USMLE My USMLE Step 2CK Thoughts and Experience, by Phloston

[Phloston]

I've written out my Step 2CK experience here in this attached PDF.

I hadn't felt there was much (if any) guidance out there for 2CK prep, so I've tried my best to put something together for future students here.

(here's the link to my original Step 1 post if you, the reader, are still prepping for that: http://forums.studentdoctor.net/threads/my-usmle-step1-thoughts-and-experience-by-phloston.977497/)

Good luck guys. Work hard and you'll be fine.

~Phloston

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[Transposony]

Congratulations for your great score Phloston.
As someone who has been there and tried everything, I know how hard it is to get anything above 250.
Great write up as expected and it will guide students for many years to come as it been for Step 1.

 

[reverieinvictus]

Congratulations on the score and happy birthday!

That point about emergency medicine being high yield is pretty interesting. Kaplan Qbank actually has almost 150 questions on EM and I was thinking about going over them before my surgery shelf exam in a couple of months.

 

[FOLLOWYOURHEART]

Congratulations!
Very well done!
Happy birthday!

 

[cocobutter]

what's considered a good score these days anyways. the average keeps changing

 

[CaliAtenza]

what's considered a good score these days anyways. the average keeps changing

The average is at 240 right now, from what I know.

 

[CaliAtenza]

I've written out my Step 2CK experience here in this attached PDF.

I hadn't felt there was much (if any) guidance out there for 2CK prep, so I've tried my best to put something together for future students here.

(here's the link to my original Step 1 post if you, the reader, are still prepping for that: http://forums.studentdoctor.net/threads/my-usmle-step1-thoughts-and-experience-by-phloston.977497/)

Good luck guys. Work hard and you'll be fine.

~Phloston

Fantastic work man, and happy birthday!

 

[Emli]

I've written out my Step 2CK experience here in this attached PDF.

I hadn't felt there was much (if any) guidance out there for 2CK prep, so I've tried my best to put something together for future students here.

(here's the link to my original Step 1 post if you, the reader, are still prepping for that: http://forums.studentdoctor.net/threads/my-usmle-step1-thoughts-and-experience-by-phloston.977497/)

Good luck guys. Work hard and you'll be fine.

~Phloston

I say, "thank you so very much for the wealth of information & the time you put into that amazing PDF"! That doesn't even begin to fully express my gratitude. Congratulations on your score and the very best wishes in your future endeavours.

 

[Pruthvi]

as ever, awesome score bro !! amazing work ethic, amazing dedication !! fantastic performance

you keep reminding me of how much i should study and learn..i have your step 1 PDF and i have read it a hundred times !! now i have your step 2 PDF thank you soo much bro..your an inspiration to me and one of my role models..

thank you and all the very best in your career always your admirer

god bless

 

[bearboots]

Happy Belated Birthday and Congratulations Pholston!! Your writeup guide was so detailed and amazingly helpful! I hope more people will read it!

I don't know why the other online question banks don't update their content. I see you used a lot of the clerkship textbook like CaseFiles and Pestana resources as found in the Clinical Rotations forum. A lot of the students there seem to be using question books + one of the textbooks like you said from your guide. Have you ever previewed these e.g. MKSAP for Students 5 IM, Pretest for Pediatrics, Lange Psychiatry, or any other pretest books? I know you did try a 10 sample trial for UWISE and doesn't look like there are so many surgery question sources that people use besides UW + Pestana.

UptoDate looks like it will take a lot of time for those who have never used it before if they have only a small dedicated study period like less than 2 months huh?

 

[au3s]

Hi Phloston, just read the experience you wrote. Want to ask, under peds, you wrote theres questions regarding PANDAS and PHACE syndrome. I have never heard about those disease (I can look up what they are myself).
DO they really pop up in the exams that often? What books resource will you actually encounter or study those kind of things. THanks

 

[skyblue2000]

They are very common syndromes.
PHACE Is mentioned in MTB…
I think I recall a question in UW about PANDAS. It may have been in the explanation for one of the options rather than the answer for a question.

