STEP 2 CK experience

Hi all, we – Amjad Elmashala, Kinana Abu-Rayyan, Mohammad Adawi- are fresh graduates of Al-Quds
University- Palestine / class of 2016. We took our exam nearly in the same period and got our results on the
same day, so we have decided to share one experience since we did pretty much the same with few differences.
We all started preparing for the USMLE by preparing for step 1 exam in the beginning of our internship year.
USMLE scores
 Amjad: 272 (step 1: 269, CS passed)
 Kinana: 271 (step 1: 257, CS passed)
 Mohammad: 267 (step 1: 259, CS not done yet)
Self assessments
AMJAD KINANA MOHAMMAD
NBME 4 Not done 273 Offline (10 mistakes)
NBME 6 Offline (11 mistakes) 262 Offline (8 mistakes)
NBME 7 247 244 252
FRED 92% 92% 92%
UWSA 1 272 281 281
UWSA 2 261 270 262

Preparation duration
It took us 3.5 – 5 months to prepare for the step 2 CK exam.
Studying hours per day
We initially studied for an average of 4-6 hours per day. Towards the end of our preparation period, we
dedicated an average of 8-14 hours per day. All of us were doing our internships during the preparation and we
did not take time off except when we travelled to the Prometric center in Amman to sit for the exam.
Materials
 UWorld for step 2: It was our ultimate resource. Our goal was to master UWorld as we were all sure that it
will be our only friend during the exam! We all did it topic wise once offline over 1.5-2 months during
which we took extensive notes, then registered for the online version for one month and did it randomly.
Our cumulative performance was on the 99th percentile and we got 95-97% correct questions. Each of us
revised the notes 2-3 times.
 Books (Kaplan & MTB): We did not rely much on books for many reasons. All three of us were in the top
10% of our class as we studied very well during our clinical rotations. As for MTB, one of us skimmed
through it rapidly while the other two did not touch it. As for Kaplan, we studied its books during college
years (especially IM and OB/GYN). Amjad went through Kaplan OB/GYN once. We did not feel the need
to spend much time on books since we were running out of time. However, our previous readings of Kaplan
books during collage definitely helped.
 UWorld for step 3: We worked on our weak points with UWorld step 3. Amjad did not solve any step 3
questions, Kinana solved psychiatry and biostatistics and Mohammad solved psychiatry, behavioral science,
biostatistics and OB/GYN. Our rational here was to solve more questions for a given subject to be more
confident during the exam.
 CMS: Each of us tried to solve as much CMS questions as they can, knowing that CMS questions are
written by the same people who write the real exam. Fields covered differ between the three of us since not
all of us had enough time to continue the whole thing. All of us solved OB/GYN and psychiatry.
 100 cases by Conrad Fischer: Not all of us did it because we all had gone through it while preparing for
the step 1. It's helpful especially for those with no prior step 1 experience.
 First Aid for step 1: The psychiatry & Biostatistics chapters are very well presented in FA, and our step 1
notes were crucial to us, so we all decided to revisit our beloved FA. For those who are taking the step 2 CK
prior to the step 1, we do highly recommend solving UWorld for the step 1 and reading FA for these two
topics.
 UpToDate: We used it whenever we felt the need to understand more about certain topic. Amjad did not
use UpToDate. The contribution of UpToDate, however, to our preparation was minimal.
Mohammad Adawi’s experience
As for step 2 CK, I started my preparation in the beginning of March, 2017. I have read many experiences and
found that all of them prioritize UWorld pretty much over everything else. Nearly all experiences mentioned
that books are not that important for STEP 2 CK compared to step 1 for which FA was the Bible :P
So I have started my journey with step 2 CK first by skimming Kaplan and MTB, just to be safe, and then began
solving UWorld offline, subject wise, with note taking which was time consuming but for sure worthy –. This
process took me about 2 months to completely and thoroughly go through it. After that I read the notes and took
my first assessment, I did NBME 6 offline and got eight wrong questions.
After that I subscribed for UWorld online. I started solving UWorld questions again, but this time it was in a
random and timed mode. I solved 100-120 questions per day, and took some additional notes. During this
period, I took NBME 4 offline, which was harder than NMBE 6. I, then, resumed solving UWorld questions
and it took me 1 month to finish it. My overall performance was 97%.
After that, I had less than a month. I have decided to reread my notes, solve the remaining assessments, and
maybe CMS questions whenever I had the time. So I took NBME7 online, and it really felt terrible since I found
it very vague with many distractions, ended up with 252. I was frustrated, because I made many silly mistakes
and had no time to study anything new. However I was a bit reassured since my friends did it too and had the
same experience and bad performance – maybe it was viral :P
I kept reading my notes and solving CMS questions. I solved all of them and finished reading my notes at the
same timeUWSA1 was OK in terms of questions length, with some short questions and some long questions. It
is not that hard and does not look like the real exam. I think it overpredicts your performance. UWSA 2 was
much harder with very long questions and resembled the real exam much more than UWSA1 – we all agreed
upon this issue.
After being done with UWSAs, and getting decent scores, I thought that there is nothing much to do left. I
solved FRED online and got 8 mistakes, 92%. And I solved behavioral, psychiatry, biostatistics and OB/GYN
from step 3. I did them just because I had time, not because they are important, and honestly I did not find them
