Indomethacin's Step 2 CK Journal

[indomethacin_]

Hey everyone, I am an IMG originally born in the U.S. I recently took my Step 1 exam for the first time on December 18th 2014 and passed with a score of a 244. It was around 10 points lower than my NBMEs and self assessments probably due to exam day stress and silly mistakes, but I am very thankful for the score.

I had originally made a thread here and studied for about 7 months, it says a bit more about me:
http://www.prep4usmle.com/forum/thread/119013/

Obecalp was a huge inspiration to me on prep4usmle forums, and pholston has been a huge inspiration for me from sdn.

I wanted to make a Step CK journal because my last journal helped me tremendously in making sure I was doing a lot of work everyday.

I started my Step CK studying on December 19th 2014. (That's right, I was so depressed walking out of the Step 1 exam that I decided to start studying for CK right away. lol)

I finished MTB 2 by the end of december and bought the Rx Qbank in the beginning of january.
The first block I scored 87% all mixed, but it was downhill from there where I would score 54% or even lower.

Most of January I got distracted from studying and was doing minimal work everyday. Sadly I was unable to finish Rx qbank, and was still scoring in the 70% zone.

I just recently started my family med rotations being my first set of rotations on Jan 26th, so I do not have much clinical experience when it comes to answering CK questions.

I am 300 qs away from finishing Rx qbank and I have a current overall of 69%. Unlike my previous step studying, for step 2 ck prep I just read through the wrong answers and did not make notes on my mistakes. I think this was a mistake because I am tending to get the same things wrong twice from Rx qbank. However for Kaplan qbank and UW I will go back to what I know works for me and make notes on anything I don't know from the qbanks.

I also am watching the Kaplan CK videos, and I do feel they are helping since I lack the clinical experience, but they are taking up way too much time even at 1.5 speed.

I took a 4 block Rx simulation yesterday and scored 65% or Rx Predicted USMLE of 219. From experience Rx overpredicted my USMLE score of 82% overall in Step 1 by 22 points. It said I would get a 266, so I know that I am probably sitting around a 200 USMLE scale if not a tad lower for Step 2 CK. So I was really disappointed about that, but I know I am capable and will do much better.

I plan to write my CK exam by the middle or end of April, and my goal is to score a 260+.

Materials to use
1.) MTB 2 (Read once, on second read now)
2.) Rx Qbank (Almost completed)
3.) Kaplan Qbank (Yet to complete)
4.) UW (Yet to complete)
5.) NBMEs (Yet to complete)
6.) UWSAs (Yet to complete)

Have yet to purchase MTB 3, FA CK, and uptodate.

obecalp from prep4usmle is the person whos template I used to study for Step 1, and he recommended FA CK for step 2. So I am considering buying it along with MTB 3. I have read pholston's pdf for step 2 ck and will definitely look into up to date. For step 1 all qbank notes went straight into FA, along with print outs of nbme mistakes and what not.

So as of right now I am making MTB 2 the main book where all my qbank notes, kaplan video notes, and management notes are going in.

Today I am going to read the FA CK pdf for peds, and then do all remaining peds questions in Rx to see how I score with FA CK information. Most of my recent block scores have been 68%-77%, but I know with the next qbanks I will do better.

Will update later, it is an honor to finally post here after lurking for over a year.

---

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[rahulmbbs]

D1stant said it the best..hardly can add anything
Just again the same wishes for you ,
Hope to display the same motivation as you do .

 

[indomethacin_]

Thank God for everything; Step 2 CK PASSED 249!
Would have liked higher score, but I am very thankful for the grade that I have been given.

Just wanted to share with you guys. The work I've done and my grades.

NBME 4
3/1/15
NBME Scale 330
USMLE Scale 202

NBME 3
4/2/15
NBME Scale 440
USMLE Scale 225

NBME 6
4/16/15
NBME Scale 470
USMLE Scale 231

UWSA
4/23/15
Scale 610
USMLE scale 242

NBME 7
4/30/15
NBME Scale 500
USMLE Scale 237

Free 131
5/1/15
88%

Test Day
5/3/15
Real Deal 249!

