USMLE Thoughts on Step 2 CK (clinical) content on the Step 1 (basic science) test !

[TheAberrantGene]

Disclaimer: Spoiler alert, talks about a couple of NBME 17 & 18 questions. Also, this is my hypothesis and may not be true 100% but prima facie seems true.

I gave NBME 17 & 18. Scored very well. 260+ in one of em 270+ in the other one.

I observed a considerable deal of content which would be CK-ish. I haven't found time to make a complete list but here's some stuff which i am 100% sure is on most CK books but not on step 1. Also, many examinees in the past mention that there was clinical stuff which was not answerable based on step 1 knowledge. Here is some:

- A NBME 17 question talking about shock and then listing colloids and crystalloids as option and asking us to pick one of them. This is in every step 2 and 3 book.
- A NBME 18 question asking about Impaired drivers with seizure disorder and the recommendation. This is in MTB CK and many other CK books
- Incontinence was a pure hardcore CK topic never seen on step 1 until recently. Now it is practically in everyone's test.

(There were more such things..this list is being expanded as i get time and recall stuff)

The NBMEs are kind of an "IN" into the system. While they may not be the same as live test items I bet that with everyone saying that solving NBMEs with their explanations increases scores considerably.. i would bet that at the very least even if test items are not the same the test writers are the same.. and u kno if i was a test writer and was instructed to make a mock to to kinda reflect the real deal, i would probably put questions from the same concepts at both places. I may not put the exact same question at both places but would atleast put the same concepts.

I wanted people's opinions on this:

- I think as step 1 scores increase each and every year they are throwing the kitchen sink at this. They are decreasing questions and decreasing the room for error.
- More and more CK-ish content is coming in to make it tougher.

What do you think ?
Pitch in... let's start a list of topics one should do for step 1 which is in CK ? Or maybe at least discuss about this. I think it will help everyone to at least consider this idea.

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[Kazaki]

This isn't new. Exams like the USMLE will always have questions that are aimed at those very few people that are extremely smart and/or go the extra mile (or two) to learn every little bit of information.
I remember seeing another post a while back about someone wanting to study ck material + step 1 material so that they "wouldn't get any surprises on exam day". Maybe people that did basic sciences a while back can benefit from learning step 2 material and linking it to step 1 in order to refresh their memories or something, I dunno.
Point is, I don't think that learning step 2 stuff is necessarily the best thing you can do to improve your score, you might get one, maybe two questions of that sort, but are they really worth the hassle? All the extra clinical knowledge you would have to learn for each disease is just ridiculous! Hence why there are preclinical and clinical years, in which you learn preclinical and clinical stuff respectively.
Besides, incontinence is clearly covered in Goljan pathology and Guyton physiology, two basic science books hmmm..... Also, I had two lectures on IV therapy during pharma (still in preclinical years) so crystalloids vs colloids isn't really rocket science and I doubt that someone who's sitting step 1 has never heard of these terms before and has never bothered googling either one of them.

 

[TheAberrantGene]

Thanks..
I agree some what with most of what you say..
-> But..some extra info... the crstalloid colloid question gives u a LIST of different ones as options (A LONG list, btw !) and asks specifically for what has to be done at a particular step in the therapy of a particular disease. Its not the words themselves.. cystalloids/colloids..

Prima Facie.. I think more and more content of CK is being added into Step 1.. I would be surprised if it was just 1-2 questions. Most people here and elsewhere think its more like 10 or so questions..

If anyone has anything else to add..please pitch in..

 

[DrPicard]

I'm definitely willing to run through select CK topics. Whether or not its something that's always been the case or a trend that just started, if I can improve my preparation with a little extra effort, why not? I definitely don't see myself going through all of medicine though. But reading only some CK topics in a cursory/selective "pick-out-the-important-details" fashion couldn't take longer than a day or two if done from a book like MTB, provided one's already well familiar with step 1 material. Its just that I have no idea how to CHOOSE what to read, and I'm certainly not going to go through the entire book.

I've also had a friends friend tell me had a question on step 1 requiring him to calculate the affected body surface area in a burn patient. Thats very step 2ish, isn't it? Its easy, but only if you know how.

 

[tvelocity514]

I've also had a friends friend tell me had a question on step 1 requiring him to calculate the affected body surface area in a burn patient. Thats very step 2ish, isn't it? Its easy, but only if you know how.

Our school made us become EMTs and we had to learn that for our emt national exam lol. That was 1.5 years ago though.


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[aspiringmd1015]

we should make a list of what should be read from MTB in a time efficient manner. ive heard gyn/obs, and their micro section is good for drugs, apparently some of the micro questions askign for treatment dont have the appropriate drug that we associate the particular bug with, something like steptomycin for tularemia etc.

