when to take step 2

[coco09]

I'm a M3 planning my M4 year. I am very happy with my step 1 score (250+), when should I take step 2? Do many of the top IM programs require step 2? Only one I saw so far is University of Chicago.

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[velo]

I'm a M3 planning my M4 year. I am very happy with my step 1 score (250+), when should I take step 2? Do many of the top IM programs require step 2? Only one I saw so far is University of Chicago.

If you did well on step 1 and are applying in medicine the answer is "as late as possible." I'm taking it coming up in march. It hasn't been an issue with any of programs I looked at, including UChicago. I also think studying for CK is a good little review before intern year so I think its nice to take it closer to the start of intern year. CS is, obviously, a joke and serves no useful purpose.

good luck on the interview trail

 

[DJ LACTULOSE]

I'm a M3 planning my M4 year. I am very happy with my step 1 score (250+), when should I take step 2? Do many of the top IM programs require step 2? Only one I saw so far is University of Chicago.

taking step 2 in march sounds like a bad idea to me. you forget a lot of stuff during med 4 (you'll have so much time off).

with your scores, i'd take it in october or november. step 2 is much easier than step 1 and if you did really well on step 1, you'll most likely do really well on step 2.

why take it in oct/nov?

the first day to submit ERAS apps is sept 1. if you submit on sept 1, you will get a ton of interviews in sept and oct before the dean's letter goes out on nov 1 (because of your step 1 score).

dean's letters go out on nov 1. most of the bigtime progs don't give out interviews until after this.

if you take step 2 in oct or nov, your step 2 score won't be available until late nov or dec. by this time, you'll have already recieved whatever bigtime interviews you're going to get based on your step 1 and dean's letter.

the closer you take step 2 to med 3, the easier it is (esp if you had to take shelf exams during med 3).

by taking step 2 in oct or nov, you're still taking it relatively close to med 3, but still getting all of your interviews based on your step 1.

trust me, you don't want to be studying for step 2 come march 2009. that would suck (sorry velo)!

 

[johnnywalker]

have to agree with DJ...i ended up taking Step II in January, which sucked. I'd have rather taken both in November and get them out of the way before interviews (or at least during the early parts of the interview season). From a motivational standpoint, I can't imagine taking either exam after interviews ending sometime in Dec or Jan, and i'm envious of my classmates that were done with interviews and Step II before Christmas.

 

[velo]

Ok, I clearly haven't taken a popular position here, but I stand by it OP and let me tell you why.

#1: As previous posters have said, Step 2 isn't hard, and it definitely won't be hard for someone who did well on Step 1. Therefore I don't think their "it's important to take it close to your M3 year" argument holds water. You can take it whenever you want and do fine

#2: Your Step 2 score doesn't really matter, with the following caveat, if you take it early, release the scores, and for some reason bomb it it makes you look bad to programs. I also think (don't know how to back this up) taking it and not releasing the scores makes you look bad. This is the standard "it can only hurt you" argument. Doing well on step 2 doesn't do anything for you if you already did well on step 1.

#3: Right now you are finishing your M3 year and feeling very knowledgable and competent. You will start your M4 year with sub-Is and finish those feeling even better about your clinical ability. Then senioritis will set in and you'll start slacking off taking easy rotations (as you should). You'll suddenly realize your clinical 'muscle' has atrophied and get just a little bit concerned about starting intern year. Now ask yourself, what would you rather do to get your confidence back and remind yourself that you do know your core clinical knowlege? Do clinical rotations late in the year or study on your own time for a few weeks for Step 2? And the studying isn't hard, you just have to read first aid and do some practice questions.

I think the answer is clear...

 

[DJ LACTULOSE]

Now ask yourself, what would you rather do to get your confidence back and remind yourself that you do know your core clinical knowlege? Do clinical rotations late in the year or study on your own time for a few weeks for Step 2?

most people don't do anything even if they do feel this way. the end of med 4 is for partying, not studying. you'll learn more in your first month as an intern than you did during med 3/4 (or so they say).

 

[velo]

most people don't do anything even if they do feel this way. the end of med 4 is for partying, not studying. you'll learn more in your first month as an intern than you did during med 3/4 (or so they say).

Ha, fair enough, I suppose you have to account for your own personal level of neurosis. But I will say that studying for step 2 and partying are activities that can easily be done concurrently. I'm living proof!

 

[HiddenTruth]

Listen, why not take it in january sometime? That way it's not too terribly late, and it still won't have any bearing on your application (you can even release the test score). The deadline for programs to submit their rank list is feb 15th. Take it by mid january, and release your score. It won't have any bearing on your application. With this plan, you should get most of your interviews completed by december, and study the first 2-3 weeks in jan, and take that.

