The United States Medical Licensing Examination (Step 2 Clinical Knowledge, aka USMLE Step 2 CK) is a 9-hour-long exam divided into eight blocks of 60 minutes each with a total of 318 questions based on clinical scenarios that test the examinees’ ability to apply medical knowledge and understanding of clinical concepts with respect to patient care, with an emphasis on health promotion and disease prevention.

Considered a vague and lengthy exam by many, USMLE Step 2 CK’s preparation almost always presents as a challenge for test-takers. To help streamline your preparation, we have mentioned below the resources and strategies to prepare for Step 2 CK.

Time required: 4-6 months

Resources:

• Uworld

Uworld is the gold standard learning tool for Step 2 CK preparation. A lot of test takers prefer to do two rounds of UWorld, but depending on the assessment scores, sometimes one round is enough as long as the first round is done in a random/mixed and timed fashion intensively over a short period of time. It is very important to make notes out of Uworld content, especially focusing on algorithms, images, and tables to revise close to the exam.

• Amboss

Both Amboss library and question bank serve as comprehensive resources for Step 2 CK. Amboss is an especially high-yield resource for questions on Public Health Sciences – ethics and communication, quality & safety, and biostatistics.

• Divine Intervention podcasts

These podcasts are considered very high-yield for Step 2 CK and are widely popular amongst test takers. A few must-do podcasts are on the following topics – Geriatrics, Military, Trauma, Quality & Safety, Screening Guidelines, Diagnostic Errors, Preventative Medicine, Palliative Care, Next Best Steps in management, and a guide on prescribing antibiotics.

• OnlineMedEd Videos/ Boards & Beyond

These are comprehensive video resources for Step 2 and are great for concept building, especially if you do not have a strong conceptual base.

• First Aid for Step 1

There is a lot of overlapping of concepts between Step 1 and Step 2 and First Aid is the best resource to reinforce Step 1 concepts alongside Step 2 preparation.

• ANKI-Decks

A lot of test takers prefer a method of learning that reinforces concepts again and again, and ANKI decks are the best resource for that purpose. You can find pre-made decks like ZANKI and add to them or create your own.

Assessments:

• NBMEs

NBME self-assessments are the forms available on the NBME website and serve as a comprehensive simulation for the Step 2 CK, covering almost all the topics that are asked on the test. 

The latest NBMEs available for Step 2 CK are forms 9-12.

NBMEs should ideally be started at 70% of Uworld and given at appropriate intervals further.

For Step 2 CK, NBME 10 is currently considered the most predictive and so should be given closer to the exam.

• UWSAs

There are two UWorld self-assessments available for Step 2 CK, and it is recommended that UWSA 1 should be given 1 month before the exam, and UWSA 2 in the last week before the exam as it is also a very predictive assessment.

• CMS forms
  

These are also the assessment forms available on the NBME website. These are subject-wise forms and are available for Surgery, Medicine, Pediatrics, Obstetrics & Gynecology, Emergency Medicine, Neurology, and Psychiatry. A lot of concepts are repeated on the exam day, so these high-yield forms should absolutely be done in the dedicated period of preparation. The latest two forms of each subject are recommended.

• Free 120 questions

Sample questions are available on the USMLE’s official website. Do these 1–2 days before the exam. They simulate the exam most closely.

Take the sample test in the Prometric center itself to get a better simulation of the exam environment.

A few pointers on preparation:

-If possible, start the preparation not too long after Step 1 (ideally no more than 4-5 months). A lot of content is repeated and too much gap between both steps makes the preparation difficult.

-Prepare intensively over a short period of time, as preparation for Step 2 CK is more practice-based.

-Do Uworld in a random/timed fashion, if possible, right from the start. If needed, do Amboss system-wise before starting with Uworld.

-Don’t focus a lot on video resources and a lot of redundant information that is available, as Step 2’s syllabus is volatile and memorizing everything is in itself a big task.

-Refer to USPSTF website for the most updated screening guidelines and focus on category A and B recommendations.

-Refer to CDC’s website for the most updated vaccination guidelines.

-For Step 2 CK, a lot of test takers struggle with time management owing to the bigger length of questions. So, make sure to practice timed blocks to hone your time management skills beforehand.

The exam may seem very intimidating and its preparation even more so than Step 1 itself, but it’s perfectly doable. While there are a lot of recommendations available on various platforms on how to prepare for the exam, you should try different resources and strategies before sticking to the one that suits you. Remember, everyone has their own unique way of going about preparation.

This blog post was written by our Match A Resident Ambassador, Dr. Parul. You can find her on Instagram: @animgsjourney