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Hello all, I figure I owe to SDN for helping me succeed on step2ck. This is my first post on SDN ever so I created an account just for this, hoping it helps someone out there, as it did for me.
I would like to describe my preparation, my score, and the struggles leading up to the exam and my experience during the actual exam. I hope this thread finds everyone helpful; if not in preparation but personal issues. Please post any 2013 experience for step2ck to help others.
First, I do attend a U.S. MD program.
My step 1 score was 224 and my step 2 was 254. The mean reported on my score sheet was "237". So it seems the national average is slowly rising. I do not know if 254 is a great score but I think it is ok.
Preparation time: 1 mo.
REsources availabe: many, first aid step 2ck, step up to medicine, step up to step 2 etc...
Resource actually used: uworld qbank and uptodate.
So reading some post on SDN, I was overwhelemd with the resources available. I heard from many that there is not one good resource and that one has to diversfy and cover all grounds....blah...blah...blah.... So, I decided to take an opposite approach. I relied only on uworld and uptodate. And this did me well. Don't get me wrong, I am like most of you nerds out there! I wanted to read all the books and prepare all the way, but then i had a deep reflective moment with myself; i asked myself why do I doubt myself so much? I think it is medical student thing. We tend to be "high strung" and bent over on performance that we lose self-confidence and it actually hurts us in the long run. I was disappointed with my step1 score and had to really nail step2. I want to tell you guys, I am by no means a "naturally smart" student---and I don't think one really exists. I have to read over material 3x or so to really sink in. I made it thus far by repetition and like most primate brains, i think we learn by repetition than "one go". For some the repetition is 2x, others 3x, etc.... but find your own niche and do not worry about others and what others are doing for resource- ---easiest advice to give, hardest to follow.
So next came figuring out a schedule that worked for me. I had one month. If I used step up to step 2, I would have to spend 2-3 days per subject for my "first go" and cover 2000 uworld qbank questions and do practice NBME. This is just not realistic. So I dropped step up to step 2 and step up to medicine and all the review books I had. I decided, they are best served collecting dust. So that left me with Uworld qbank only. Now you may ask, you give advice on staying on one resource but isn't that risky? no! First, I want to tell you, I only got 1 honors in my clerkship. So I was not the student who nailed every shelf exams. In fact, my shelf scores ranged in 60s and 70s. Sometimes 50s. And my preparation for shelf was like any other medical student; casefiles, pretest, but I did do all of uworld by the time my clerkship ended. So do not worry about your shelf score predicting your step2 performance...it is all hocus pocus. Focus on learning the material well and you will own the exam--but stick with uworld and uptodate.
So I decided I will stick to Uworld and uptodate and if I have time I will read the review books. This was good strategy for two reasons; one, you learn best by doing questions and learning why you missed them. Forget that whole "oh I only got 56% on my first pass on uworld stuff." Do not worry about % correct. FOCUS on LEARNING the material well. So when I finished by 3rd yr clerkships, I had finished ALL of uworld qbank once. My average was probably in 50-60%, I do not remember the exact number and it does not matter. So Then, I reset my qbank. So everyday I did about 3-4 blocks per day. I did them random. 3 blocks is about 123 questions. Doing and reviewing that many questions per day is ALOT! And if you review them well, your brain will be exhausted and you will not be able to do anymore. This means you are ACTIVELY, and CRITICALLY thinking. So please, please, please do NOT scheme read the explanations. I think people who take the exam and say it does not help are those that try to do only pattern recognition studying and do not go through EVERY word on uworld question. Remember, Step2ck is a NATIONAL exam. Hardly, questions are based only on buzz words. There are some, but every1 gets those. The separation comes with being able to think critically and actively, not passively.
Example: 1 mo old newborn has abdominal distention, nasuea, vomiting. KUB shows pneumotosis intestinalis. What is dx?
A) necrotizing enterocolitis
B) meconium ileus
C) Hirschprungs
D) volvulus
E) perforated bowel viscus
So most people doing the above quesiton will say the answer is A. And it is. And on uworld they will move on, at most reading the educational objective. Now if you took Step2 and got a question like below;
Step2 make believe question: 1 mo old newborn has abdominal distention, nausea, vomiting. KUB shows no intramural air. Nurse and parents noted no bowel movement as of yet. The younger sibling has chronic pneumonia. What is diagnosis?