 

[walakin25]

Throw in uw ck medicine and you'll handle the 5-20 ck style questions your bound to see.

 

[breadlover72]

I've also had a friends friend tell me had a question on step 1 requiring him to calculate the affected body surface area in a burn patient. Thats very step 2ish, isn't it? Its easy, but only if you know how.

That topic is no where in any review books for Step 1 that I used and it might have made an appearance for me. I only knew it because I was a nurse prior.

Anyway I definitely agree that there have been quite a few CK like questions or at least on mine there was. Which I was thankful for but I'm an exception. The only things that stand out in my memory at the moment for everything I have done are the driving and seizure disorders and total body surface area for burns (rule of 9s.) It doesn't hurt to browse a thread like this that may get you a few more questions right. I also had a newer UWorld question (spoiler alert again) about a patient struck by lightning. I thought that was out of no where.

 

[TheAberrantGene]

@breadlover72
Thanks for pitching in..much appreciated.

Can u put a rough number on the amount of questions you had which you would say were pretty CK-ish on your test ?

Btw..about what u said..I knew about both from the Experiences thread... Answers to both:

1. Driving/seizure: 2CK MTB (2nd Edition) pg567
2. Burn BSA: 2CK MTB (2nd Edition) pg547


Great to see more people contributing !
Thanks !

 

[tvelocity514]

@breadlover72
Thanks for pitching in..much appreciated.

Can u put a rough number on the amount of questions you had which you would say were pretty CK-ish on your test ?

Btw..about what u said..I knew about both from the Experiences thread... Answers to both:

1. Driving/seizure: 2CK MTB (2nd Edition) pg567
2. Burn BSA: 2CK MTB (2nd Edition) pg547


Great to see more people contributing !
Thanks !

For those of us that don't have MTB 2ck would you mind typing the big picture of those two things please?


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[breadlover72]

@breadlover72
Thanks for pitching in..much appreciated.

Can u put a rough number on the amount of questions you had which you would say were pretty CK-ish on your test ?

Btw..about what u said..I knew about both from the Experiences thread... Answers to both:

1. Driving/seizure: 2CK MTB (2nd Edition) pg567
2. Burn BSA: 2CK MTB (2nd Edition) pg547


Great to see more people contributing !
Thanks !

No problem. It's hard to remember exactly since it all seems to be a blur now but I want to say I had at least 5 questions that asked me what would you do FIRST treatment wise. Probably about 5-10 that were random like the burn surface area percentage. Maybe these were experimental? I dunno. Sorry, I get my score today and I've been suppressing questions trying not to think about it anymore, haha.

@tvelocity514 For the seizure one, it's state dependent but what I found in general was if theyre 6 months seizure free and well controlled on meds they can legally drive. Otherwise, if they are still having seizures legally they cannot drive and must be reported (someone correct me if I'm wrong.) Now for the burn one... look up the burn patient rule of 9s... there's a nice graphic of it which helps. But in general one arm is 9% (anterior 4.5%, posterior 4.5%), anterior leg is 9%, posterior leg is 9%... and so on. Hope this helps.

 

[breadlover72]

For those of us that don't have MTB 2ck would you mind typing the big picture of those two things please?


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Here, I couldn't figure out how to get this on here til now, still new and learning, haha.

 

[tvelocity514]

Here, I couldn't figure out how to get this on here til now, still new and learning, haha.

Thank you!!


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[TheAberrantGene]

Thanks !

 

[TheAberrantGene]

@tvelocity514

Might be a good idea to get a copy of mtb ck.. atleast a pdf one..

 

[TheAberrantGene]

(Spoiler Alert !! NBME 17 !!)

Btw one more CK content on step 1:
- Hospice care was only in Step 2 CK books.. then it creeped into the real deal and Step 1 NBME 17.. then into UW step 1..

...when you do CK UW have a look at the table and the stuff written.. it is the same stuff that's written in UW Step 1.. its verbatim the same thing..

 

[tvelocity514]

(Spoiler Alert !! NBME 17 !!)

Btw one more CK content on step 1:
- Hospice care was only in Step 2 CK books.. then it creeped into the real deal and Step 1 NBME 17.. then into UW step 1..

...when you do CK UW have a look at the table and the stuff written.. it is the same stuff that's written in UW Step 1.. its verbatim the same thing..

Just curious how do you know that? Do you have ck uworld already? Just got a copy thanks! You can delete your message now w the website part


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[TheAberrantGene]

Just curious how do you know that? Do you have ck uworld already? Just got a copy thanks! You can delete your message now w the website part


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Yeah i have a UW CK subscription..
How well are you doing in Step 1...
The CK UW may not necessarily be the best place to use time if you arent > 250 on Step 1 already.

