I hope everyone is doing well. I'm writing this post to describe my experiences with the USMLE Step 1, Step 2 CK, and Step 2 CS, and to offer advice regarding what to study and how to best study it for those who still feel lost and unsure of what to do. The reason why I'm doing this is because I've noticed that I have received several emails repeating the same questions about these tests. And while I'm more than happy to answer any questions, it would probably be easier and quicker for everyone if I cover all the basic and most asked about info right here.
I'll go over the resources for each test, what the test was like, and general tips to help improve your preparation. Any input from people who've done the test is appreciated. You'll probably notice that my advice is somewhat different from the advice of others, and that's fine. There is no one perfect way to prepare for these tests. Everyone has their own style and strategies that suit them. You don't need to follow every single tip - just take whatever you think will suit you and create your own study plan. This is going to be a long post, but here we go...
USMLE Step 1:
If you want to apply to the US, this is possibly the most important exam you'll take in your life. No pressure. I'd say you should start studying this as early as possible (I'll go over what I think is the optimum study schedule later in the general tips). Just keep in mind-Step 1 is more important than your university tests, GPA, research, electives, LORs, happiness, and time with your family. But if you study hard and more importantly, study smart, you should be able to ace this exam easily inshallah.
Now, this is very important. When it comes to studying the content of FA, just understanding it is not enough - YOU MUST MEMORIZE. You need to understand the information first, then you need to memorize it. FA is a review book, meaning everything inside it is important. I knew people who were finishing more than 9 or 10 pages of FA every hour. Unless you have photographic memory, that's way too fast. I'd say an average of 3-5 pages every per hour is a good range. I would highly recommend going over FA at least twice. And focus on the 3 P's - Pathology, Physiology, and Pharmacology. These are the most important and most high-yield topics.
Now, what about other books, videos, websites, etc.? Well, that depends. If you have trouble understanding something in FA, it will be very difficult to memorize. Then you'll need to study that material from someplace else, understand it, then go back to FA and memorize it. For example, I had difficulty understanding Biochemistry and Biostatistics from FA, so I watched the Kaplan videos first, then went back to FA. If you have difficulty understanding pathology, use Pathoma. If you have difficulty with anatomy, consider using BRS. If you look at the end of FA, there is a list of recommended resources for each topic. Don't make the same mistake I did and buy something for every topic. Only use the ones that you need.
The only book that I'd recommend everyone use is FA, other than that you should tailor your resources to fit your needs. For me that meant FA, and Kaplan videos for Biochem and Biostats. I didn't use Pathoma, BRS books, DIT videos, Kaplan books, Step 1 Secrets, or other resources so I can't answer questions about them. The one other resource I would probably recommend for everyone is a website for heart sounds, because you will definitely have those in your exam. This is an example, but there are other great websites you can use.
B. Question Banks:
UWorld Qbank: UWorld will be your best friend when preparing for the Steps. They have the best questions available. Often the questions are even more difficult than those of the actual exam. Now, I would highly recommend you do UWorld like the actual test. In my opinion, doing it tutored is a waste. Do the sections timed, then review the correct and incorrect answers with the explanations. The most important part of the explanation is the "Educational Objective". I don't suggest reading the entire explanation unless you got the question wrong or you had doubts about your answers.
USMLE Rx: A nice bonus if you have time. Not as good or difficult as UWorld though. Going through UWorld twice is definitely more important than doing Uworld once and Rx once.
I didn't use the Kaplan Qbank, so I'm not sure how useful it is.
C. Practice tests:
UWorld Self-Assessment Tests: There are two tests by UWorld, and you can get them for a discounted price if you buy them with the Qbank. I like these more than the NBMEs because you can actually go over your questions and see explanations for them, just like the UWorld Qbank.
NBMEs: The classic practice tests. You can find them here. For the Step 1, you'll need to do the Comprehensive Basic Science Self-Assessment (CBSSA) tests. Do the most recent ones. I'd recommend doing at least 2 of them. The major disadvantage of the NBMEs is that they only give you your score, they DO NOT provide feedback. If you buy the extended feedback version (which costs $10 extra), you'll be able to see what questions you got wrong. But you will not be able to see the right answers, and there won't be any explanations. For that, you'll have to search the internet for forums that have the answers.
About the test itself:
Because it's so important, a lot of people make it seem that Step 1 is impossibly difficult. This is absolutely false. Step 1 is challenging but it can be conquered, and the more you study (and the smarter you study), the higher your score will be inshallah. FA + UWorld + Self-Assessments should cover more than 90% of the exam. The most important issue is time management, and the best way to prepare for that is to do all your question banks and practice tests timed to increase your speed, and to do as many as possible to build endurance.