Now you run into the trouble. Because you only studied the educational objective, you freak out. You know it is not necrotizing enterocolitis because it does not fit into your "memory banks" of how it presents. So you freak out!! haha. But relax. If you read all of uworld qbank you know the trick. The younger sibling probably has cystic fibrosis and they are hinting that the 1 mo without bowel movement probably has a meconium ileus and probably also CF. And the feeding is leading to vomiting and bloating. See how the game works?
So my point is, read ALL of uworld. So after I reset my qbank, I ran through all of uworld my second time (first time after my clerkship ended) and read everything!
Again, ignore what other people are doing and have confidence in your abilities. This was really hard for me because at times, my lousy step1 score would creep up and it would remind me of working just as hard and not doing well. So half the battle in succeeding on step2, or any of these national exam is mental battle. And part of my mistake in step1 was spreading myself too thin with too many resources.
So, now what do we do? I bought uworld again. sounds silly, but I did it. I wanted to run through it the third time. Now remember the most I was able to do per day was about 3 blocks, sometimes 4 blocks if I can muster up the strength. And this included reviewing every single question, word for word, alphabet for alphabet. Sound out the vowels....haha.
My friends thought I was taking a risk. But I had to ignore them. THis was hard to do but had to be done.
So after my second uworld compeltion, i bought uworld again and I decided to take NBME 4 to see my baseline in studying. Now, everyone will ask which NBME is most reflective? which is best to take? haha. STOP asking these questions and use the NBME to LEARN how you think, what makes you pick one answer over the other, and is it lack of knowledge that makes you miss the question, is it careless mistake? Analyze your behaviour rather than using it to predict or foresee how step2 is going to be. In fact, step2ck is a hybrid of both NBME practice exam, shelf exam, and uworld--mark my word; HYBRID!
So I took NBME 4 in timed mode with expanded feedback so I can see which questions I missed. Please do this! pay the extra 10 bucks! This is why I decided to do NBME 4 and 6 and not the other ones because you cannot see what questions you missed and it is important to know. BTW, That is what your loan money is for .
So I got a score of 240 on NBME 4. I was happy but it does not mean squat. So when you get a score of 240 on a practice, take it to mean it can easily be 10 points above or below. So I am in the range of 230-250. This means I am passing. That is all it means! Nothing more. Because after all, it is only practice. And as medical students if we get 220 we get discouraged . Please do not take it to mean that much! Remember part of the battle is mental.
So I decided I need to run on uworld 1 more time. This would mean going over uworld 3x. Now, time was closing in. I had 1 week and like 2-3 days to run through 2000 questions again. So this time, I broke it into subjects. So I did ob/gyn like for 2 days, surgery 1 day, psych 1 day. etc.... based on how much questions there was for that subject. This is a good way to feel "accomplished." lol And on my third go, I only read educational objectives and key answer choices I needed refreshing on. For example, I always forget breastfeeding jaundice versus breast milk jaundice. Ugh. So simple but I am dyslexic or something and can never remember the difference. lol
So I finished about half of uworld on my third go and decided to take NBME 6 for practice. Again, this has expanded feedback with the wrong answers available. So I got a 231. Disappointing, but I had to remind myself---half of the battle is mental and the score means nothing. Like I said, plus or minus 10 above or below. So my range is consistently 220-240, and if i am lucky, above 250. This is all it means. Unless I get explosive diarrhea and fecal incontience from test anxiety, I should not drop to 210.
So I do not remember the exact dates, nor did I ever keep a tight schedule on paper. So I cannot tell you the timing exactly. But I took uworld practice exam like 3 days before the exam. I got 245 on this one. Again, be indifferent to your score on practices. Also, keep doing uworld EVERY, SINGLE day. And review, review the NBME. The internet has a great way of looking up the right answer
So I did complete uworld 3x. The first two go were complete reading word for word. The last go was only educational objectives to jog my memory.
Now, how did I use uptodate? So i made a list of all the topics I was weak on. So like peripheral vascular disease, I would read on uptodate only the SUMMARY section. This was good because in less than one page you got an idea when to do aspirin, cliostazol, embolectomy, angioplasty, stenting, or simply recommending exercise as management. This is the beauty of uptodate. Remember stick with the summary. Somtimes I read pathophysiology if I had no idea on the subject. A good chunck of step2 does have basic pathophysiology and the wordings are always annoying. See example below,
Increased bronchial secretions, edema, and inflmmation of terminal bronchials is found in which disease?
A) asthma
B) bronchitis
C) bronchiolitis
D) croup
E) tracheitis.
F) emphysema
This is totally made up so do not try to figure out the answer. lol. I am not sure if it even makes sense . but you get the point.