 

[noxe]

Congrats man!

 

[Fatalis]

congrats!
So based on your experience, what resources were the most helpful?

 

[indomethacin_]

congrats!
So based on your experience, what resources were the most helpful?

MOST HELPFUL SOURCES and the ONLY 5 sources I recommend:
1.) FA Step 1 & Medical School Step 1 knowledge material as reference.

2.) UW2, do that 2-3 times. Read ALL explanations AT LEAST TWICE. Read ALL educational OBJECTIVES AT LEAST 3 times.
This is coming from someone who is not a genius. So if you can read it once or twice and get it, more power to you.

3.) Clinical Mastery Series and Self Assessments.

4.) MTB 2 CK (Since all of my UW, NBME, Clinical Mastery Series, and UWSA notes were in it) and MTB 3 was also helpful for me a tad since I am a relatively new to clinical rotations. Also throw in Pestanas Surgery Notes.

5.) Pholston's PDF (Probably should give this a thorough read once or twice before you even start studying.)


THIS IS AN EXTENSIVE SUMMARY OF WHAT I DID, I USED A TON OF RESOURCES IN THE FIRST MONTH OF MY PREP WHICH WAS NOT NECESSARY:

Sources I used:
1.) MTB 2 & MTB 3
2.) UW qbank
3.) Rx qbank
4.) USMLE Step 2 Secrets
5.) First Aid Step 1
6.) Pestana's Surgery notes
7.) Clinical Mastery Series
8.) NBMEs & UWSA

How I studied:
1.) Read MTB 2 twice, finished Rx qbank, and then took my first NBME and failed it.

2.) Started UW along with reading MTB 2 third time and reading MTB 3 for the first time. Made notes on anything I did not know and anything I found important. Read ALL explanations even for the ones I got right I put all notes into MTB 2.
Took my second NBME, score went up 25 points.

3.) Read MTB 2 third time and MTB 3 second time and repeated UW again without taking notes and just reading explanations. Took third NBME score went up 5-10 points.

4.) Did all Clinical Mastery Series questions 100 qs a day in 6 days. Took a picture of all questions and made notes directly into MTB 2. Took another NBME score went up 5-10 points.

5.) Reviewed all educational objectives in UW and then took UWSA.
6.) Reviewed weak areas and took NBME 7 five days before exam, and Free 131 from USMLE website day before my exam.
DO WHAT WORKS FOR YOU, AS LONG AS YOU CAN REMEMBER, UNDERSTAND, AND RECALL THE INFO, THAT'S ALL THAT MATTERS.

Exam experience:
- Only had 1 drug ad with 3 questions, super long and super hard. Was in my 7th block of 8 and felt like I got uppercut to my face. But I was thankful it was just one drug ad.
- A lot of immuno. Review FA Step 1 immuno chapter.
- Know how the presentation, management of diagnosis, management of treatment, and pathophysiology of stress, urge, and overflow incontinence.
- Know the rinne and weber tests for conductive and sensineural deafness and know examples of things that can cause the two different types of deafness.
- 40-45% OF MY EXAM FELT LIKE STEP 1 RECALL!
- Know all of the leukemias
- Know the childhood bone disorders of congenital hip dysplasia, osgood schlatter, and leg calves perthes disease.
-Know guidelines for PPD & HPV.
- Know all options for contraceptions and in which scenario they are indicated.
- NO BIOCHEM questions on my exam.
- 1 or 2 Chromosome Genetics questions on my exam.
- A LOT of biostat questions with number needed to treat, bias types, and study types.
- Xray differentiations of pneumothorax, from pleural effusion, etc.
- Know the effects of maneuvers on the heart sounds.
- Felt harder than all NBMEs, but felt closest to a mix between UWSA and NBME 7.
- Know risk factors and preventions for major types of cancers such as ovarian, endometrial, lung, thyroid cancers.
- Know the difference between basal cell and squamous cell carcinoma location on the face.
- Know the bone tumors such as osteochondroma and how it looks on xray vs how osteosarcoma looks on xray.
- Know the side effects of ALL drugs of abuse and drugs in the psych chapter of MTB. Lithium, Cocaine, Benzodiazepines, Marijuana etc.
- Know how to manage acute HAV infection, is it supportive care? Immune globulin, or HAV vaccine as a 1st step?
- Know how to manage aneursym rupture. Do you do immediate surgery or give drugs to decrease blood pressure first?