 

[Phloston]

Happy Belated Birthday and Congratulations Pholston!! Your writeup guide was so detailed and amazingly helpful! I hope more people will read it!

I don't know why the other online question banks don't update their content. I see you used a lot of the clerkship textbook like CaseFiles and Pestana resources as found in the Clinical Rotations forum. A lot of the students there seem to be using question books + one of the textbooks like you said from your guide. Have you ever previewed these e.g. MKSAP for Students 5 IM, Pretest for Pediatrics, Lange Psychiatry, or any other pretest books? I know you did try a 10 sample trial for UWISE and doesn't look like there are so many surgery question sources that people use besides UW + Pestana.

UptoDate looks like it will take a lot of time for those who have never used it before if they have only a small dedicated study period like less than 2 months huh?

The summaries/recommendations section at the end of each UpToDate article is usually very helpful. Read more from the textual bodies for really HY things like screening guidelines. I also had not used any of the other resources you've mentioned here. One thing I learned from Step 1 prep is that consolidation of resources is really important. So I chose a select few and ran with them.

 

[Phloston]

Hi Phloston, just read the experience you wrote. Want to ask, under peds, you wrote theres questions regarding PANDAS and PHACE syndrome. I have never heard about those disease (I can look up what they are myself).
DO they really pop up in the exams that often? What books resource will you actually encounter or study those kind of things. THanks

PANDAS is talked about in Case Files Psychiatry, and I think that's the only place I can remember having ever seen it. It showed up on my exam in a clever way, so definitely know what PANDAS is and the particular ways it manifests.

PHACES syndrome and Rosenthal-Kloepfer syndrome I would say are really LY but showed up on my form.

 

[Apoplexy__]

Yeah, I was surprised to read they tested you on PANDAS. I only knew about it from my Psych attending, then later stumbled upon it in Case Files. It's casually referenced in FA Psych, but never explicitly called PANDAS ("there is an association of tics with pediatric GAS infections" or something like that).

As for PHACES and Rosenthal-Kloepfer, never heard of them. I'm sure they'll come up with other weird stuff on my exam.

 

[notbobtrustme]

Is it just me or is Uworld unnecessarily tricky or obscure?

I'm sitting at or below the average for IM right now because it tests all these stupid, obscure factoids that have exactly zero bearing on clinical practice. For example, knowing the pathology of how a kidney damaged by hypertension looks like compared to diabetes. No one facking cares. You follow their kidney function, get their sugars/pressure controlled and move on. No one on the wards is talking about kidneys look on gross biopsy. Or that pseudogout crystals look a certain way.

Like half these questions are written by academic nerds who haven't touched a patient in 20 years.

 

[notbobtrustme]

They are very common syndromes.
PHACE Is mentioned in MTB…
I think I recall a question in UW about PANDAS. It may have been in the explanation for one of the options rather than the answer for a question.

Common? PHACE is like once in a career syndrome at a major academic hospital center. PANDAS is like once every 5 years. They are commonly tested but you are unlikely to see them in regular practice.

 

[skyblue2000]

Sorry, common wasn't the correct word to use. I was simply meant that the syndromes are mentioned in common resources, i.e. UW and MTB.

 

[Phloston]

Is it just me or is Uworld unnecessarily tricky or obscure?

I'm sitting at or below the average for IM right now because it tests all these stupid, obscure factoids that have exactly zero bearing on clinical practice. For example, knowing the pathology of how a kidney damaged by hypertension looks like compared to diabetes. No one facking cares. You follow their kidney function, get their sugars/pressure controlled and move on. No one on the wards is talking about kidneys look on gross biopsy. Or that pseudogout crystals look a certain way.

Like half these questions are written by academic nerds who haven't touched a patient in 20 years.

