Monday, July 24, 2017

How to study for USMLE Step 2 CK

If you are short of time, don't read this. Seriously, if you have 2-3 months to prepare - Just do UW, assessments and give the exam. You will do great!

If you have a good 6-12 months, you are just starting your prep and need honest advice, here is mine.

I haven't got my score yet, but the post has been requested before I even gave my exam. So here it is =) I wonder if my credibility changes after my result. Oh well, guess I'll never know.

Remember for step 1, we saw all the Kaplan videos, heard the Goljan audio, did the Qbanks and then did USMLE World question bank (UW)?

Step 2 CK is nothing like it. The only book that is highly recommended is Master The Boards by Conrad Fischer and Step up to step 2 CK. I didn't like either of these books. They felt like they were telling me random points without context. Reading it first felt like wasting time, even if they were high yield.

Then there are Kaplan videos. They are great, but if you do them first, they will take forever.

Now this post will be blurry between "what I did" vs "what I think you should do".  Regardless, take what suits you :)

So what I did was - I started UW.

Phase 1: Get the info
Duration: 6 +/- 2 months
Sources: UW - Reading books - Flashcards

Phase 2: Time to test yourself
Duration: 1-2 months
Sources: CMS - NBME - UWSA

Phase 3: Exam
Duration: 9 hours
Sources: Your braaaaain :P

If I wasn't comfortable with a UW topic / question, I would go back and look up the sources I have stored in my computer.

Now these "sources" have to be better than UW, should have the explanation in detail with the latest guidelines and should make sense to you.

These were my sources, I found them over time and they were really helpful.

Remember, I looked up these sources only when UW did not make sense / wanted to read more. I did not read these books from front to cover / did not listen to all the audios or see all the videos.

Phase 1: Getting the information

UW: I did it in timed, random mode from the start. It is because I get bored with the same subject easily.

Flashcards: If there is something volatile, I used to enter it in my Anki flashcards. Now entering all data into your deck can be time consuming, so I downloaded ready made decks and transferred cards from others decks into mine. I kept revising mine throughout my prep. It helps you remember. A wise quote - The bane of knowledge is to forget.
I also used to Google images on my phone and take a screenshot of various image types and enter it in my flashcards. Example, fundoscopy images of CRAO or CMV retinitis. Or what the rash of disseminated gonococcemia looks like. I was comfortable with images as a result.
I shared my decks on Anki but they removed it due to insufficient downloads :/
I'll probably share them again on Google drive.

UpToDate: If there is any guideline mentioned in UW, look it up on UpToDate (U2D) for more information. Or at least read the "Summary and recommendations". REALLY helps!

Initially, I tried reading Harrison / step up to step 2 CK / MTB. None of these resources are perfect. I would recommend U2D for it. UW should be enough.
I loved listening to MKSAP audios (topics that I find tough) in my free time. Because it was listening and my eyes could rest :)

Blueprints obstetrics and gynaecology
If I needed to read more: Williams Obstetrics
For incontinence, I referred Kaplan videos.

Pediatrics secrets
Pediatrics board study guide

Surgery A case based clinical review (ABSOLUTELY LOVE this book)
Kaplan videos from step 2 CK or step 3 if I was uncomfortable with a topic.

UW and U2D is enough.
Recommendation: Know the guideline in and out. Duartion of symptoms. What "symptoms" actually qualify for a particular disease.
Questions will be super confusing (especially CMS ones) and you will realize that real life is not nice and beautiful like UW :P

Guidelines in preventive medicine:
Remember, look up ALL the guidelines, in and out from USPSTF website and UpToDate. Example, UW tests you who should be screened for AAA. In the exam, you will also be asked who needs treatment ( > 5.5 cm) so if you don't know this in and out - you will get this wrong.
(I will try to put my notes on the blog).
Know these thoroughly:
Screening intervals.
Immunization guidelines.
Risk factors.

Random stuff I did (Of course, not completely):
Kaplan step 2 HY: Quick and nice videos!
ACP Internal Medicine Board Review videos: I think I did Acid Base and Electrolyte disorders from it. They are good.
Ethics: I read a few cases from journal of ethics by AMA while looking up some NBME / UW answers. It's good. It's like a story book tbh - (Only a sadist can find this entertaining lol but you gotta do what you gotta do for exams)
Dermatology: The Netter Collection of medical illustrations - Integumentary System. It is short and sweet! Screenshots of every rash from Google images overview in my flashcards.
Ophthalmology: Again, screenshot everything!
Medquest IM videos: I think I looked them up randomly.

Phase 2: Prepare to die for it is assessment time

CMS: After you are done with UW, do CMS.
(I gave NBME 7 before doing CMS - It was an eye opener.)
What is CMS? Clinical Mastery Forms - 4 form of IM, surg, peads, neuro and psych each. They are brutal. After CMS, give an NBME. I gave 6 or 4 I think.
CMS doubts: I troubled everyone on the planet to help me with my answers. (Thank you to everyone who helped!)

More assessments: I think I did UW2 again, completed NBMEs, UWSAs, FRED 120.
I will update my scores after I get my results so you can gauge the correlation.

Recommendation: If you have the time, do UW3. I wish I did!
Why? Because most questions were management based and I felt like I could do better if I read UW3.

Before the exam:
Do biostatistics thoroughly before the exam. It will help you score points if done well.
Biostats from step 1, including drug trial phases and types of prevention. Do everything you can from step 1. HIGHLY RECOMMEND IT!

Phase 3: Well, you thought that was hard? You are mistaken...

 My exam felt horrible. All the answers seemed plausible. There was stuff from step 1 and I felt like banging my head on the keyboard :P

I (somehow) completed the darn thing and felt terrible and betrayed.
Anyway, I am glad I got done with it.

My friend told me this amazing thing - "You did everything you could."
That is comforting. Regardless of the result.

That's all!
Hope this helps! Leave your questions in the comments below, I'll answer them :)

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