i did moderately well during basic science years (M1-M2), never honored anything, and aside from not passing physiology and having to re-take the exam over the summer, i didn't fail any other courses. step 1, i studied the "standard" 4-5 weeks x10-12hrs a day using Kaplan Qbank and my own review books. that's honestly the hardest i've every studied in my life. I took the test and walking out i didn't feel good about it. my score came back 4 weeks later... 182 = pass by the hair on my chinny chin chin i was hoping to match into an emergency med residency (mildly competetive but increasingly so) and so this was a huge discouragement. ... during 3rd year, i worked hard and changed my study method a little bit. after not scoring well on my first shelf (medicine), i started incorporating questions into my study regimen to a greater degree. ie instead of going through a Pre-Test book 1 week before my shelf and going through a book like Case Files (to supplement reading from other review books like Blueprints- which i never finished for any rotation), i went through Pre-Test 2x and Case Files 2xs before each shelf (this would usually take at least 2 weeks) I'm not advocating either book, they worked for me, but my point is doing more questions helped me perform better on my shelf exams. so when summer pre-Step2 came around, i decided to do massive amounts of questions (USMLE World is definitely awesome) over the course of 6 weeks (time I took off to study for Step 2... IF you need to improve on Step 2, I would NOT recommend only studying the "2 weeks" you generally hear from everyone... that's usually for people who just need to pass. Though taking 6 weeks off between M3 and M4 means you wont finish as early as your peers, we're talking about future career here, so it's worth it). In those 6 weeks I worked through - NMS Step 2 - UW 1.5X - Step 2 secrets 1.5x I then did a 4 week EM rotation and didn't have much time to study, but found that learning EM was helpful because a good amount of Step 2 questions are in the setting of the emergency room (ie "what's your next step in management" types of questions- one EM residency director said up to 30% of step 2 questions is EM related... i don't know if that's 100% accurate, but from experience it seemed that way). I took the next 2 weeks off to go through all the questions I got wrong on UW.. this means I completed UW close to two times. I took the NBME practice test the week before and scored 208. This was a disappointment because I thought I would do much better than that (going in my realistic goal was 220-230 range). I then took Step 2 and was surprised how straightforward it was compared to Step 1. this could be for many reasons 1. it really is more straightforward 2. clinical info is generally easier *for me* to remember 3. i spent 6 weeks preparing .. some of the questions were so straightforward, I was wary if there was some trick. i dont want to give the impression that it's easy or even "easier" than step 1, because maybe it's just that i studied more and clinical info is easier for me to remember all in all, I felt good leaving the test center. my score came back within 3 weeks online (i think it's because my test date was at the end of a testing block or maybe because it was electronically reported and not via snail mail) and i got... 244. i was amazed cause i historically suck at taking tests. in short, i'm still applying EM and interviews are slowly trickling in (i'm expecting them to come in early Nov- which is when most EM interviews are offered). One of the most competetive programs in the city i'm in offered me an interview last week. i thought that was incredible given my step 1 score, and it made me more confident that I would be able to match in EM in the city i prefer. SO.. if u bombed step 1, keep your head up.. work hard during 3rd year, do massive amounts of questions throughout the year and definitely spend more than the "standard 2 weeks" to prep for step 2.