I agree with you that the UW question style is often very different from the NBMEs/USMLE. This annoyance gets interesting though in that the "obscure factoids" that are stupidly the answers to some of the UW questions sometimes show up in the vignettes on the real deal, despite the real USMLE questions being more straightforward/clinically relevant. I forget the actual % (would have to double-check the USMLE website), but a fraction of the 2CK questions are Step 1-like. I had several questions that were pedantic and pathophysiology-based on the 2CK. Quite frankly though, these are actually a relief to get because they have definite/objective answers, unlike the vast majority of the 2CK which feels entirely subjective.

 

[xadmin]

Pholston, do you recommend using UsmleRx Qbank? What did you not like about the Qbank?

 

[Apoplexy__]

Recently bought USMLERx after reading your report. Thought you'd be interested in knowing that there's question in it just like the Immuno one you described, where you had to deduce from the vignette that the patient had autoimmune diseases, and therefore pick the autoimmune answer choice the patient was predisposed to.

I'm finding USMLERx pretty helpful so far, but it seems significantly more simple/one-dimensional/non-deceptive than UWorld and the NBME practice tests I've done. Would you agree?

 

[Phloston]

Pholston, do you recommend using UsmleRx Qbank? What did you not like about the Qbank?

Recently bought USMLERx after reading your report. Thought you'd be interested in knowing that there's question in it just like the Immuno one you described, where you had to deduce from the vignette that the patient had autoimmune diseases, and therefore pick the autoimmune answer choice the patient was predisposed to.

I'm finding USMLERx pretty helpful so far, but it seems significantly more simple/one-dimensional/non-deceptive than UWorld and the NBME practice tests I've done. Would you agree?

If you have time for a QBank before UWorld, then do either Kaplan or Rx (or both). I went through all of Rx and 2-300 Qs of Kaplan before UWorld. If I could go back in time having done the same exact number of questions, I would have done ~1/2 of both Rx and Kaplan. Rx had a lot of really bad questions; in other words, I found that most of the questions I was getting wrong were stupid tricks or regarding minutiae details that I knew would never be tested in a million years. I was often extremely annoyed going through the QBank and it made me apathetic about 2CK prep in general, where questions just became a routine for the sake of doing them, and in turn I didn't really have confidence in the way the QBank questions were asked. That's why I spent a good bulk of my time using UpToDate to supplement questions. UWorld was fine for 2CK, but not excellent. It's not a good thing that UW questions train you to over-think. Real USMLE questions aren't designed to trick you. If you get a hard USMLE/NBME/clinical mastery series question, it's because the vignette/presentation was odd (i.e., one variable might not be what you'd expect), but they don't overtly lead you down the wrong path the way UW does. Can't really argue about UW though cuz there's no better resource out there. I'd say it was an A-, whereas the Step 1 UW was an A+. And I'd say Rx and Kaplan for 2CK were both B, whereas for Step 1 I'd say they were both A-.

 

[xadmin]

I found that most of the questions I was getting wrong were stupid tricks or regarding minutiae details that I knew would never be tested in a million years

Did this apply to both Rx and Kaplan Qbank? So you do recommend to do at least one qbank before Uworld?

 

[au3s]

HI Phloston, just have a question need your advice please. I have gone through uworld, and I'm really having trouble with the drug ads and the abstracts in the biostats section of uworld. It really takes me like 3 mins to go through each ad or abstract. Also, I think there's only 3 sets of ads and 3 sets of abstracts in uworld (not enough practice IMO). My point is do you think it would be helpful to subscribe the uworld step 3 qbank and do the biostats questions there? It says on the uworld website that they have added like 100+ questions in the qbank and "special emphasis on Biostatistics, Epidemiology/Population Health, Interpretation of the Medical Literature, and Social Sciences (Ethics/Legal/Cultural Issues, Communication and Interpersonal Skills)."
So do you think if I do those questions it would be more practice towards the biostats, drug ads and abstract questions on step 2 ck?
I know some people only get 1 ad and 1 abstracts, but you may get 5-6 sets or so (each being like 3 questions). So I want to be more ready than pray to be lucky to not get them on the exam day.