So now you have gone over uworld 3x and uptodate on key areas of improving.
So 1 day before exam; I relaxed as much as possible. Only studying I did was biostats. I crammed it based on uworld. The rest of day was spent in mental battle between serotonin activating my area postrema and inducing nausea and vomiting and watching tv. I did not sleep well at all that night. Only 4 hrs of sleep. But then again, sleep has really never been a factor in influcing my performance because the adrenaline kicks in!
So the day of Exam: I did get diarrhea, but not explosive and no fecal incontience.
Wow, I felt good about block 1. I had 10-15 minute left. I was beasting it up. Felt like a long uworld exam. The vignette was definitely longer than uworld but the concept was same. They gave you enough clues. But sometimes the battle was between two answers. Not until I saw 4 questions back to back on a biostat article that I lost motivation again. I felt, wow this is like step1. I am failing. I had to block out the thought of doing bad and focus on each question as if I were caring for that patient.
Boy, was the exam demotivating. I did not feel comfortable at all. And as each block progressed I saw my stamina wave. I barely finished the blocks, with only 2 minutes to check my 15 or so marked questions. Yes! I marked like 15 per block. But if you run into this during exam day, fight it. Keep convincing yourself it is almost over so I am going to go hard on every question. I realized from this experience, doing well on step2 largely involves on your ability to get into the "examiners" head. The person writing the question wants you to know something. What is it? ask yourself this to help you. Example below,
15 yr old is jogging outside on a spring day. He has already had flu vaccine. Suddenly he develops stridor and oropharyngeal swelling. What is next step?
Obviously the above question writer is hinting to something. If he is jogging outside and developed respiratory distress, he probably got stung by a bee. LOL. So you have to assume this. And your answer choices will guide you. If you see epinephrine, dobutamine, norephinrine as choices you know they are hinting to this. Use this strategy to your advantage.
Also what helped me during the actual exam was reading the last 1-2 sentence and glancing at the answer choices so I know how to think and know what i am looking for. So if the question says "what is the next best step in management?" glance at the sentence before this.... and the answer choices to get the gist. Also, skip the bs of smoking and alcohol hx. In your mind, paint a picture of the patient. Instead reading "the patient smokes 1 pack of cig per day for last 30 day" summarize into your mind "heavy smoker." lol This will help save time and stay concise. It is like playing a game of Clue (yes the board game).
I would like to describe my preparation, my score, and the struggles leading up to the exam and my experience during the actual exam. I hope this thread finds everyone helpful; if not in preparation but personal issues. Please post any 2013 experience for step2ck to help others.
First, I do attend a U.S. MD program.
My step 1 score was 224 and my step 2 was 254. The mean reported on my score sheet was "237". So it seems the national average is slowly rising. I do not know if 254 is a great score but I think it is ok.
Preparation time: 1 mo.
REsources availabe: many, first aid step 2ck, step up to medicine, step up to step 2 etc...
Resource actually used: uworld qbank and uptodate.
So reading some post on SDN, I was overwhelemd with the resources available. I heard from many that there is not one good resource and that one has to diversfy and cover all grounds....blah...blah...blah.... So, I decided to take an opposite approach. I relied only on uworld and uptodate. And this did me well. Don't get me wrong, I am like most of you nerds out there! I wanted to read all the books and prepare all the way, but then i had a deep reflective moment with myself; i asked myself why do I doubt myself so much? I think it is medical student thing. We tend to be "high strung" and bent over on performance that we lose self-confidence and it actually hurts us in the long run. I was disappointed with my step1 score and had to really nail step2. I want to tell you guys, I am by no means a "naturally smart" student---and I don't think one really exists. I have to read over material 3x or so to really sink in. I made it thus far by repetition and like most primate brains, i think we learn by repetition than "one go". For some the repetition is 2x, others 3x, etc.... but find your own niche and do not worry about others and what others are doing for resource- ---easiest advice to give, hardest to follow.
So next came figuring out a schedule that worked for me. I had one month. If I used step up to step 2, I would have to spend 2-3 days per subject for my "first go" and cover 2000 uworld qbank questions and do practice NBME. This is just not realistic. So I dropped step up to step 2 and step up to medicine and all the review books I had. I decided, they are best served collecting dust. So that left me with Uworld qbank only. Now you may ask, you give advice on staying on one resource but isn't that risky? no! First, I want to tell you, I only got 1 honors in my clerkship. So I was not the student who nailed every shelf exams. In fact, my shelf scores ranged in 60s and 70s. Sometimes 50s. And my preparation for shelf was like any other medical student; casefiles, pretest, but I did do all of uworld by the time my clerkship ended. So do not worry about your shelf score predicting your step2 performance...it is all hocus pocus. Focus on learning the material well and you will own the exam--but stick with uworld and uptodate.