FOCUS ON THE BEST NEXT STEP, FOR EXAMPLE:
Do you elevate head first or do you put the airway first in a person who has difficulty breathing?
ANSWER: It DEPENDS.
- If person has facial trauma with gurgling sounds? You do cricothrotomy first.
- If a person has aspiration pneumonia then you elevate head first.
There are NOT that many questions that will ask the difference between most accurate vs initial.
So remember you need to know what do you do next from the first thing all the way down to the day the patient gets better and goes home.
In short I recommened:
1.) Use MTB 2 and MTB 3 to help build the skeleton of a foundation which is necessary to build upon.
2.) Do either Rx OR Kaplan qbank before you do UW, IF you have the time. This will orient your mind to the kinds of questions Step 2 CK expects you to know.

3.) IF you have 2-3 months to study or are very low on time, or second qbank is to Focus on UW2 and go through all of it 2-3 times before the exam. Know all of the scenarios and managements in all of the given scenarios. Read ALL explanations even if you get it right and make notes. I felt my exam was very close to the scenarios and concepts of UW.
4.) Do all clinical mastery series and do nbmes to monitor your progress. Save UWSA and NBME 7 for last since they are the closest thing to the exam.
5.) Should probably be listed as number 1, but believe in the work that you've done have faith that the preparation you do will help you get the score that you are shooting for.

OB was my lowest grade perhaps because I have not done OB rotations yet. But I have not done IM or even Surgery rotations either. So it is more than possible to do welll on this exam just from Step 1 and UW2 knowledge.

Best of luck everyone.

 

[med_student101]

May I ask, do you think someone who scored low on step 1 follows your footsteps for step 2 CK preparation do just as well?

 

[indomethacin_]

May I ask, do you think someone who scored low on step 1 follows your footsteps for step 2 CK preparation do just as well?

I think it is possible, I am a person of average intelligence that works harder than most.
USMLE is all about the effort you put in, but with that said, a lot of Step 2 CK scoring is going to be indicative of your past Step 1 knowledge and prep.

I don't know what your exact Step 1 score is, but I do think it is very possible to improve great strides for the Step 2 CK.

 

[med_student101]

I think it is possible, I am a person of average intelligence that works harder than most.
USMLE is all about the effort you put in, but with that said, a lot of Step 2 CK scoring is going to be indicative of your past Step 1 knowledge and prep.

I don't know what your exact Step 1 score is, but I do think it is very possible to improve great strides for the Step 2 CK.

Thank you, I plan to follow your foot steps... Your journal and you have been an inspiration. Thank you for posting your journal and sharing your views and immense hard work with all of us to inspire and learn from.

 

[rcdamania]

MOST HELPFUL SOURCES and the ONLY 5 sources I recommend:
1.) FA Step 1 & Medical School Step 1 knowledge material as reference.

2.) UW2, do that 2-3 times. Read ALL explanations AT LEAST TWICE. Read ALL educational OBJECTIVES AT LEAST 3 times.
This is coming from someone who is not a genius. So if you can read it once or twice and get it, more power to you.

3.) Clinical Mastery Series and Self Assessments.