 

[TheAberrantGene]

If u r doing well on Step 1 it may be a good idea to do UW CK..

it is easier than u think.. Mean and SD for step 2 is'nt much higher than Step 1 for nothing..
You will be astonished by how much u already know when u do CK stuff.. I am getting mid 60s to mid 70s on CK blocks..

They should call Step 2 as Step 1 (Pro version).. lolz

......And perhaps Step 3 as Step 1 (Pro version) + A couple of stupid case simulations - add on

 

[tvelocity514]

If u r doing well on Step 1 it may be a good idea to do UW CK..

it is easier than u think.. Mean and SD for step 2 is'nt much higher than Step 1 for nothing..
You will be astonished by how much u already know when u do CK stuff.. I am getting mid 60s to mid 70s on CK blocks..

They should call Step 2 as Step 1 (Pro version).. lolz

......And perhaps Step 3 as Step 1 (Pro version) + A couple of stupid case simulations - add on

Yeah not that good yet haha.


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[mcloaf]

@tvelocity514

Might be a good idea to get a copy of mtb ck.. atleast a pdf one..

There is more than enough step 1 content to go around. Of all the reports of people scoring 260+ on this board I don't ever recall seeing anyone who added step 2 resources to get there. I think you guys are over selling this stuff.

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[pd1112]

This is a waste of time. Can't think of anyone scoring high and recommending this. Your working memory is finite. Fill it with what makes up 98% of the test, not the 2%.

 

[TheAberrantGene]

Yeah i agree.... it is for those who wanna go an extra mile

 

[DrPicard]

So are you just doing UWorld CK or reading all of MTB as well? And, just out of curiosity, how are you approaching UWorld CK? Devouring everything or only focusing on sharpening your diagnostic skills?

 

[TheAberrantGene]

So are you just doing UWorld CK or reading all of MTB as well? And, just out of curiosity, how are you approaching UWorld CK? Devouring everything or only focusing on sharpening your diagnostic skills?

I am gonna be starting out by saying.. I see that a few on this forum don't agree with my way of studying.. I have ALWAYS had a different approach than others..and well.. it has worked out well for me.. But you know to each his own.. so i had a lengthy rebuttal to the above 2 arguments but then edited and deleted it all and wrote: yeah i agree..whatever.. above your comment. (You can see the LAST EDITED as 5 hrs after the original comment was posted.. I think I am right, but that's the way contrarian thinking works.. people think you are wrong till you turn out to be right..Whether it is in the markets or in studies.. I am not gonna delve in depth about what that is..as it will take 5 days to explain it..and no one has time.. long story short.. i gave a detailed response and then deleted it coz i thought it wasn't worth arguing about..)

So the following is what I am doing. You should think over what is good for yourself before you embark on this. (FYI I have been getting 260s & one 270 since a while and am an IMG so I don't have a time limit for the test. I will give it after I am firmly over 270 on NBMEs..maybe nudging/crossing 280s..So well..this is what I am doing but think over it before u decide to replicate the same..)

I am doing :

UW CK, Kaplan CK, MTB 2, MTB 3, Medquest ABIM, Medquest Step 3, Kaplan CK Cases, DIT 2, DIT 3...and Fischer's card series..diagnostic etc, 200 cards per series..
along with step 1 stuff of course..

But yeah, I had always had a different approach than most others in my med school, as well as, life in general. So, again, before you embark on this path, think over it if this will work for you or not. Also as i stated.. i have been scoring very well..so think over it before u go on this path.

 

[TheAberrantGene]

UW CK..I am taking core concepts in..

Whereever it says XYZ guidelines by ABC association says "bla bla bla"... i dont memorize it that way.. as in like a guidelines kinda way.. i take the concept in..

Also, FYI, the Step 2 CK is pedantic about timings of vaccines..and also timings for screening and USPSTF stuff.. that is IMO out of limits for what can be asked on step 1..

I leave the excessive pedantic stuff and do the broader big picture stuff..and am not memorizing in word for word either..

 

[TheAberrantGene]

Basically.. take in like 70% or so of UW CK which is easily memorizable..and u will be leagues ahead of others.. dont get too caught up on the minutae..coz u know..its minutae for the Step 2 and we are doing it in step 1..so we are already ahead of the curve..no point torturing ourself too stuff which has very little if any chance of coming on the step 1..

 

[mcloaf]

am an IMG so I don't have a time limit for the test

This trumps anything else that's been written ITT. I hope you achieve the score you're hoping for, but the methods you're using and advocating are a terrible idea for students who have only 4-8 weeks of dedicated time to study for step 1.

 

[fri4583]

Hey!could you please put up a list so that it'll be helpful for those with less time/resource?