I can see velo's point, but I have some friends that are studying right now, and while they're doing it (no choice), it really sucks! Everyone's focused on the match, and straight up just chilling. While, step 2 isn't difficult, it still is an important exam and psychologically it sucks to have it dwelling over your head.

 

[carter]

How about for a US IMG (caribbean) student with great step 1 score? does this still apply or is it wiser to take it early and have both scores?

 

[johnnywalker]

take it in march while your friends are at the bar every night, and you'll regret it...no later than late jan 4 sure

 

[anon999]

There's no right answer for everybody -- if you take it early and do well it will certainly help (particularly at better programs). You'll be done with it early and you can enjoy 4th year.

There is the risk that you'll bomb it though and that WILL definitely hurt you.

It's a bit misleading to call the exam "easy." While it's more interesting to study for and more relevant than step 1, it's challenging in it's own right. Long wordy vignettes with many areas of medicine you just plain haven't seen or experienced yet. Not to mention that much of the material is self-taught -- at least at my school we had little support or lectures to guide us through (unlike the structured curriculum of years 1-2).

 

[CernerDrone]

Easy answer:

Step II CS before November.

Step II CK between October and January.

 

[Rogue_Leader]

Easy answer:

Step II CS before November.

Step II CK between October and January.

I conquer with this statement. The CS is easy enough once you've done your 3rd year clerkships (Med, Surg, Psych, Peds, Ob/Gyn, Family), with the caveat that neuro is also a useful clerkship to have taken before the CS. As for the CK, I took mine in on December 10, and got my results in early January. I think it works well in that if you did well enough on Step I, then it won't affect which interviews you get, and if you do well on step II, you can release you scores with enough time so that it may help you on your rankings.

 

[NotAProgDirector]

#2: Your Step 2 score doesn't really matter, with the following caveat, if you take it early, release the scores, and for some reason bomb it it makes you look bad to programs. I also think (don't know how to back this up) taking it and not releasing the scores makes you look bad. This is the standard "it can only hurt you" argument. Doing well on step 2 doesn't do anything for you if you already did well on step 1.

Don't forget that Step 2 matters quite a bit for fellowships. Doing well should still be a high priority.

How about for a US IMG (caribbean) student with great step 1 score? does this still apply or is it wiser to take it early and have both scores?

As an IMG, you should take Step 2 early to have the best chances. Honestly, having your Step 2 score reported by Nov 1st would be the best option if possible.

 

[DJ LACTULOSE]

Don't forget that Step 2 matters quite a bit for fellowships. Doing well should still be a high priority.

i was told that step scores don't matter for fellowships. the most important things are research, letters of rec from attendings in the field, and your evals as a resident. i heard that as long as you don'thave any fails, they look at step 1 and 2 as pass/fail.

 

[CernerDrone]

I also heard that step I and II didn't matter as much for fellowships. But then again I've heard both.

I guess it's better to do well than not well =)

 

[velo]

i was told that step scores don't matter for fellowships. the most important things are research, letters of rec from attendings in the field, and your evals as a resident. i heard that as long as you don'thave any fails, they look at step 1 and 2 as pass/fail.

I've heard this as well, could aProgDirector comment?

 

[gutonc]

How about for a US IMG (caribbean) student with great step 1 score? does this still apply or is it wiser to take it early and have both scores?

I commented on this in another thread that I'm too lazy to look up right now.

Bottom Line:

US Grad w/ Good Step 1: Take step 2 late (late is relative, Jan - April, depending on your schedule and your school - mine required that we take it by Jan 31...I took it Jan 30)

US Grad w/ Bad Step 1: Take Step 2 early (Aug-Oct) and rock it.

IMG/FMG: Take Step 2 in July of your 4th year, rock it and get your ECFMG ducks in a row. Many good programs use Step 2 and ECFMG status as a cut-off for IMG interviews. Is it "required?" No. Do you need it? Yes.

 

[0382938]

US Grad w/ Good Step 1: Take step 2 late (late is relative, Jan - April, depending on your schedule and your school - min required that we take it by Jan 31...I took it Jan 30)

I would advise not taking it the day of or immediately prior to any deadline (either your school's or the 3-month block in which you paid for the exam). Having had an experience with one of my steps where I was unable to take it on the scheduled day, I ended up just paying the $90 to reschedule within the last week of my exam window, but it was close.

 

[gutonc]

I would advise not taking it the day of or immediately prior to any deadline (either your school's or the 3-month block in which you paid for the exam). Having had an experience with one of my steps where I was unable to take it on the scheduled day, I ended up just paying the $90 to reschedule within the last week of my exam window, but it was close.