4.) MTB 2 CK (Since all of my UW, NBME, Clinical Mastery Series, and UWSA notes were in it) and MTB 3 was also helpful for me a tad since I am a relatively new to clinical rotations. Also throw in Pestanas Surgery Notes.

5.) Pholston's PDF (Probably should give this a thorough read once or twice before you even start studying.)


THIS IS AN EXTENSIVE SUMMARY OF WHAT I DID, I USED A TON OF RESOURCES IN THE FIRST MONTH OF MY PREP WHICH WAS NOT NECESSARY:

Sources I used:
1.) MTB 2 & MTB 3
2.) UW qbank
3.) Rx qbank
4.) USMLE Step 2 Secrets
5.) First Aid Step 1
6.) Pestana's Surgery notes
7.) Clinical Mastery Series
8.) NBMEs & UWSA

How I studied:
1.) Read MTB 2 twice, finished Rx qbank, and then took my first NBME and failed it.

2.) Started UW along with reading MTB 2 third time and reading MTB 3 for the first time. Made notes on anything I did not know and anything I found important. Read ALL explanations even for the ones I got right I put all notes into MTB 2.
Took my second NBME, score went up 25 points.

3.) Read MTB 2 third time and MTB 3 second time and repeated UW again without taking notes and just reading explanations. Took third NBME score went up 5-10 points.

4.) Did all Clinical Mastery Series questions 100 qs a day in 6 days. Took a picture of all questions and made notes directly into MTB 2. Took another NBME score went up 5-10 points.

5.) Reviewed all educational objectives in UW and then took UWSA.
6.) Reviewed weak areas and took NBME 7 five days before exam, and Free 131 from USMLE website day before my exam.
DO WHAT WORKS FOR YOU, AS LONG AS YOU CAN REMEMBER, UNDERSTAND, AND RECALL THE INFO, THAT'S ALL THAT MATTERS.

Exam experience:
- Only had 1 drug ad with 3 questions, super long and super hard. Was in my 7th block of 8 and felt like I got uppercut to my face. But I was thankful it was just one drug ad.
- A lot of immuno. Review FA Step 1 immuno chapter.
- Know how the presentation, management of diagnosis, management of treatment, and pathophysiology of stress, urge, and overflow incontinence.
- Know the rinne and weber tests for conductive and sensineural deafness and know examples of things that can cause the two different types of deafness.
- 40-45% OF MY EXAM FELT LIKE STEP 1 RECALL!
- Know all of the leukemias
- Know the childhood bone disorders of congenital hip dysplasia, osgood schlatter, and leg calves perthes disease.
-Know guidelines for PPD & HPV.
- Know all options for contraceptions and in which scenario they are indicated.
- NO BIOCHEM questions on my exam.
- 1 or 2 Chromosome Genetics questions on my exam.
- A LOT of biostat questions with number needed to treat, bias types, and study types.
- Xray differentiations of pneumothorax, from pleural effusion, etc.
- Know the effects of maneuvers on the heart sounds.
- Felt harder than all NBMEs, but felt closest to a mix between UWSA and NBME 7.
- Know risk factors and preventions for major types of cancers such as ovarian, endometrial, lung, thyroid cancers.
- Know the difference between basal cell and squamous cell carcinoma location on the face.
- Know the bone tumors such as osteochondroma and how it looks on xray vs how osteosarcoma looks on xray.
- Know the side effects of ALL drugs of abuse and drugs in the psych chapter of MTB. Lithium, Cocaine, Benzodiazepines, Marijuana etc.
- Know how to manage acute HAV infection, is it supportive care? Immune globulin, or HAV vaccine as a 1st step?
- Know how to manage aneursym rupture. Do you do immediate surgery or give drugs to decrease blood pressure first?

