Took the heinous thing a month ago and got results back (262- respect to previous posters, I used their studying advice). Step I of 258.
Overall, I found the test quite balanced. I wouldn't disagree with people who claim an Ob/Gyn emphasis, but my other friends didn't see it. Some got hammered with neuro instead. My comment would be you need a broad base of knowledge... yeah, can't really narrow it down
Yep, USMLEworld is much like the real deal. If you had only $100, I would get that. Before a review book even.
It was a strange, discouraging exam when I took it. I'd see a few gimmies, but I got a lot more questions where I felt instinct was more important than pure knowledge and experience. It's like working at the world's worst hospital (can't we order labs AND the EKG AND the CXR at the same time?!). Toward the middle of the exam, I felt hungover and was reflexing-clickling the mouse half the time. The worst part was when they would ask a similar question on the same topic a few sections later. I was stuck thinking, well, I would like to do the same thing I told you guys earlier, but you're probably trying to trick me, what's different about this scenario, etc. This is followed by thinking you missed both questions at the end of the exam.
So I guess the moral is don't worry, just take the d*** thing. Answer the question with your instincts. Answer to make yourself feel good. Go home feeling like you answered the way you would in real life. Don't try to outthink the testors. Channel your Zen, Chi, Yoda, Jesus, Oprah, whom/whatever.
There were also zebras. I had two questions on neurofibromatosis, for example. A general surgery question dealing with thyroid cancer (not a zebra per se, but the question seemed more fit for a resident).
For studying, I adhered to the advice that memorizing Step 2 Secrets was the way to go. I had Family and Peds prior to Step 2, and so I also studied during those rotations (esp. Family). I started doing QBank (semi-OK) and QBook (better) as well. Subscribed to USMLEworld a month prior to test date and started to gorge on humble pie. After I finished Peds, I had about 10 dedicated days before test time. I felt I knew Step 2 Secrets well, but USMLEworld was really frustrating me. Managed to finish USMLEworld just before I took the test (scoring the low 70%s). Browsed First Aid Step 2 CK the day before and felt I should've done that instead of Secrets.
That said, I also prepped a lot for individual shelf exams during the year. Also did QBook with my shelf exams (very reasonable questions). Ergo, didn't do any subject specific studying. Part me of attributes my score to luck, I didn't deserve this as much as some people. I was much more dedicated in studying for Step I. My overall advice would be to know a broad base of basics cold. Who cares about the mechanism of phosphorylation of gene GFKYSLF anyway (or when is it so emergent that you can't look it up)?