I'll reserve comment about how I would approach MSII differently until after my surg shelf and unhealthy amounts of alcohol this friday.
I will say most of your actual "board" prep won't happen until after spring break at the earliest. I took mine June 20, and didn't start full-tilt board shiz until the monday after block 5, and even then it was pretty much just IHI/path, with very little pharm. If I did it again, I don't know if I would approach finals much different, other than sew up your grades as much as you can prior to that, so you can ****can studying for classes and study for what really matters. I largely did that, but resigned myself to making whatever I was gonna make in class. It all worked out, but only because Ihnat gave back enough on the final. But, I would take my step earlier. I was SO done by the last week. I mean, really really done. Like not checking traffic before walking out in the street and ****. I have my plan if anyone wants it, but really I'd encourage you to make your own. My weaknesses are not yours, unless you also suck at bioc, endo, and micro. Which, also being OU people, just may be the case I guess. I'll say this, I had a lot more neuro and a lot more anatomy than I've heard complaints of in the past. Ok for me, b/c that meant fewer of the aforementioned holes in my edu.
****, so much for reservation. Must...study...
Before I do, not like I'm some rockstar or anything, but I guarantee there are people with higher GPA than myself but a worse score. So I'm still awaiting the correlation coeff. b/t OU GPA and Step score.

But, the best thing you can do is LEARN the stuff from second year. Integrate it with what you already know. Buckle down when that time comes, but right now don't even think about step one. Until around holidays, when it would be a REAL good idea to schedule it, b/c you could get hosed on the timing of it if you wait.