useful - too advanced for Step 2 CK.
Exam Day
I have tried to sleep well before the exam since this was my mistake in Step 1. I went to bed at 9.30, but was not
able to sleep until 12.00 a.m. and kept awaking throughout the night. As I entered the exam room and started
solving the questions, I felt they were very similar to UWorld style but they were much harder and with less
clues. I took a break every 2 blocks initially and then after each block of the last three. I have stayed focused till
the sixth block but after that – you know mental frying and fatigue kicked in. I managed to finish on time. I had
extra 5-8 minutes in every block. After finishing the exam, I felt very happy since I did my best.
If I am going to give you an advice, it would be doing something for the behavioral. The questions were tricky.
I know I did not perform well on them as my performance was borderline.
Kinana’s experience
I started preparation in April after finishing my CS exam. I started by reading UWorld offline. I was slow in the
beginning but then I became faster. I timed myself to get done with UWorld offline in 2 months. I didn’t take
regular days off. I just had a break whenever I felt tired or had something to do. My plan was to do MTB with
UWorld but when I did one of the chapters, I found that its content is much less than UWorld with insignificant
additions. So I decided to forget about it at that time. During that time, taking notes was time consuming but, of
course, worthy.
When I finished UWorld first time, I rapidly went through my notes over around 10 days after which I
subscribed for UWorld online for one month. I had to do a minimum of 80 questions a day randomly which was
overwhelming to me but I managed to finish on time. During my second run, I had NBME 6 (6 weeks before
exam) and NBME 4 (3 weeks before exam). Then, I went through my notes for the second time over 6 days,
and took NBME 7 (10 days before exam), I was disappointed by the results. My problem was that I ran out of
time in 2 blocks and had to leave some questions unsolved. Two days later, I did FRED which was kind of easy
with a few confusing questions. I also did CMS offline for psychiatry and OB/GYN. I wanted to do the whole
thing but I was running out of time. Five days prior to the exam, I did both UWSA 1 & UWSA 2 together. My
scores assured me that I was ready for the exam. In the last week before the exam, I did UWorld step 3 for
psychiatry and biostatistics. I also went rapidly through 100 cases by Conrad for ethics. I revised easily
forgotten subjects like development charts, drugs of abuse and dementia subtypes.
On the night before the exam, I slept well and was not anxious since I went through such experience in step 1.
The exam day was very long and mentally exhausting. I took short breaks after each block. I had 3-5 minutes
after each block, which were not enough to revise tagged questions. In most blocks I did not revise anything. I
was able to answer a maximum of 30 questions per block from my studying. For the remaining 10 questions, I
had to think of logically and analyze before giving my best guess. My advice to you is to be as much relaxed
during the exam as you can and get used to the USMLE pattern of questions. My impression after the exam was
that I did not do very well and the exam was harder than I expected. For me, UWSA 2 was the most predictive
of the real score.
Amjad’s experience
I resumed my journey with USMLE in the beginning of April when after I got back from my step 2 CS exam
and took a two week break. I did not feel the need to go back to books since I have studied Kaplan for IM and
OB/GYN, first aid for surgery and the illustrated textbook of Pediatrics during my 6th year of medical school.
I began solving UWorld questions offline and took notes extensively as I went through. My performance was
very good in most topics. This process took me a month and a half. Then I dedicated two days to refresh my
memory with Kaplan OB/GYN. After that, I printed my notes and went through them once (two weeks) and
took my first self-assessment (NBME 6).
I registered for the UWorld online for one month and was able to go through all of the questions randomly in 20
days (120 questions per day). My overall performance was 95%. I took NBME 7 online and got 247 … at this
point I was devastated! I had one month to go, so I revised my notes one more time over a period of 10 days,
took the UWSA 1 & 2 on the same day, solved psychiatry, OB/GYN and half of IM CMS questions and took
FRED self-assessment online. I went back to my FA and read biostatistics, psychiatry and microbiology (fungi
and parasites only). I was planning on doing the step 3 questions for psychiatry, but as I read the first five
questions, I knew that the exam will not ask questions like these.
My exam was on July 19th, so I took one week off of my internship and travelled to Jordan three days before the
exam. I did not study as I wanted to not be mentally exhausted on the day of the exam. I slept well on the night
of the exam and woke up a couple of times … but who wouldn’t, right? The questions on the exam were similar
in difficulty level to UWSA 2, and definitely harder than UWorld and UWSA 1. On the first two block, I had
+20 minutes extra to revise. As I was going through the exam, my performance was getting slower – with only
5 minutes remaining in the last block. I felt comfortable after the exam, but knew that I did not perform well in
behavioral and psychiatry (which I studied most) as this was reflected in my score report.

A frequently asked question

 Do you think taking step 1 prior to step 2 CK is better, even after graduation?
Absolutely! We all agree that preparing for the step 1 before the step2 CK has saved us a lot of time and, of
course, has boosted our scores. It was very helpful especially for psychiatry, statistics and infectious (fungal and
parasites). We do strongly advise doing step 1 before.

BEST OF LUCK TO YOU ALL