The exam is 8 hours longs consisting of 7 blocks, each one lasting an hour. There's a 15 min tutorial, and 45 mins of break that you can divide between the blocks however you want. Anytime you finish a section early, the remaining time of that section gets added to the break time. If you skip the tutorial, you'll get 15 extra minutes of break time (making it an hour long). Just don't skip the part of the tutorial where you test your headphones.
Bring lunch with you, and sleep well the entire week before your exam. You'll need to leave your house early because security at the embassies can be congested. You can see the tutorial before you go to the exam by checking out this website.
USMLE Step 2 CK:
While not as important as Step 1, Step 2 CK is still a pretty big test so focus well on it. Also, if you didn't do as well as you had hoped for in Step 1, it's not the end of the world. You can use Step 2 as an opportunity to score high and show program directors that you've improved. Keep in mind that people tend to score higher on Step 2 than Step 1 and the average is higher. I believe that the best way to prepare for CK is to study Step 1 really well. While CK is more of a clinical test, there is some overlap in basic concepts from Step 1. Internal Medicine makes up the majority of this test, followed by Psychiatry, Surgery, Pediatrics, Ob/Gyn, and others (Ethics, Biostats).
This is the biggest challenge with studying for Step 2. Unfortunately, there is no single good book like FA for Step 1.
Master the Boards for USMLE Step 2 CK: This was my main book, and I found it to be pretty useful. I really liked the Internal Medicine subjects, but Ob/Gyn and Peds were weak. Sadly, the book isn't very detailed and because of that a lot of people don't like it. Only you can decide if this book suits you or not.
USMLE Step 2 Secrets: I was only able to study a few sections from this book but what I read was well written and covered high-yield info.
There are other books like FA for Step 2 CK (but I heard mixed opinions about this, so I avoided it) and MTB for Step 3 (people used this for the Ob/Gyn and Peds that were weak in MTB for Step 2), but I didn't have the chance to use them, so I can't make any recommendations. I've also been recently hearing about Step Up to Step 2 CK, so that might be worth checking out too.
B. Question Banks:
That's right - UWorld: The best resource for Step 2 CK by far. In fact, some people only study UWorld without using any books. Just like Step 1, I'd recommend covering this at least twice. The explanations are important here because there is no single best book to study.
USMLE Rx: I did this Qbank, but honestly I regret doing it because I felt like it was a waste of time. I wish I had done Uworld a third time instead.
C. Practice Tests:
UWSA Tests: Again, they have the correct answers with detailed explanations for each question. Buy them with the UWorld Qbank for a discounted price (no, sadly I'm not sponsored by UWorld)
NBMEs: This time you'll need to do the Comprehensive Clinical Science Self-Assessment (CCSSA) tests. When I was preparing there were 3 of them. And these do not provide feedback either. NBMEs are overrated if you ask me.
Clinical Science Mastery Series: These are like mini-NBMEs for individual subjects (IM, Surgery, Psychiatry, etc.). I don't recommend doing all of them, just the ones for the subjects you are weak on. You'll find them on the NBME website.
About the test itself:
Now, I personally felt that Step 2 CK was harder than Step 1, and my friends who've taken it agree. The questions felt more difficult and ... vague. Honestly, some of the questions even seemed poorly written, without enough information provided. Then again, that might also be because I took the test before completing my preparation (and I didn't want to delay it), so I might not be the best judge. But it seems that the grading curve for CK is more generous and that's why people score higher, not because the test is easier. People usually score higher than they expect (good news, finally).
It's the same thing in terms of timing, except for one difference. CK has 8 blocks, meaning that it's 9 hours long (it also has a 15 minute tutorial and a 45 minute break you can divide as you want).
USMLE STEP 2 CS:
Now that you've finished Step 1 and CK, can you finally relax? Well...almost. Step 2 CS is coming up, and while there is no "score" for it (only a PASS or FAIL result), you want to crush this exam because you’re a boss and nothing gets in your way. You need to practice for this test a lot, because it's unlike Step 1 and CK. And unlike American students, it's also really different from our OSCEs. So my most important advice for this test is to practice, practice, practice. Find someone to practice with, and mimic the exam as much as possible. Use a patient gown that ties behind the neck, have a CS timer to keep exact timing, and write your practice notes on the USMLE note-writing website (links below).
First Aid for the USMLE Step 2 CS. This is the only book you'll need for your practice. You can go over the mini-cases by yourself, but there are 44 long cases you should practice with a friend. Practice the cases as if you were in the actual exam.
Note-writing website: http://www.usmle.org/…/step-2-cs/patient-note-practice2.html This is exactly the same format you'll use to write the notes in your exam.
About the exam:
The exam is 12 encounters with simulated patients. Your job is to take history, physically examine, and counsel the patients in 15 minutes, then write a patient note in 10 minutes. The exam wasn't difficult, but time was probably the biggest challenge. So do a lot of practice cases and note-writing with the exact timing of the exam.
