Dr. Shalhoub’s #USMLE #Step2CK Experience
Duration of preparation :
From April till August 19th, roughly 4.5 months.
Study schedule:
Average of 6 -8 hours\ day. Used to hit the gym 5 times\week. Thursdays I was mostly chilling,
studied a couple of hours at the beginning of the day.
Materials & journey:
First of all, I did step 1 on Feb 18th, and that of course helped.
I started by giving MTB2 Internal Medicine a quick look, just to get into the mood of Step 2,
and get out of Step 1 way of thinking.
I used to do the blocks of each IM chapter from UW2013 (offline),to train myself to questions
mood from the beginning.
I did not really retain that much from MTB. For me, it was just an introduction. I only did the IM
part at the beginning in like 2- 3 weeks.
Then I quickly went over Kaplan ObGyn in 3 -4 days, to refresh it in my mind, as there is not a
lot of commonalities between ObGyn step 1 and step 2.
I jumped right away to the pediatrics, surgery and ObGyn parts of UW13, without reading the
MTB.
I then bought the UW Online for 3 months and started doing 2 blocks\ day and take down
notes.
I read all the explanations carefully and I often went back to Uptodate.com specially when
something was not very clear to me.
Uptodate helped me a lot. When I have a question, it was easy to find the answer in one
source. When I just want to know what this topic is all about, I would only read the summary at
the end of an article, which is typically 6 -12 bulletpoints. If there was an interesting idea there, I
would go back to the text and read a bit more about it. I also used to check if there are any
algorithms or tables that could help.
My average in UW was around 90%. I used to answer the questions I did wrong in the offline
UW13 with the same answer and get them wrong again, so as not the skew my %.
My plan while taking the notes was like this:
1)I am not allowed to mark more than 10 questions\ block
2)The questions that I was not going to mark, I would take all the notes that I need from them,
because I knew that I am not gonna come back to them
3)I am only going to redo the wrong\marked questions after the first round of UW
Preventive was bugging my soul, so I made a separate part for it in my notebook and used to
visit it again every now and then.
After finishing the first round of UW, I went back to MTB3. I quickly read the pediatrics,
tricks, and for it to guide me as to what to look for on Uptodate. To be honest, there are a lot of
information that I found was wrong and outdated in MTB, thats why i mostly used it to guide me
as to what to look for on UTD.
After that, I went back to my notes and read them again.
Took my first assessment, NBME4,on august 2nd(2+ weeksbefore my exam). I got 286and was
thrilled. I knew it was overestimating, but I was confident I am doing the right thing. To me,
and to many others, this assessment was really easy and looked nothing like the real exam.
I started doing Clinical Mastery series, roughly a block a day. I would do the block in 1 hour,
and then meet with 2 of my friends at 10 pm and we would discuss the questions in 2 hours.
I went back to the the marked\wrong questions and finished them. There was a total of
roughly 500 questions.
Second assessment was on August 14th ( 5 daysbefore my test), NBME7, and got 267.I
knew it was underestimating and kept telling myself to believe in numbers. I hated this
assessment. The kind of questions and tricks asked are very similar to the ones they try to trick
you in in the real test.
3 days before the test, I did UWSA and got 265+,i also did the 3 FRED blocks with it, trying
to simulate an exam experience. UWSA was also way too easy and looked like nothing like the
test.
Exam day
The exam was so long. It’s mentally tiring. The questions ranged from direct ones to the
WTH ones where you have no idea what’s going on.
Direct questions were not the predominant pattern, like it’s the case in UW. The thing
about the exam is that they throw in a lot of distractors.
I took the first 2 blocks, 8 min block, 2 blocks, 10 minutes block. Then roughly 10
minutes after each block.
Topics asked were mostly topics that everyone knows. It is just asked in a particular
situation, and you have to apply your common sense and go ahead. No book can
guarantee you a right answer, but you knowledge would help you in total in trying to apply
common sense and choosing an answer.
Topics that I felt were heavily tested: Post op complications, Psychiatry, trauma and
emergency.
Got media that I found was OK. I couldn’t figure it out from the stem, but listening was
not an issue for me.
After the test, I had no idea how it went. I literally told my friend I can get 240 and I could
get 270. I will have to wait!
Important tips:
I believe the duration is not the most important factor in preparing for the USMLEs. I did
my step 1 in 5 months and this in 4.5. I believe it’s all about studying effectively and not
dive in the low yield materials. My Step 2CK preparation was helped by my step 1
preparation, but I believe 5 6 months should suffice.
