Hello everyone, my name is Ayman Saey-eldin, I took my CK exam while I was a GP, and right now I’m a cardiology resident in Egypt.
I realize there are better experiences with more impressive scores in the files section, but I wanted to write my experience because I’ve made some mistakes that I think you should avoid and it would save you much time that I wasted during my preparation.
I will try to keep it short and detailed, what we’re gonna talk about is the following:
• Intro about the CK exam and the STEP 1 dilemma
• Sources
• Studying phase I) the first read
• Studying phase II) the questions
• Studying phase III) Revision
• Shelf exams / self-assessments
• Tips and Tricks about the last 10 days
• Final word
Some abbreviations that I’m going to use:
• UW = Usmle World question bank
• NBME = National board of Medical Examiners self-assessment exams
• CMS = Clinical Mastery series Shelf exams
• MTB = Master The Boards review book
• FRED = the software that the exam is using, with 150 sample questions, available for free on the USMLE website
Now I think we’re all set, let’s start with:
1- Intro about the CK and STEP 1
STEP 2 CK exam is about the clinical knowledge. The main bulk of the exam is internal medicine with subsections including (Cardiology / GIT / hematology / oncology / respiratory / Renal / infection / Rheumatology and Neurology).
You also have the Pediatrics / Surgery & Trauma / ObGyn / ENT / ophthalmology / Psychiatry and behavioral sciences.
IM is large and makes up about 50% of the material. 15% is pediatrics, 10% for surgery, 10% for ObGyn, 10% for psychiatry & behavioral and 5% for the rest. So plan your schedule wisely.
That doesn’t mean the IM is more important, it’s NOT. With most of your time being spent on medicine concepts most of your problems and weak points would fall in other branches, so that’s something you should be aware of. I for one had problems with psychiatry and ethics, and with the misc subjects that I couldn’t find a good source for them, we’ll talk about that later.
STEP 1 is useful yes. My first mistake is that I took a long studying gap between step 1 and the CK test. I often went back to check some of the basis before I went back. I could have saved that time if I started the next test within a couple of months.
Should you start with STEP 1 or the CK; definitely step 1 if you can. It’s hard and long but it makes up 30% of the concepts and it would help you a lot with your preparation. Many places require both steps right now so there’s no motive to only take the CK only. And your previous clinical info is helpful, but not like step 1.
So YES, if you can start with STEP 1: YOU SHOULD.
2- Sources:
So we have the Kaplan books and Kaplan videos. These are the large books.
MTB books are the review books, there’s the MTB for STEP 2 CK, and the MTB for STEP 3 which is better than the previous in branches other than IM.
Some people mentioned DIT videos, Step up books, medstudy videos. I haven’t done them so I wouldn’t judge.
There’s First Aid for Step 2 CK, but unfortunately it’s not like the great Step 1 book. Mostly basic info with no real orientation. Don’t do it.
The most important source is UW. There was some good person who collected the algorithms and tables of UW and put them out there system wise. For me I think this is the most important source of information together with the questions of course.
Kaplan Qbank, I have tried some of the cardiology blocks. Didn’t like it, same concepts with pretentious vignettes trying to be smart. Also most people say it’s a waste of time, so I didn’t put much thought into doing it.
CMS questions are shelf exams, 4 blocks for each of IM / Neurology / Peds / ObGyn / psychiatry / surgery. Collectively they are 24 exams. They have no answers but they contain some old and new info. Some people consider them a source of info.
3- Studying phase I) the first read
This depends on your time frame. What I did was reading Kaplan in each subject then reading MTB. This was a waste of time. I ended up wasting time on Kaplan which had some good info but not really helpful with answering questions.
What I suggest is: read each chapter from MTB, then read the UW algorithms and tables very well, and then move to the next subject. If you have a problem with a concept then you can go to Kaplan, but reading Kaplan with everything was my Second mistake.
The videos: they say they are okay, I only watched the ObGyn part, which I could do without. But nevertheless, watch it if you have the time.
MTB 2 is for IM, everything else is from MTB 3. Except for pediatrics which I did from both MTB 2 and MTB 3. This shouldn't take you more that 2 months to finish. The faster you move on to questions phase the better.
For statistics: UW questions. I had an idea from STEP1, but they say DIT videos are okay too. There are some extra UW questions with good explanations that you can do. They are 74 questions and they are NOT easy but they’d help you if you found yourself struggling with biostats.
4- Studying phase II) the questions:
UW is the most important source. Try to subscribe for at least 2 months. Before each subject read the tables for the second time and then answer the questions and take your notes.
It’s important to read the explanations very well, even those questions that you did right. Read the correct and wrong answers explanations and take notes. Invest time in those questions because you won’t have time to answer them again.
Try to solve UW online, and don’t take more than two months if you can. Some people tried the offline version first, this is a wrong thing to do because: a) questions are always updated. B) you’re gonna mess with your overall score.