Thank you

 

[master of usmle]

Truly amazing article...I just gave step 1 and was wondering how to approach step 2..u hit the nail on the head ..truly amazing!!!....god bless and give u d best residency out there buddy!!

 

[EmanO]

congratulations & many thanks for sharing your experience in details...

 

[arda]

mtb says initiate art immediately but you can stop treatment if the cd4 level is above 500.

Page 38 it says exactly like this

If the pregnant women has high cd4 (500 or higher) and does not need antiretroviral medications for her own health,treatment with antiretrovirals should be still given to prevent perinatal transmission.

 

[EmanO]

Hi Phloston,
Is it possible to list the high yield topics that u have read from Uptodate, please?

 

[meisner]

UptoDate is too much and a waste of time to me. UW gives plenty of current changes in guidelines and other staff that might be tested on real exam, including immunizations/screenings/treatment for metabolic syndrome, etc. UW is huge, try to complete it!

 

[Phloston]

UptoDate is too much and a waste of time to me. UW gives plenty of current changes in guidelines and other staff that might be tested on real exam, including immunizations/screenings/treatment for metabolic syndrome, etc. UW is huge, try to complete it!

I recommend reading the summaries/recommendations sections of articles of important topics if you're too ADD to read the textual bodies.

 

[arda]

I am also using uptodate,it is really amazing.If you really do not want to lose anytime,just read suggestions section at the and,it is like a summary.

Thanks for the suggestion @Phloston ,i am using it for everything now.

 

[drayu]

A fantastic and an exhaustive review given by you....hats off...

U rightly said that MTB is outdated and just gives more emphasis on the Initial n Most Accurate test....whereas the real exam asks you about the next step in management....which is all about knowing the algorithm and what to do next in the correct sequence.

Since you have started preparing for Step 3 i see....do u think reading step 3 CCS cases will help us out for CK as CCS gives more emphasis on next best step, what all investigations to do in sequence along with which setting like emergency or office to do.....Kindly opine...

Secondly, UptoDate is one thing which i find is even more exhaustive than your Step 2 CK review...
How to tackle it....just reading the summary at the end will suffice....??? u said to read the textual body for HY topics like screening guidelines.....but which topics do u suggest should we read in whole....please innumerate them.What to write in the search box while searching for a topic coz they have sub-sub topics for everything...!!!

Do u suggest doing all the
3 Qbanks...UW...KAPLAN And Rx Q banks without touching UptoDate
or UW plus UptoDate....???

Thank you so much once again for being the light....

 

[Phloston]

A fantastic and an exhaustive review given by you....hats off...

U rightly said that MTB is outdated and just gives more emphasis on the Initial n Most Accurate test....whereas the real exam asks you about the next step in management....which is all about knowing the algorithm and what to do next in the correct sequence.

Since you have started preparing for Step 3 i see....do u think reading step 3 CCS cases will help us out for CK as CCS gives more emphasis on next best step, what all investigations to do in sequence along with which setting like emergency or office to do.....Kindly opine...

Secondly, UptoDate is one thing which i find is even more exhaustive than your Step 2 CK review...
How to tackle it....just reading the summary at the end will suffice....??? u said to read the textual body for HY topics like screening guidelines.....but which topics do u suggest should we read in whole....please innumerate them.What to write in the search box while searching for a topic coz they have sub-sub topics for everything...!!!

Do u suggest doing all the
3 Qbanks...UW...KAPLAN And Rx Q banks without touching UptoDate
or UW plus UptoDate....???

Thank you so much once again for being the light....

No, don't venture into Step 3 questions or CCS stuff for 2CK. Just focus on Step 2 stuff. In terms of UpToDate, I would recommend going through it alongside UW questions when you want more elaboration on something. I found reading articles quickly was the way to go. Summaries/recommendations are good if you're touching upon the same topic again or want to really just get the conclusion but nothing more. I'd definitely recommend doing two QBanks (Kaplan or Rx, + UW) + UpToDate, versus doing all three QBanks without UpToDate. There's no shortcut for actual reading/learning. Figure that the amount of reading you do in one QBank could easily be = to the amount you'd do in UpToDate.