Books are fine. Questions are the best.You see, books are great, once you’re done
with a chapter, you feel like a god. But 1 week later, it’s all gone. If knowledge was not
applied, it will be forgotten. There comes the role of questions.
Try to understand the WHYbehind everything. Don’t just memorize if the patient had
back pain with this then the next step is an XR, and if with that then MRI. Rather, know
the WHY. The reason for this is that in the exam, you will have to think in seconds and
there are many distractors. Understanding the WHY can help you get the answers right
and save you a lot of time.
There is no “ Recipe”for Step 2CK. Everyone has his own way of studying and
understanding. I did this and it worked for me, you can do whatever works for you, as
long as you are not screwing up in your resources or the way you prepare.
Learn the differential diagnosis very well. Not just know the name of it, NO, go and
look after how is it different from my main diagnosis. The reason for this is that the
distractors thrown in the exam are usually stuff that will help you rule out\in those
differentials. Make sure you master this point. This comes in really handy in Psychiatry. If
you just go with what is there in the books, you’re not gonna be able to answer with
confidence in the test. They can easily make you go crazy with their distractors.
Master the criteria for Psychiatry. Know what every word means. Again,
UNDERSTAND, and not just memorize. They will be able to trick you in any of these
points. It’s all about mastering the criteria. Knowing the differential helps tremendously
too, again, not just the name, but why its this and not that.
UTD was of great help when it came to mastering the differential diagnosis, because
there is always a part in the article that talks briefly about each differential and how it is
different than the main diagnosis. This is lacking in Medscape, as it only puts the
reference for the differential’s article, without talking about why and how it is different.
UTD is a HUGE reference. If you see this experience and start reading all the articles in
UTD, you’re gonna fail or you’re gonna spend the rest of your life preparing for the test.
You have to be careful and specific when using it. Unless it’s something you really want
to master, I would suggest just reading the summary and algorithms and then going from
there.
MTB is fine, but be careful and don’t take things for granted. Anything that looks odd to
you, go back and confirm it. I can’t tell you how many mistakes I found there, and thats
the main reason I never really read it back again.
The clinical mastery series were helpful. First of all, I did an extra 500 600 questions.
Second of all, its from the NBME! You kind of get yourself in the mood of their way of
asking questions, so it helped. But again, the length of the questions is too short
compared to the real deal.
The exam day was not a pleasant experience. In many of the questions, I was
answering without any confidence. I marked A LOT of questions each block. I remember
in step 1 I barely marked 5 10 because I never came back again to the WTF kind of
questions there. But in Step 2, you know what the question is talking about, but you’re
confused as what to do next, and many times i was like “ Maybe if I read it again I will find
something”. I had about 10 minutes left in each block, but these did me nothing, as most
of the time I was just staring at the questions and I did not know what to do. At the end,
just trust your guts and the NUMBERS. NUMBERS DO NOT LIE. If your assessments
are satisfactory for you, DO IT.
Try to master the timing. I used to try to finish UW blocks with at least 15 20 minutes
left, because I knew the exam is not going to be the same. Try to push yourself. Learn
how to ignore the distractors. My way was like this : I would read the chief complaint, then
quickly move to the end of the question and see what is the question asking for and then quickly glance over the options. After that, I would skim through the stem, but this time I
know what I am looking for and what should I ignore. It’s like going to take history and
physical from a patient when you already know their chief complaint, you will be more
prepared knowing what to ask for and what to examine.
UW is a fantastic source. There is so much information that each time I read the
question, I learn something knew. Read it carefully and try to understand all the little
details thrown in there. Also, undoubtedly, master the algorithms.
Assessments are the best tools to assess yourself. Do not delay them till it’s too late ( I
delayed mine, do not do that). I would suggest doing the first one 5 6 weeks before your
desired date and acting according to the performance. Once you get to the score you
want, go for the test. There is never gonna be a moment in your life that you are gonna
feel confident to do the test. Arm yourself with numbers, aka assessments! Delaying is
not gonna do you any good if you reached your target score, it can actually be worse for
you.
SUMMARY:
Total prep : 4.5 Months
NBME4 (2+ weeks) : 286
NBME7( 5 days): 267
UWSA: 265+
Sources: MTB, UW, UTD.
Final word:
I remember the day I decided I wanted to start preparing for step 1. I read MANY
experiences. It seems just like yesterday. The way to success in USMLE is not an easy
one, but it’s definitely a doable one. I remember myself thinking about people who gets
the 250s and be like “ These people must belong to somewhere else!! “. Do not fall out
short on what most people think is “ good”. Dream big, work hard and you will get there.
Good luck to each and everyone of you. Thank you to each and everyone that helped me get there
in any possible way