So I decided I will stick to Uworld and uptodate and if I have time I will read the review books. This was good strategy for two reasons; one, you learn best by doing questions and learning why you missed them. Forget that whole "oh I only got 56% on my first pass on uworld stuff." Do not worry about % correct. FOCUS on LEARNING the material well. So when I finished by 3rd yr clerkships, I had finished ALL of uworld qbank once. My average was probably in 50-60%, I do not remember the exact number and it does not matter. So Then, I reset my qbank. So everyday I did about 3-4 blocks per day. I did them random. 3 blocks is about 123 questions. Doing and reviewing that many questions per day is ALOT! And if you review them well, your brain will be exhausted and you will not be able to do anymore. This means you are ACTIVELY, and CRITICALLY thinking. So please, please, please do NOT scheme read the explanations. I think people who take the exam and say it does not help are those that try to do only pattern recognition studying and do not go through EVERY word on uworld question. Remember, Step2ck is a NATIONAL exam. Hardly, questions are based only on buzz words. There are some, but every1 gets those. The separation comes with being able to think critically and actively, not passively.
Example: 1 mo old newborn has abdominal distention, nasuea, vomiting. KUB shows pneumotosis intestinalis. What is dx?
A) necrotizing enterocolitis
B) meconium ileus
C) Hirschprungs
D) volvulus
E) perforated bowel viscus
So most people doing the above quesiton will say the answer is A. And it is. And on uworld they will move on, at most reading the educational objective. Now if you took Step2 and got a question like below;
Step2 make believe question: 1 mo old newborn has abdominal distention, nausea, vomiting. KUB shows no intramural air. Nurse and parents noted no bowel movement as of yet. The younger sibling has chronic pneumonia. What is diagnosis?
Now you run into the trouble. Because you only studied the educational objective, you freak out. You know it is not necrotizing enterocolitis because it does not fit into your "memory banks" of how it presents. So you freak out!! haha. But relax. If you read all of uworld qbank you know the trick. The younger sibling probably has cystic fibrosis and they are hinting that the 1 mo without bowel movement probably has a meconium ileus and probably also CF. And the feeding is leading to vomiting and bloating. See how the game works?
So my point is, read ALL of uworld. So after I reset my qbank, I ran through all of uworld my second time (first time after my clerkship ended) and read everything!
Again, ignore what other people are doing and have confidence in your abilities. This was really hard for me because at times, my lousy step1 score would creep up and it would remind me of working just as hard and not doing well. So half the battle in succeeding on step2, or any of these national exam is mental battle. And part of my mistake in step1 was spreading myself too thin with too many resources.
So, now what do we do? I bought uworld again. sounds silly, but I did it. I wanted to run through it the third time. Now remember the most I was able to do per day was about 3 blocks, sometimes 4 blocks if I can muster up the strength. And this included reviewing every single question, word for word, alphabet for alphabet. Sound out the vowels....haha.
My friends thought I was taking a risk. But I had to ignore them. THis was hard to do but had to be done.
So after my second uworld compeltion, i bought uworld again and I decided to take NBME 4 to see my baseline in studying. Now, everyone will ask which NBME is most reflective? which is best to take? haha. STOP asking these questions and use the NBME to LEARN how you think, what makes you pick one answer over the other, and is it lack of knowledge that makes you miss the question, is it careless mistake? Analyze your behaviour rather than using it to predict or foresee how step2 is going to be. In fact, step2ck is a hybrid of both NBME practice exam, shelf exam, and uworld--mark my word; HYBRID!
So I took NBME 4 in timed mode with expanded feedback so I can see which questions I missed. Please do this! pay the extra 10 bucks! This is why I decided to do NBME 4 and 6 and not the other ones because you cannot see what questions you missed and it is important to know. BTW, That is what your loan money is for .
So I got a score of 240 on NBME 4. I was happy but it does not mean squat. So when you get a score of 240 on a practice, take it to mean it can easily be 10 points above or below. So I am in the range of 230-250. This means I am passing.