 

[wyliedeneal]

Phloston,

I would like to profusely thank you for these posts and the time you invested in them as I have found them to be very informative and exceedingly beneficial in planning my preparation strategy for the Step exams. In your PDF, you mentioned a powerpoint file that had some questions you found to be useful to review from the extended feedback. Any chance you would post that powerpoint here?

 

[Phloston]

Phloston,

I would like to profusely thank you for these posts and the time you invested in them as I have found them to be very informative and exceedingly beneficial in planning my preparation strategy for the Step exams. In your PDF, you mentioned a powerpoint file that had some questions you found to be useful to review from the extended feedback. Any chance you would post that powerpoint here?

The PPT you make is custom to you. It should contain PrntScr images of your incorrect clinical mastery series, NBME and Free-131 questions. One slide is a question, the next is an answer. Bear in mind that all of these questions are copyrighted, so after you use them for your own prep it's probably wise to delete them.

 

[TaYeM-]

thank u for sharing ur experience its very informative and am very thankful for that . I got my exam on 18th of march & I have 2 Q’s:
1.about neuro ,u mentioned knowing the paths very well & localizing lesions, should i go over the neuro chapter from FA? or the UW covers enough regarding lesions ?i didn't take Step 1 exam
2.the avg length of Q's in the exam ( 9 lines? more or less?) . for UW i have ~20 extra min left per block
thank you

 

[Phloston]

thank u for sharing ur experience its very informative and am very thankful for that . I got my exam on 18th of march & I have 2 Q’s:
1.about neuro ,u mentioned knowing the paths very well & localizing lesions, should i go over the neuro chapter from FA? or the UW covers enough regarding lesions ?i didn't take Step 1 exam
2.the avg length of Q's in the exam ( 9 lines? more or less?) . for UW i have ~20 extra min left per block
thank you

1) Only review the stroke syndromes (e.g., lateral/medial medullary, etc.) from FA Step 1 neuro. The neuro that comes up is literally very clinical.

2) The real exam questions were longer than those in UW/UWSA. I think I had finished UWSA blocks with probably >10-15 to spare. On the real deal, three of my blocks had like 1-3 mins left (the others were 10-15 IIRC).

 

[BP87]

Thanks a million Phloston! Seriously you rock! I'm so thankful people like you exist : )
Quick question, you mentioned Pestana's notes for surgery, is that an actual book or just this pdf
Thanks and all the best with everything

 

[Phloston]

Thanks a million Phloston! Seriously you rock! I'm so thankful people like you exist : )
Quick question, you mentioned Pestana's notes for surgery, is that an actual book or just this pdf
Thanks and all the best with everything

I only use hard copy books.

 

[rbmuru]

this is an amazing guide...I have CK coming up in July and this gives me so much time to prepare

 

[RAY QUEST]

hi Phloston
thanks for guide

i am planning to give STEP 2 CK before step 1 , please can you guide me on this ?
what are the important topics from step 1 which are vital for step 2 ck exam ?
what qbanks banks to use ? i don't have access to update ? so how to fill the void created by "no update access"
please give all the advise possible
thanks

 

[mido114]

Thank you for the guide

 

[seminoma]

@Phloston thanks for the post. I didn't see any reference to your performance on shelf exams in that PDF (or in this thread), but I'm curious how well you did and if you think they're indicative of step 2 CK scores?

I ask because I did well on the medicine shelf, then kind of got destroyed by the FM shelf despite actually feeling better while sitting for the FM shelf.

 

[Phloston]

@Phloston thanks for the post. I didn't see any reference to your performance on shelf exams in that PDF (or in this thread), but I'm curious how well you did and if you think they're indicative of step 2 CK scores?

I ask because I did well on the medicine shelf, then kind of got destroyed by the FM shelf despite actually feeling better while sitting for the FM shelf.

