from 95% to 91%. This is almost a doubling of the fail rate from 5% to 9%. Going back to 2013, it looks like the lowest pass rate was about 94%. In 2020, the pass rate was 97%.

USMLE Data

Students shouldn't blow off Step 1 cuz it's P/F!

 

[DO2015CA]

Most people don’t have dedicated for step 2. You will be fine

 

[LunaOri]

Pathology is a nice quiet elective

 

[mrbreakfast]

Came to give advice but this thread is so high-yield that everything I was going to say has already been said:

-Most med students have zero dedicated for step 2
-If you want some dedicated time, the standard approach is to take a "chill" elective (e.g. few hours/day) beforehand
-EM is typically not a "chill" or useful study elective
-The traditional "chill" elective is pathology, but radiology is also a good choice. Ask around, people at your school will definitely know

 

[ciestar]

Most people don’t have dedicated for step 2. You will be fine

My school gave two weeks. It was more than enough if you do well with your rotations and score well on shelf exams.

People saying take it on a light elective are spot on. This advice also stands for step 3. I wasn’t about to use my vacation time to study for step 3 lol

 

[ciestar]

Pretty wild that so many schools didn't adjust to the change given how important it is for applications. Forcing people to take useless electives instead of studying doesn't seem very productive. My school started giving 2 months for step 2 and it improved the average score.

I mean, I took step 2 in 2019 so things may have changed since then. I have no idea now

 

[DO2015CA]

I mean, I took step 2 in 2019 so things may have changed since then. I have no idea now

True mine was also when step 1 was scored. But saying that, even with no dedicated, our scores increased 20+ points usually. So I mean study hard for step 1 and it should still translate to 2

 

[ciestar]

True mine was also when step 1 was scored. But saying that, even with no dedicated, our scores increased 20+ points usually. So I mean study hard for step 1 and it should still translate to 2

I did terrible on step 1 but manage to score about 35 points higher on step 2. I did well on my shelf exams so it greatly helped on step 2 since you’re legit preparing for it the entire time.

 

[Mr.Smile12]

I actually posted this question on Reddit first and literally all the comments were about how stupid I was to not allocate time for Step 2 dedicated, how I shouldn’t have listened to my advisor, and that I set myself up for failure. Not a single response actually had advice… So I just wanted to get it out of the way that I recognize maybe I should’ve done something else and maybe I am an idiot, and maybe I should’ve posted on here before deciding my schedule, but there is literally nothing I can do about it now at all. Just wanted to make sure the discussion could stay focused on advice rather than “shoulds” and calling me stupid lol

Just tell everyone SDN >>> Reddit. 🙂

 

[Mr.Smile12]

Pretty wild that so many schools didn't adjust to the change given how important it is for applications. Forcing people to take useless electives instead of studying doesn't seem very productive. My school started giving 2 months for step 2 and it improved the average score.

Nothing forces a curricular change like a higher-than-expected fail rate... 😉