That is all it means! Nothing more. Because after all, it is only practice. And as medical students if we get 220 we get discouraged . Please do not take it to mean that much! Remember part of the battle is mental.So I decided I need to run on uworld 1 more time. This would mean going over uworld 3x. Now, time was closing in. I had 1 week and like 2-3 days to run through 2000 questions again. So this time, I broke it into subjects. So I did ob/gyn like for 2 days, surgery 1 day, psych 1 day. etc.... based on how much questions there was for that subject. This is a good way to feel "accomplished." lol And on my third go, I only read educational objectives and key answer choices I needed refreshing on. For example, I always forget breastfeeding jaundice versus breast milk jaundice. Ugh. So simple but I am dyslexic or something and can never remember the difference. lol
So I finished about half of uworld on my third go and decided to take NBME 6 for practice. Again, this has expanded feedback with the wrong answers available. So I got a 231. Disappointing, but I had to remind myself---half of the battle is mental and the score means nothing. Like I said, plus or minus 10 above or below. So my range is consistently 220-240, and if i am lucky, above 250. This is all it means. Unless I get explosive diarrhea and fecal incontience from test anxiety, I should not drop to 210.
So I do not remember the exact dates, nor did I ever keep a tight schedule on paper. So I cannot tell you the timing exactly. But I took uworld practice exam like 3 days before the exam. I got 245 on this one. Again, be indifferent to your score on practices. Also, keep doing uworld EVERY, SINGLE day. And review, review the NBME. The internet has a great way of looking up the right answer
So I did complete uworld 3x. The first two go were complete reading word for word. The last go was only educational objectives to jog my memory.
Now, how did I use uptodate? So i made a list of all the topics I was weak on. So like peripheral vascular disease, I would read on uptodate only the SUMMARY section. This was good because in less than one page you got an idea when to do aspirin, cliostazol, embolectomy, angioplasty, stenting, or simply recommending exercise as management. This is the beauty of uptodate. Remember stick with the summary. Somtimes I read pathophysiology if I had no idea on the subject. A good chunck of step2 does have basic pathophysiology and the wordings are always annoying. See example below,
Increased bronchial secretions, edema, and inflmmation of terminal bronchials is found in which disease?
A) asthma
B) bronchitis
C) bronchiolitis
D) croup
E) tracheitis.
F) emphysema
This is totally made up so do not try to figure out the answer. lol. I am not sure if it even makes sense . but you get the point.
So now you have gone over uworld 3x and uptodate on key areas of improving.
So 1 day before exam; I relaxed as much as possible. Only studying I did was biostats. I crammed it based on uworld. The rest of day was spent in mental battle between serotonin activating my area postrema and inducing nausea and vomiting and watching tv. I did not sleep well at all that night. Only 4 hrs of sleep. But then again, sleep has really never been a factor in influcing my performance because the adrenaline kicks in!
So the day of Exam:
I did get diarrhea, but not explosive and no fecal incontience.Wow, I felt good about block 1. I had 10-15 minute left. I was beasting it up. Felt like a long uworld exam. The vignette was definitely longer than uworld but the concept was same. They gave you enough clues. But sometimes the battle was between two answers. Not until I saw 4 questions back to back on a biostat article that I lost motivation again. I felt, wow this is like step1. I am failing. I had to block out the thought of doing bad and focus on each question as if I were caring for that patient.
Boy, was the exam demotivating. I did not feel comfortable at all. And as each block progressed I saw my stamina wave. I barely finished the blocks, with only 2 minutes to check my 15 or so marked questions. Yes! I marked like 15 per block. But if you run into this during exam day, fight it. Keep convincing yourself it is almost over so I am going to go hard on every question. I realized from this experience, doing well on step2 largely involves on your ability to get into the "examiners" head. The person writing the question wants you to know something. What is it? ask yourself this to help you. Example below,
15 yr old is jogging outside on a spring day. He has already had flu vaccine. Suddenly he develops stridor and oropharyngeal swelling. What is next step?
Obviously the above question writer is hinting to something. If he is jogging outside and developed respiratory distress, he probably got stung by a bee. LOL. So you have to assume this. And your answer choices will guide you. If you see epinephrine, dobutamine, norephinrine as choices you know they are hinting to this. Use this strategy to your advantage.
Also what helped me during the actual exam was reading the last 1-2 sentence and glancing at the answer choices so I know how to think and know what i am looking for. So if the question says "what is the next best step in management?" glance at the sentence before this.... and the answer choices to get the gist. Also, skip the bs of smoking and alcohol hx. In your mind, paint a picture of the patient. Instead reading "the patient smokes 1 pack of cig per day for last 30 day" summarize into your mind "heavy smoker." lol This will help save time and stay concise. It is like playing a game of Clue (yes the board game).
