Logistical questions about Medical School

[deleted1064759]

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From what I understand, Step 1 covers the preclinical years (1-2 years at most schools) -- so does Step 2 cover solely the clinical year's content? As in is there any overlap between content from Step 1 to Step 2?

I also understand that people take Step 1 at the end of M2, so does that mean people take Step 2 CK after M3? I've heard that some people don't even take it before submitting ERAS because they have a score for Step 1. I imagine this will change now.

Do rotations actually help for Step 2 CK or is it focused more on shelf exams, UWorld, and other external resources (online MedEd, casefiles?, etc)? Where does Step 2 CS fit into all of this (when would we take it and how is the preparation like)?

I realize these are all pretty rookie questions but would appreciate any feedback.

 

[ciestar]

Prep for CS is your entire third year.

 

[DrStephenStrange]

Medical knowledge is medical knowledge, and it doesn't just disappear in your clinical years. What you learn in year 1 and 2 for step 1 will certainly have huge overlap with Step 2 CK and shelf exams, and that's to be expected.

 

[longhaul3]

There is a lot of overlap between step 1 and step 2 ck. Much more than junior med students realize. I think that with step 1 going p/f, people will study much less for it, and then be less prepared for step 2.

The foundation that you build from rigorous step 1 studying is hard to overestimate. I would not be surprised if the average step 2 score actually goes down when step 1 becomes p/f despite the prediction that people will focus much harder on step 2 for residency applications.

 

[M&L]

Medical knowledge is medical knowledge, and it doesn't just disappear in your clinical years. What you learn in year 1 and 2 for step 1 will certainly have huge overlap with Step 2 CK and shelf exams, and that's to be expected.

Yeah I was actually surprised - tried out a few step 2 questions in GI just to check them out , and they mostly sort of looked like step 1 questions on GI, except vignettes were bigger and more answer options . But of course, I am only studying for step 1 now, so my knowledge about step 2 is limited . I just saw a few questions

 

[operaman]

Yeah there’s definitely overlap. There were step 1 level questions on my specialty written board exams after residency, not to mention step 2/3, so the need for that basic medical knowledge never goes away.

Rotations definitely help with step 2, both CK and CS. You’ll do a lot of study for shelves along with it, but the clinical thinking from the wards will help on your exam too.

 

[aldol16]

From what I understand, Step 1 covers the preclinical years (1-2 years at most schools) -- so does Step 2 cover solely the clinical year's content? As in is there any overlap between content from Step 1 to Step 2?

Remember that medicine is all cumulative. It's like stacking blocks into a pyramid. Each level builds on the one below it. That said, there is esoteric knowledge that you learn for Step 1 that doesn't show up again. But there's also a ton of knowledge that you need in order to do well on Step 2.

I also understand that people take Step 1 at the end of M2, so does that mean people take Step 2 CK after M3? I've heard that some people don't even take it before submitting ERAS because they have a score for Step 1. I imagine this will change now.

Generally people take Step 1 after their pre-clinical years and CK sometime between the end of their third year and into the fourth year. CK is all about your rotations and clinical decision-making. It's longer than Step 1. Generally, people say 2 months for Step 1, 2 weeks for Step 2 CK, 2 days for Step 2 CS. It's not necessarily an easier exam - but being on rotations kind of forces you to prepare for the same stuff that's tested on CK.

As to when people take it, it's likely that when Step 1 goes P/F, people will start taking CK earlier and earlier so they have a score for residency. In the past (and presently), people with high Step 1 scores like to delay their Step 2 CK until after ERAS is due. This is because if you score lower on CK than Step 1, that can hurt you. The higher your Step 1 score is, the easier it is to do that.

Do rotations actually help for Step 2 CK or is it focused more on shelf exams, UWorld, and other external resources (online MedEd, casefiles?, etc)? Where does Step 2 CS fit into all of this (when would we take it and how is the preparation like)?

Yes to all of the above. On rotations you'll be studying for the rotation as well as for the shelf on that rotation. You'll probably be using UW to study for the shelf. The shelf exams have material that overlaps with what gets tested on CK. They all build on one another.

CS is something that people take before they graduate (in some instances, programs might want it before they rank you). Not a huge deal - rotations prepares you for it.

 

[TelemarketingEnigma]

Yeah I was actually surprised - tried out a few step 2 questions in GI just to check them out , and they mostly sort of looked like step 1 questions on GI, except vignettes were bigger and more answer options . But of course, I am only studying for step 1 now, so my knowledge about step 2 is limited . I just saw a few questions

I haven't taken step 2 yet, but at least on shelf exams there are a lot more clinical "judgement call" type questions than on step 1. There can be questions with multiple reasonable answers, but they are looking for the MOST important next clinical step, not just anything that could possibly work. Vignettes are also a lot vaguer on shelf/step 2 than step one IMO, because the idea is to test your clinical reasoning rather than to use the vignette as set up for a basic science question. There are also questions on things like USPSTF guidelines, etc that you aren't required to know for step 1

 

[DrStephenStrange]

I haven't taken step 2 yet, but at least on shelf exams there are a lot more clinical "judgement call" type questions than on step 1. There can be questions with multiple reasonable answers, but they are looking for the MOST important next clinical step, not just anything that could possibly work. Vignettes are also a lot vaguer on shelf/step 2 than step one IMO, because the idea is to test your clinical reasoning rather than to use the vignette as set up for a basic science question. There are also questions on things like USPSTF guidelines, etc that you aren't required to know for step 1

Yes, there are more clinical questions, but they're also based on your knowledge of the basic science too. There are many questions on my shelfs so far that I got right base solely on me knowing the basics and wouldn't have known any other way.

 

[TelemarketingEnigma]

Yes, there are more clinical questions, but they're also based on your knowledge of the basic science too. There are many questions on my shelfs so far that I got right base solely on me knowing the basics and wouldn't have known any other way.

I mean, yeah, you still need to know basic science, I never said you didn't. but not nearly to the degree of minutia thats on step 1. You have to carry the major concepts through for sure, but i've dumped plenty of tiny details that I learned for Step 1 from my brain and haven't missed them at all. I've done fine on shelves so far

 

[ekmf27050]

I go to one of the schools that does core clinical year and then Step 1. They showed us stats from some nationwide study that for schools with this curriculum structure, taking Step 2 within three months of taking Step 1 is significantly correlated with very much higher scores.

 

[suzygroanberg]

I am a 4th year MD student and mentor incoming students/underclassmen about this stuff all the time. Idk if this is an actual figure, but I estimate that 80% of CK material comes directly from step 1. There really isn't that much more you need to learn. If you want to well on step 2, the easiest way to do that is by doing well on step 1, thereby forming an excellent knowledge base. I do predict that with less incentive to work hard on step 1 now, CK averages will plummet. If you want to go into a competitive specialty/go to a low-tier school, you cannot let this happen to you. You need to treat your time studying the basic sciences and preparing for step 1 like your scores matter, even if you have p/f for everything. No chance you're going to get the score you now needed on CK without that. But I would also imagine that CK will be going p/f at some point in the not so distant future. I think these changes are awful.