FOCUS ON THE BEST NEXT STEP, FOR EXAMPLE:
Do you elevate head first or do you put the airway first in a person who has difficulty breathing?
ANSWER: It DEPENDS.
- If person has facial trauma with gurgling sounds? You do cricothrotomy first.
- If a person has aspiration pneumonia then you elevate head first.
There are NOT that many questions that will ask the difference between most accurate vs initial.
So remember you need to know what do you do next from the first thing all the way down to the day the patient gets better and goes home.
In short I recommened:
1.) Use MTB 2 and MTB 3 to help build the skeleton of a foundation which is necessary to build upon.
2.) Do either Rx OR Kaplan qbank before you do UW, IF you have the time. This will orient your mind to the kinds of questions Step 2 CK expects you to know.

3.) IF you have 2-3 months to study or are very low on time, or second qbank is to Focus on UW2 and go through all of it 2-3 times before the exam. Know all of the scenarios and managements in all of the given scenarios. Read ALL explanations even if you get it right and make notes. I felt my exam was very close to the scenarios and concepts of UW.
4.) Do all clinical mastery series and do nbmes to monitor your progress. Save UWSA and NBME 7 for last since they are the closest thing to the exam.
5.) Should probably be listed as number 1, but believe in the work that you've done have faith that the preparation you do will help you get the score that you are shooting for.

OB was my lowest grade perhaps because I have not done OB rotations yet. But I have not done IM or even Surgery rotations either. So it is more than possible to do welll on this exam just from Step 1 and UW2 knowledge.

Best of luck everyone.

First off thank you so much for posting this. Quick Questions:

1 Currently going thru UW2 for the second time after doing it throughout the year. Do you think that it would be beneficial to do UW2 in tutor or in timed mode. I take my exam July 29th so was wondering what your thoughts on how to attack UW?

2 Also, I was wondering how you went thru NBMEs and Clinical Mastery series b/c you do not get the answers to the actual questions? And at what intervals in my studying should I take them.

3 Anyone have any thoughts on DIT Step 2 CK?


Thanks for everyone's help!

 

[indomethacin_]

Thank you, I plan to follow your foot steps... Your journal and you have been an inspiration. Thank you for posting your journal and sharing your views and immense hard work with all of us to inspire and learn from.

Glad to be of some inspiration, good luck with your prep.

First off thank you so much for posting this. Quick Questions:

1 Currently going thru UW2 for the second time after doing it throughout the year. Do you think that it would be beneficial to do UW2 in tutor or in timed mode. I take my exam July 29th so was wondering what your thoughts on how to attack UW?

2 Also, I was wondering how you went thru NBMEs and Clinical Mastery series b/c you do not get the answers to the actual questions? And at what intervals in my studying should I take them.

3 Anyone have any thoughts on DIT Step 2 CK?


Thanks for everyone's help!

1.) If you plan on doing UW2 second time only, then do Mixed timed. If you plan on doing UW2 three times, do tutor mode subject wise untimed, and then for the third time through do mixed timed.

2.) Well you can know which ones you circled right because they won't show up in your extended feedback. For the ones you do get wrong, I searched for the answers on various forums and went with the majority of what people put for that certain answer. I did one NBME after each successive pass of UW, and clinical mastery series after I took two NBMEs.

3.) Can't say here, didn't do DIT for Step 2 CK.

 

[med_student101]

When would you recommend doing the Clinical Mastery Series?

 

[indomethacin_]

When would you recommend doing the Clinical Mastery Series?

After one pass of UW2 if your plan to do UW2 once or twice OR After two passes of UW2 if your plan is to do UW2 three times.

 

[med_student101]

Thanks, how long did it take you to finish your first round of uw?

 

[indomethacin_]

Thanks, how long did it take you to finish your first round of uw?

Somewhere about 17 days or so, should be in my journal somewhere. I documented the 1st pass, 2nd pass, and 3rd pass. You can look into it.

 

[usmleswot]

Thanks, how long did it take you to finish your first round of uw?

He took about 24-25 days I think. I had the same question. I think he started it early march and finished late march.