There are only 5 centers in the US that do the CS, so seats fill up quickly. You'll need to register in advance. Most students say that the Houston and Chicago centers are probably the most “IMG friendly" ones, and rumor has it that the Philadelphia center is the hardest. Another important thing to keep in mind, the CS result can take from 1 - 3 months to come out, so keep that in mind when planning when to take your exam.
So that's the basic information I think everybody should know about these tests.
General tips for studying:
When doing question banks or practice tests, there will be questions on information that's not present in FA. These are important (especially the ones in UWorld). I'd advise you to write this new information in FA so that when you study it the second time it will be a complete source with all of the information from the questions in it.
Start studying early. Meaning start studying for Step 1 from your first year if you can. Don't make the same mistake I did and start at the end of your 4th year.
THIS IS IMPORTANT: For the first 3 years (Phase 1 & 2), focus primarily on your university material. USMLE should be extra, light studying that supplements your university studying, NOT replaces it. I believe the university taught us very well, especially in Years 1-3, and I can say that for a simple reason - 99% of what I learned in the first 4 years was from our uni lectures and powerpoints we received. I almost never studied from medical textbooks or websites. In fact, I think that books like Gray's Anatomy, Guyton, Robbin's, etc are useless, but that's just my opinion. I focused entirely on the lectures and taking notes, as well as studying the presentations we got. And when I began studying for Step 1, I realized that I had been exposed to about 70% of what was in FA from the university lectures, especially the high yield info. People who studied the same way I did agree with me as well. Now, I know this study strategy doesn't suit everyone and some people prefer studying from textbooks, so I'm not trying to convince anyone to do anything they're not comfortable with. All I'm trying to say is to give your university lectures the credit they deserve - attend them all (and focus), write notes, and go over the slides really well before considering going to textbooks or websites.The better you prepare for your block exams, the easier studying for the USMLE will be. And if you absolutely have to study from books, I suggest using USMLE review books like First Aid, Pathoma, BRS, etc instead of the suggested textbooks.
When you enter 4th year, start shifting your focus towards the USMLE more. University material is still important though, especially Internal Medicine and Surgery. They will help you a lot when preparing for the USMLE because of the clinical aspect of year 4. But at this point USMLE should make a big portion of your studying, especially on the weekends. I'd suggest you take Step 1 at the end of your 4th summer, right before 5th year. That way you have the summer to study extensively. Pace yourself well - you don't want to study USMLE really hard in years 2 & 3 and then burnout in year 4. The most important time is the last few months before the exam, and you'll have to put the maximum effort in those months.
If you do Step 1 before 5th year, then you can spend the 5th year studying for Step 2 CK. Keep in mind, after 5th year you'll only have one month of summer vacation. Internship will start July. The goal would be to do CK before your internship or in the first few months. Studying for Step 1 or CK will be difficult during internship. Try to get them done before.
Now if you've done Step 1 before internship, you have the advantage of being able to apply for electives in the US, as almost all of them will require a Step 1 passing score. Step 2 CK is not usually required for electives, but will definitely help. Electives in the US will help you in so many ways (experience, LORs, etc...), but an additional advantage is that it will be easier to take CS if you are already in the US. So the best way would be to take CS while you're doing an elective in America. The only challenge will be finding someone to practice with while you're there.
Please note that this is what I think might be the ideal schedule. It doesn't mean you have to do it this way at all. Other schedules might suit you better, or you might have started studying too late. Don't worry, and do not panic. I know people who did Step 1 during internship and scored really high mashallah. What I wrote above is just a suggestion. Ultimately, the most important thing is that you study hard and practice a lot of questions, so make the most use of whatever time you have and you'll do fine inshallah.
While you can take these tests in any order, don't try to do Step 2 CK before Step 1. The best way to prepare for CK is to study Step 1 very well.
"How many hours were you studying a day?" This question is not a useful one. The number of hours you study is pointless - it's the amount of content you study plus the quality of your study that matters. Some people can memorize FA in 2 months, others might need 3. Your goal should be how much content do you want to study, not how many hours.
Do not get into the habit of delaying your exams after you've registered and selected a date. I've noticed that people who delay their exam to a later date are more likely to delay again and again. Set a realistic date based on your study plan, and avoid delaying that date unless you absolutely have to.
If you can, try to avoid taking a year off after you graduate to study for the exams, because that will be a negative point on your application. Of course, you can do that if you absolutely have to because it is better than scoring low on the USMLE, but don't be that person in their 2nd or 3rd year who has already decided they will take a year off for these exams and won't study for the USMLE until after they graduate. It is NEVER too late to start studying, so please don’t use that as an excuse to avoid studying.
That’s what I can think of for now. Others have posted their advice here as well, and hopefully you will benefit from our tips, avoid the mistakes we made, and perform better than we did inshallah. If you have any questions, please don’t hesitate to ask.
و الله يوفقنا جميعا