Tips on Preparing for &

Taking USMLE Step 2 CK

Marilyn Becker, Ph.D., LP

Director of Learner Development
B 624 Mayo
612/626-7196
becke024@umn.edu

March 27, 2009

Session Overview

 Understanding Step 2
 Exam content and structure
 Factors contributing to score

 Planning Your Preparation

 Identifying strengths and weaknesses [ongoing]
 Determining appropriate resources
 Constructing a preparation plan
 Setting your exam date

 Taking Step 2
 Effective test-taking
 Planning your exam day

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 UNDERSTANDING
STEP 2

STEP 2 DESCRIPTION:

 assesses whether you can apply medical knowledge,

skills, and understanding of clinical science essential
for the provision of patient care under supervision
and includes emphasis on health promotion and
disease prevention.

 ensures that due attention is devoted to principles

of clinical sciences and basic patient-centered skills
that provide the foundation for the safe and
competent practice of medicine.

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 Normal Conditions and Disease categories (Dimension
1) - normal growth and development, basic concepts,
and general principles.

 Sections focusing on individual disorders are

subdivided according to Physician Task (Dimension 2).

 Promoting Preventive Medicine and Health

Maintenance [15%–20%]

 Understanding Mechanisms of Disease [20%–35%]

 Establishing a Diagnosis [25%–40%]

 Applying Principles of Management [15%–25%]

CONTENT AREAS

 Internal Medicine
 Obstetrics/Gynecology
 Pediatrics
 Psychiatry
 Surgery

Preventive Medicine/Public Health

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 EXAM FORMAT
 9 Hour CBT Exam Day
 8 1-hour exam blocks [45 q’s/block]
 1 hour “break time”
 Multiple Choice Questions
 Single One Best Answer
 Statement or question followed by THREE to
TWENTY-SIX response options.
 Matching Sets
 Series of questions related to a common topic.
 At least two questions.
 FOUR to TWENTY-SIX response options.
 A small number of multiple-choice items contain
exhibits involving audio and/or video clips [USMLE
Orientation materials]

USMLE
 Registration Process
http://www.nbme.org
 Deadline for taking Step 2CK: February 1, 2010

 Orientation and Practice Materials

 2009 Tutorial
 2009 Practice Test Items [set #1 –untimed]

http://www.usmle.org/Examinations/step2/step2
ck.html

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PLANNING YOUR EXAM PREP

Factors Contributing to
Exam Score

Knowledge
Base

Test Prep Test-taking

Activities Behaviors

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Setting Your Exam Date
 Set performance goal.

 Identify current performance level.

 Plan out schedule. Set aside dedicated

time for final exam prep.

 Consider important factors that may

impact on board review and test
performance.

Identifying Strengths and

Weaknesses

 Initial Self Assessment

 Review performance on shelf exams
 Reflect on personal evaluation of content strengths/weaknesses
 Consider Step 1 performance
 Utilize NBME Self-Assessment Program at
 https://apps.nbme.org/nsasweb/servlet/mesa_main
The Comprehensive Clinical Science Self-Assessment
(CCSSA)
 Ongoing Self-Assessment
 Monitor progress on practice exam questions
 Utilize USMLE Practice Items – sets #2 & #3 [timed]
 NBME Self-Assessment Program

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 Determining Appropriate Prep
Resources

 Types of Review Materials

 Main Review Source
 Reference Source/Major Subject Area
 Practice Question Source(s)
 Exam Master
http://www.exammaster2.com/wdsentry/umn.htm
 Key Points on Selecting Materials
 Limit Sources
 Consider Sources in Relation to Strengths/Weaknesses and
Content Representation on Exam
 Incorporate Previously Used Materials [used on rotations,
First Aid Step 1]

Constructing a Review Schedule

 Determine Bd Prep time and schedule in –
 NBME Self-Assessment Exam #1
 USMLE Practice Test #1 [untimed]
 Review of major deficits, review of very “old” content,
review of major content areas
 Emphasize use of practice questions.

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 Establish final review time
 Plan on dedicated comprehensive “final review”.
 Consider NBME Self Assessment #2 at beginning of
final review time.
 Schedule content/day.
 Allow time for review of Step 1 memorized
information [bugs, drugs].
 Use untimed practice questions as major review
strategy.
 Determine use of CBT functions [USMLE Tutorial].
 Practice timing.
 Plan on reviewing no more than a few hours on day
before exam.

Effective
Test-Taking

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COMPUTER BASED TESTING
 FUNCTIONS
 Mark questions to come back to later.
 Annotate individual items.
 Highlight text/strikeout answer options.

 RESOURCES
 TIME INFORMATION
 REMAINING – BLOCK, DAY
 TIME SUMMARY WINDOW
 STANDARD LAB VALUES TABLE

Be very familiar with and strategic in use of

CBT functions and resources.

APPROACHING QUESTIONS

 Fewer # of Answer Options [3-5].

 Read Question Stem.
 Read Question “Case” – Interpret
Information as You Read  Clear
Understanding  Pause to Formulate
“Answer”.
 Consider Each Answer Option and
Immediately Make a Decision [“Keep”,
“Throw Out”].
 Reread Question if Down to Two Answers -
Consider Both and Select “Best”.

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  Greater # of Answer Options.
 Read Question Stem.
 Read Question “Case” – Interpret
Information as You Read  Clear
Understanding  Formulate Possible
Answer(s).
 Look at Answer Option List for Possible
Answers.
 Reread Question if Down to Two Answers -
Consider Both and Select “Best”.

Planning Your Exam Day

 Exam #1 8 – 1 hour exams
 Break 1 hour total break time
 Exam #2 [includes tutorial time]
 Break
 Exam #3
 Break
 Exam #4
 Break
 Exam #5
 Break Food and Beverages
 Exam #6
 Break
 Exam #7
 Break
 Exam #8

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Recognize that effective test-taking
will include …….

 Using knowledge and clinical reasoning skills.

 Depending on recall.
 Considering the whole “case”.
 Using all that you know – what you know to be
incorrect is as valuable as what you know to be
correct.
 Thinking horses not zebras.
 Using practice questions to establish effective
test-taking.
 Maintaining your performance level throughout
the exam day.

Key Points for Successful

Exam Performance

 Recognize that you won’t know everything, but

that you need to use everything you do know.
 Match test behaviors with past learning and
performance activities.
 Use optimal test-taking approach.
 Maintain focus and attention.
 Practice, practice, practice with questions.
 Resolve test-taking difficulties [test anxiety, poor
standardized test-taking] prior to exam.
 Maintain healthy life-style.

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GOOD LUCK !!

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