I spent about 18 days studying for Step 2. In all, it was MUCH BETTER than studying for Step 1. For one thing, a lot of the information seemed much more logical, and I could actually remember it in the context of my own patients...this is so important, because in step 1 studying everything was so abstract and memorization-heavy. i can honestly say i did very little "memorization" for this exam; it was more "algorithms" and knowing what test to order, what treatment, etc. My advice would be to study TREATMENTS as much as possible because this is where we are weaker in general - a lot of the time on the test, I would know the exact diagnosis within the first sentence but the question would ask for something regarding "best next test", "associated genetic abnormality", "complication" or "treatment". I also strangely felt very good after studying, because I finally felt like things had come together and I was finally kind of growing into my own as a future doctor. Silly, I know, but still.
I studied about 6-10 hours a day. The first week, I went through all of First Aid, three sections a day, highlighting and taking notes. I only did 1 or 2 question blocks at most during this week. Then the second week, I read some of Step 2 Secrets and did about 2-3 question blocks a day. The final week or so, I essentially plowed through 4-5 question blocks a day to finish up everything 1 day before the test. I started out TERRIBLE (i.e. low 40s) and by the end my average was ~ 65%; toward the end I was getting tests with averages in the high 70s and low 80s. I took most of my tests in tutor mode, taking lots of notes and really trying to learn. toward the end of the study session i did a lot more timed just to make sure I could handle the time pressure. I took the night off before the test and just went over some high yield things. Of course I could not sleep and ended up getting about 2-3 hours. This I would not recommend.
The actual test was pretty tough, I won't lie. I was disappointed walking out of the center and nearly burst into tears - I had felt a LOT more confident going in than I did coming out. It was so completely frustrating, because for nearly every question I KNEW what was going on, knew the diagnosis, knew exactly how I would proceed, etc. but the stupid answer choices were just off the wall, or I would narrow it down to two, and then keep second-guessing myself and changing my answer. I feel terrified because I changed my answer on so many of the questions, which always leaves you with a bad feeling. Sigh. It is so terrible that this is the way they're going to assess my clinical knowledge. 🙁 🙁 In terms of difficulty, I would say certain questions were definitely along the lines of UsmleWorld - in fact, as other posters have suggested, there were about 5-6 that I didn't even read because they were almost verbatim from UWorld. That was definitely helpful. I would say the ethics and epidemiology questions, which nearly made me want to break my computer when I was taking them in USMLEWORLD, were 10000 times easier on the real exam (i.e. what is sensitivity? specificiity? 🙂 ) Oddly enough, I feel like I got at least 5 questions on the real exam that were repeats of each other, which would have been nice if I'd known the answer. Trauma was still hard (as hard if not harder than USMLEworld)....
Anyway, I'll post my scores when I get them back. Just so you know the numbers:
Step 1 score 229
Shelfs: terrible in the beginning to okay - highest was 94 in Psych, 88 internal med, 78 OB/GYN, 68 surg (ouch), 72 FP, 70 Peds
Good luck to all and if anyone has any questions feel free to PM me. 🙂