Practice answering questions in a timed manner to get used to the time/block. In the end you can answer the questions you did wrong again. And also you can answer the questions you marked again.
Solving the whole Qbank again is a mistake, because you’ll remember the questions and answers and you’d be wasting time. Better off: revise the tables and your notes.
This is a hard phase and the questions are long and exhausting, but the quality of your studying is what’s going to get you the scores.
Other Qbanks are not recommended. Most of the info you’ll need are buried inside UW. Revise your notes and revise the tables better than answering other Qbanks.
5- Studying phase II) Revision
After answering UW and re-answering the wrong questions, it’s time to assess yourself. Assessments are important because they guide you in this important phase. Reading the same stuff over and over again is not helpful. Instead, if you’re weak on something, this is what you should focus on.
Read the tables for the third time together with your notes then take a self-assessment. The score you’ll get should give you an idea about the quality of your studying. Which SA you should take? We’ll talk about that later
After taking the SA you should revise your weak spots, read from Kaplan or some other source, use UpToDate if you can in topics you want to look up on, solidify your already studied concepts, revise again and take another SA.
Keep doing these steps until you feel you’re ready to take the test. Don’t feel down if you got a bad score, instead; figure out why you fell and work on it. This is better than living in delusions.
This phase is stressful but we all went through with it. Focus on the UW tables and algorithms, they contain the most important concepts you’ll need. And work on yourself.
6- Shelf exams / self-assessments
NBME has a couple of exams, the most predictive is NBME4. NBME 6 is good but is a bit easy. NBME7 some found it hard, including me. Downside is that the questions are shorter than the real exam.
UWSA is more like the exam, but a bit easier. They say it’s the most predictive.
My scores were:
UWSA: 259 8 weeks before the exam
NBME 4 : 254 4 weeks before the exam (19 wrong answers)
NBME 7: 231: 2 weeks before the exam (39 wrong answers)
NBME 6: 1 week before the exam (offline) 16 wrong answers + FRED in the same day (9 wrong answers)
I hated NBME 7. It broke my spirit and shattered my confidence. But I revised it and realized that my problem was anxiety and not reading the stem well. So I worked on that.
CMS are okay. They have no answers so you have to google stuff. There are some groups with very useful discussions, and on the EAMTAR group we’re working on providing explanations for them and some are already done.
I used UpToDate in most of the questions which helped me a lot. Solidified my information and gave me new concepts. CMS questions are not mandatory and they are probably retired questions from old exams. Take them as an assessment of as a source of refreshing your info, also as a means to learn how to think about the questions.
If you’re short on time answer the psychiatry blocks. Maybe ObGyn too.
Now regarding the answers, as I said people are trying to form some reliable answer key. I have some notes for each block that some people might find it useful. Also some UpToDate screenshots from CMS topics. I will upload them if anyone is interested.
7- Tips and Tricks about the last 10 days:
RELAX. You’ve done your best, now is not the time to panic. Revise the tables and algorithms, don’t do MTB.
At least once, answer 8 blocks in the same day to prepare yourself for the big test. I did NBME6 + FRED in the same day which was exhausting but important to do.
Sport will take your mind off things; I used to run every other day. Also try to ditch negative thoughts, I got 231 on NBME 7 which shattered my confidence, but I got over it Alhamdulillah.
By now you should have a strategy for answering long questions. For me I read the last line and the answers first, so that I could orient my mind to find the answers.
For hard questions: mark and leave till the last. Spending time on hard questions will take the time from others that you already know. So better off leave them to the end.
Practice taking breaks. For me I took 2 blocks > break > 2 blocks > break > 2 blocks > break > last 2 blocks.
What’s important is to stay comfortable. I wanted to take large breaks and drink coffee so I did the two blocks thing.
Also I don’t do well with sneakers so I went to prometric with sweat pants and slippers so try staying comfortable.
8- Final word
Stay positive, do your best, help others and trust yourself. It’s not an easy test but it’s doable. Aim high and work for it. If you’re religious; Pray and make Du’aa.
I read Khaled Abd-Elmaksoud’s experience which helped me a lot, here’s a link:
For the CMS notes I’ve uploaded them into Drop box, together with some UTD threads. maybe someone could find them useful
These are some notes from UW that I found forgettable, maybe someone would skim through them after studying
https://drive.google.com/file/d/0ByZM76SXu2XNT3F5c25aajY5LTg/view?usp=sharing
These are the stuff I always forget
https://drive.google.com/file/d/0ByZM76SXu2XNU3NrNFV3ejVoOGM/view?usp=sharing
This is a collection about cancer cervix because I always found it confusing
https://drive.google.com/folderview?id=0ByZM76SXu2XNUkJuVHNZbk5LM1U&usp=sharing
Also please check the links at the end of Khaled’s experience
That’s it, thanks a lot for reading, ask me if you need anything.
Ayman