If it's a school deadline (and it's not graduation day) it's usually no big deal. A bunch of my classmates had trouble taking CK in the weeks before I took it and had to re-schedule for after the deadline (computer trouble at one particular test center) and the school didn't have a problem w/ it. NBME deadlines on the other hand are less flexible and will invariably cost you cash, brain cells and hair.

 

[LameMedStudent]

...I am very happy with my step 1 score (250+)...

Seriously, is this post real or just to gloat that you scored over 60 points higher than me on Step 1?

 

[ceftazidime]

Hi guys, these posts are really helpful. But what would you recommend if I got a USMLE Step I score of 218, 90? (exactly the national mean). Should I have my step 2 scores in by interview time, or can I go ahead and wait till Sep/Oct? I'm looking into applying to schools in North Carolina like UNC and Wake Forest. (Plus I'm a 3rd year DO student )

 

[NotAProgDirector]

Hi guys, these posts are really helpful. But what would you recommend if I got a USMLE Step I score of 218, 90? (exactly the national mean). Should I have my step 2 scores in by interview time, or can I go ahead and wait till Sep/Oct? I'm looking into applying to schools in North Carolina like UNC and Wake Forest. (Plus I'm a 3rd year DO student )

As a DO student, I would seriously recommend that you have your Step 2 score in early. Some programs might not consider you without it.

 

[subtle1epiphany]

As a DO student, I would seriously recommend that you have your Step 2 score in early. Some programs might not consider you without it.

This hits pretty close to home for me, also a DO student, who would be pushing it to take Step 2 anything other than quite late. I don't mean to hijack the thread, but in a similar situation as the OP, 240/99 and 617/90 on USMLE1 and COMLEX1, respectively. At the moment, looking at a step2 (COMLEX and/or USMLE) around January
I'd love some input on this.

 

[predodoc]

Im having almost the exact same internal debate. I have a 239 and 646. It seems like I change my mind about the timing of this test every time somone says "you should take it late, early, in between b/c such and such". Im starting to think that there are so many variables to everyones situation that any time would be ok as long as it doesnt screw you over in what you want to do. As for me, I think Im going to take it in between(Aug-OCT) just so I dont get screwed either way. Now I just have to figure out which of the 3 months and more importantly whether to take usmle again.

This hits pretty close to home for me, also a DO student, who would be pushing it to take Step 2 anything other than quite late. I don't mean to hijack the thread, but in a similar situation as the OP, 240/99 and 617/90 on USMLE1 and COMLEX1, respectively. At the moment, looking at a step2 (COMLEX and/or USMLE) around January
I'd love some input on this.

 

[Dazeo]

Remember that as long as you take step 2 after Sept 1st, you can withhold your scores as long as you want. I studied a lot during third year for shelf exams, and then I started 4th year with a sub-I followed by MICU, and so I probably knew more then than any other time in 4th year. I took 2 weeks off to study for step 2 and took it in mid-September. I scored a 257, higher than my step 1 score.
My advice: No matter your step 1 score, take step 2 early, you'll probably score higher, and if not you can hold out on releasing your score if you choose to. This should apply to DO students also.

 

[emroyka]

Also, know that schools which require a passing CK score for graduation need to have that score back before the February ROL deadline so they can certify you for the match.

I wish I'd gotten it over with sooner, so ITA with taking it in the fall (before interview season hits) and not automatically retransmitting your scores in case.

 

[Doctorkill]

Just wanted to throw my two cents in.

If you look at surveys of residency directors you will find that Step 2 score is often given more weight than step 1 scores. Also many programs have started to require that you finish and submit step 2 scores in Jan or Feb so that they can be considered when a program is making there rank list. For example http://medicine.iupui.edu/residency/application/criteria/
The administration at my school has repeatedly warned us that residency directors are wary of a person who a) doesn't release there step 2 scores or b) puts off taking step 2 until after the match..take that for what it is worth. I would recommend contacting programs you are interested in applying to and finding out about their policy regarding step 2.

Personally I would suggest taking the test as soon as possible after having taken your medicine clerkship or sub internship as the test is mostly a medicine test but does revisit OBGYN, psych, neuro and peds concepts, the majority of which I have completely forgotten about at this stage in the game. I finished my third year with medicine and I moved my step 2 date forward to take advantage of all of the studying I had to do for my clerkship. I spent 10 days reveiwing OBGYN, etc... I ended up rocking the test. I guarantee that if I took the test now I would be hosed as I have literally forgotten 90% of what I learned over the course of the third year, and a poor step 2 could come back to haunt you when applying for fellowship.

Good luck with whatever you decide to do