We don't have shelf exams in Australia.

 

[seminoma]

We don't have shelf exams in Australia.

Ah ok thanks! Regarding your comments on MTB2/3 and FA 2CK, what would you do if you could go back in time and re-study? Obviously MTB2/3 and FA CK worked out given your score, but you seem to imply throughout the PDF that you spent more time than necessary on them. So where do you feel your time would have been better spent? Or, what do you recommend instead of pouring over those resources? Again, sorry if this was already covered, but I didn't see it in that PDF.

 

[Phloston]

Ah ok thanks! Regarding your comments on MTB2/3 and FA 2CK, what would you do if you could go back in time and re-study? Obviously MTB2/3 and FA CK worked out given your score, but you seem to imply throughout the PDF that you spent more time than necessary on them. So where do you feel your time would have been better spent? Or, what do you recommend instead of pouring over those resources? Again, sorry if this was already covered, but I didn't see it in that PDF.

I would have spent less time trying to memorize MTB2/3 and FA2CK and instead just done a very cursory pass of them. I had assiduously gone through the MTBs and FA2CK and made flashcards from them. I had the impression (because of lack of guidance) that it would be important to know everything in those books the same way we needed to know everything in FA for Step 1. But 2CK is vastly different and it was annoying that the resources just simply weren't as good. I recommend using the MTBs and FA2CK to merely become aware of what potential management options exist for any given condition, but don't try to memorize. Use those books for foundation then start as soon as you can with questions. I would have spent much more of my time going through QBanks. As I said, I didn't finish Kaplan QBank for 2CK, mostly because it seemed ultra-minutiae-focused, same as for Step 1, but I have to be honest that out of the questions I did from Kaplan, two showed up on my exam. And the other thing I would have done is waited until after my paeds, obgyn and critical care rotations to sit the 2CK. These are fourth-year rotations at my school in Australia, and I couldn't stand the idea of having the 2CK over my shoulder till the end of med school, so I prepped as hard as I could in a short time period, and took the exam early. I was essentially willing to get a slightly lower score and just have the exam out of the way than to hold off and do better. But now that I'm almost through fourth-year, I would have scored higher holding off.

 

[FedFan25]

Hello Phloston.
Thank you so much for helping students throughout the world by creating these PDF documents which are just the best resource ever.
I took my step 1 exam and I wasn't even aware of this online forum and all these ways of IMGs helping each other ace USMLE exams. I did all my step 1 prep and everything on my own without study partners. I wish someone had told me about your step 1 PDF. But whats done is done. I am happy that I am done with step 1.
And I did not find it easy handling the stress and not having a study guide. I want to change things for step 2. And be open to the idea of seeking help in these forums.

I am looking to you for some inspiration. . Reading those 25 pages of your step 2 CK are already inspiring.
I graduated in 2014. Did 1 year of mandatory internship. That ended in june 2015 and then I sat for my USMLE Step 1 exam in late december.
I scored 243.
I would love to be in the 250s on my step 2 CK.

I have read up on your CK experience. I want to ask you a few questions.
Is there any way I can contact you? My email I.d is [email protected]

 

[dzoni]

I've written out my Step 2CK experience here in this attached PDF.

I hadn't felt there was much (if any) guidance out there for 2CK prep, so I've tried my best to put something together for future students here.

(here's the link to my original Step 1 post if you, the reader, are still prepping for that: http://forums.studentdoctor.net/threads/my-usmle-step1-thoughts-and-experience-by-phloston.977497/)

Good luck guys. Work hard and you'll be fine.

~Phloston

Im sorry maybe I can't see it but there is no attached PDF here. If you could attach it that would be great.

 

[ucheeee]

yea i dont see a PDF either. @Phloston could you please upload your PDF so we can look at it Ive been reading your posts though and they are very helpful. Thank you

 

[JFTArgentina]

I dont see a PDF either. @Phloston please upload your pdf!!!