Mastering Step 2 CK: The Role of Recalls and Past Papers

Before I embarked on my dedicated study period, I had already completed my first pass of UWorld and revisited the incorrect questions during my clerkship year from January to December 2022. My initial UWorld performance stood at 78%, which included the redoing of incorrects, implying a potentially lower true percentage. Alongside this, I consistently utilized the Lightyear Anki deck, a resource that had proven its worth during my pre-clinical years. My primary mode of learning revolved around UWorld and UpToDate throughout the year.

At the end of January 2023, I took Step 1 after a 4-week dedicated period and successfully passed it. Although Step 1 is now pass/fail, I highly recommend preparing for it as if it were still scored. In my view, having a robust foundation built during Step 1 preparation is a key factor in achieving success on Step 2 CK.

My dedicated period spanned 8 weeks, with a well-deserved 3-day break in the middle. I had ample time to cover all the material I intended to, although I did feel that the last few weeks might have been somewhat excessive. Nevertheless, during the final week of dedicated, I undertook a comprehensive review of all my incorrect answers from previous NBMEs and UWSAs. This fine-tuning of my knowledge was heavily informed by my prior exposure to recalls and past papers.

Recalls and past papers, particularly UWorld, formed the core of my dedicated preparation. When reviewing UWorld blocks, I diligently created Anki cards for questions I missed and key information from explanations that I didn't fully grasp. I also marked questions that I answered correctly but needed a better understanding of the underlying concept. I repeated my incorrects and marked questions after completing my second pass (the first pass having taken place during clerkships). It's worth noting that I generally trusted UWorld as the most up-to-date resource in cases of conflicting information.

First pass: 78%

Second pass: 89%

The role of recalls continued with self-assessments. I highly recommend taking all four available self-assessments (NBME 9, 10, 11, and 12) if time permits. These assessments have a different question style compared to UWorld, and adjusting to them can be initially frustrating. It's vital to approach them with a clear strategy, as they often employ subtle one-sentence phrases meant to change the answer, as opposed to UWorld's approach. Overthinking questions led to incorrect answers for me, and my advice is to focus on the answer that aligns with the majority of the paragraph's content and avoid getting sidetracked by red herrings.

Recalls and Anki continued to be invaluable resources in my preparation. I used Anki to review concepts that I had missed or marked during my UWorld or NBME practice tests, resulting in a total of approximately 1200 cards created during my dedicated period. The practice of resetting and spacing out cards in the final week proved highly beneficial. Notably, I did not employ a dedicated Step 2 Anki deck.

As for textbooks, First Aid Step 2 played a central role, with its "key facts" often being tested. The tables within the book were also helpful, although some information was not as up-to-date as UWorld, particularly regarding childhood developmental milestones.

Step-Up 2 Step 2, in contrast, I found to be somewhat superficial, especially when compared to First Aid. Depending on your available time and familiarity with clinical medicine, it might be worthwhile to briefly skim through at the start of your dedicated period.

The inclusion of Amboss and Divine Intervention Podcasts catered to different learning styles. I preferred reading over listening, so I leaned more toward UWorld and textbooks. However, the resources are indeed valuable for those who find podcasts appealing. I ended up listening to specific Divine Intervention Podcast episodes near the end of my dedicated period, which may have assisted with a few questions, although I had already covered most of the information during my other reviews.

Emma Holliday Videos served as a useful refresher, particularly if it had been a while since delving into clinical medicine. I watched these videos at the beginning of my dedicated period.

UWise came into play to address my weaker area in OBGYN. Although it helped reinforce concepts, in retrospect, my time might have been more wisely allocated elsewhere.

The role of recalls and past papers in self-assessments was crucial in guiding my progress. Here are the results:

- NBME 9: 260 (43 days out)

- UWSA 1: 270 (36 days out)

- NBME 10: 265 (30 days out)

- NBME 11: 268 (22 days out)

- NBME 12: 267 (15 days out)

- UWSA 2: 270 (8 days out)

- Old Free 120: 90% (5 days out)

- New Free 120: 93% (3 days out)

UWSA 2 stood out as the most predictive of my final score, which was precisely the same. Trusting your practice tests is a common piece of advice, and it certainly held true in my experience.

**Testing Day: Staying True to My Strategy**

On the day of the test, the format was closest to UWSA 2 and Free 120, although some question stems proved lengthier than expected. To manage the day effectively, I took a break after every two sections for restroom breaks, hydration, and a small snack. I marked a fair number of questions in each section for review, in line with my testing style and strategy. I concluded each section with approximately 5-10 minutes remaining. Staying true to your established testing strategy is essential, and last-minute changes are best avoided.

In hindsight, I am content with my schedule and felt I had ample time to study while maintaining my sanity. If I were to make changes, I might have condensed my schedule into 5-6 weeks, skipping resources like Step-Up 2 Step 2 and UWise. In their place, I would consider integrating CMEs and perhaps the Amboss question bank into my schedule.

As you embark on your Step 2 CK journey, I wish you the best of luck. Feel free to reach out if you have any questions, although I may only check this account sparingly in the coming days. Your dedication, along with the wise use of recalls and past papers, will guide you toward success.

Here is the link for all USMLE Recalls/Past Papers/Biopsies