USMLE Step 2CK Experience – 270

Dr. Shalhoub’s #USMLE #Step2CK Experience

  • Duration of preparation :

From April till August 19th, roughly 4.5 months.

  • Study schedule:

Average of 6­-8 hours\ day. Used to hit the gym 5 times\week. Thursdays I was mostly chilling,

studied a couple of hours at the beginning of the day.

  • Materials & journey:

First of all, I did step 1 on Feb 18th, and that of course helped.

I started by giving MTB2 Internal Medicine a quick look, just to get into the mood of Step 2,

and get out of Step 1 way of thinking.

I used to do the blocks of each IM chapter from UW2013 (offline),to train myself to questions

mood from the beginning.

I did not really retain that much from MTB. For me, it was just an introduction. I only did the IM

part at the beginning in like 2-­3 weeks.

Then I quickly went over Kaplan ObGyn in 3­-4 days, to refresh it in my mind, as there is not a

lot of commonalities between ObGyn step 1 and step 2.

I jumped right away to the pediatrics, surgery and ObGyn parts of UW13, without reading the


I then bought the UW Online for 3 months and started doing 2 blocks\ day and take down


I read all the explanations carefully and I often went back to specially when

something was not very clear to me.

Uptodate helped me a lot. When I have a question, it was easy to find the answer in one

source. When I just want to know what this topic is all about, I would only read the summary at

the end of an article, which is typically 6­-12 bulletpoints. If there was an interesting idea there, I

would go back to the text and read a bit more about it. I also used to check if there are any

algorithms or tables that could help.

My average in UW was around 90%. I used to answer the questions I did wrong in the offline

UW13 with the same answer and get them wrong again, so as not the skew my %.

My plan while taking the notes was like this:

1)I am not allowed to mark more than 10 questions\ block

2)The questions that I was not going to mark, I would take all the notes that I need from them,

because I knew that I am not gonna come back to them

3)I am only going to redo the wrong\marked questions after the first round of UW

Preventive was bugging my soul, so I made a separate part for it in my notebook and used to

visit it again every now and then.

After finishing the first round of UW, I went back to MTB3. I quickly read the pediatrics,

surgery and psychiatry parts. Roughly gave 1­2 days for each one. I used it mainly to know the

tricks, and for it to guide me as to what to look for on Uptodate. To be honest, there are a lot of

information that I found was wrong and outdated in MTB, thats why i mostly used it to guide me

as to what to look for on UTD.

After that, I went back to my notes and read them again.

Took my first assessment, NBME4,on august 2nd(2+ weeksbefore my exam). I got 286and was thrilled. I knew it was overestimating, but I was confident I am doing the right thing. To me,

and to many others, this assessment was really easy and looked nothing like the real exam.

I started doing Clinical Mastery series, roughly a block a day. I would do the block in 1 hour,

and then meet with 2 of my friends at 10 pm and we would discuss the questions in 2 hours.

I went back to the the marked\wrong questions and finished them. There was a total of

roughly 500 questions.

Second assessment was on August 14th ( 5 daysbefore my test), NBME7, and got 267.I

knew it was underestimating and kept telling myself to believe in numbers. I hated this

assessment. The kind of questions and tricks asked are very similar to the ones they try to trick

you in in the real test.

3 days before the test, I did UWSA and got 265+,i also did the 3 FRED blocks with it, trying

to simulate an exam experience. UWSA was also way too easy and looked like nothing like the


  • Exam day :

The exam was so long. It’s mentally tiring. The questions ranged from direct ones to the

WTH ones where you have no idea what’s going on.

Direct questions were not the predominant pattern, like it’s the case in UW. The thing

about the exam is that they throw in a lot of distractors.

I took the first 2 blocks, 8 min block, 2 blocks, 10 minutes block. Then roughly 10

minutes after each block.

Topics asked were mostly topics that everyone knows. It is just asked in a particular

situation, and you have to apply your common sense and go ahead. No book can

guarantee you a right answer, but you knowledge would help you in total in trying to apply

common sense and choosing an answer.

Topics that I felt were heavily tested: Post­op complications, Psychiatry, trauma and


Got media that I found was OK. I couldn’t figure it out from the stem, but listening was

not an issue for me.

After the test, I had no idea how it went. I literally told my friend I can get 240 and I could

get 270. I will have to wait!

  • Important tips:

I believe the duration is not the most important factor in preparing for the USMLEs. I did

my step 1 in 5 months and this in 4.5. I believe it’s all about studying effectively and not

dive in the low yield materials. My Step 2CK preparation was helped by my step 1

preparation, but I believe 5­6 months should suffice.

Books are fine. Questions are the best.You see, books are great, once you’re done

with a chapter, you feel like a god. But 1 week later, it’s all gone. If knowledge was not

applied, it will be forgotten. There comes the role of questions.

Try to understand the WHYbehind everything. Don’t just memorize if the patient had

back pain with this then the next step is an XR, and if with that then MRI. Rather, know

the WHY. The reason for this is that in the exam, you will have to think in seconds and

there are many distractors. Understanding the WHY can help you get the answers right

and save you a lot of time.

There is no “ Recipe”for Step 2CK. Everyone has his own way of studying and

understanding. I did this and it worked for me, you can do whatever works for you, as

long as you are not screwing up in your resources or the way you prepare.

Learn the differential diagnosis very well. Not just know the name of it, NO, go and

look after how is it different from my main diagnosis. The reason for this is that the

distractors thrown in the exam are usually stuff that will help you rule out\in those

differentials. Make sure you master this point. This comes in really handy in Psychiatry. If

you just go with what is there in the books, you’re not gonna be able to answer with

confidence in the test. They can easily make you go crazy with their distractors.

Master the criteria for Psychiatry. Know what every word means. Again,

UNDERSTAND, and not just memorize. They will be able to trick you in any of these

points. It’s all about mastering the criteria. Knowing the differential helps tremendously

too, again, not just the name, but why its this and not that.

UTD was of great help when it came to mastering the differential diagnosis, because

there is always a part in the article that talks briefly about each differential and how it is

different than the main diagnosis. This is lacking in Medscape, as it only puts the

reference for the differential’s article, without talking about why and how it is different.

UTD is a HUGE reference. If you see this experience and start reading all the articles in

UTD, you’re gonna fail or you’re gonna spend the rest of your life preparing for the test.

You have to be careful and specific when using it. Unless it’s something you really want

to master, I would suggest just reading the summary and algorithms and then going from


MTB is fine, but be careful and don’t take things for granted. Anything that looks odd to

you, go back and confirm it. I can’t tell you how many mistakes I found there, and thats

the main reason I never really read it back again.

The clinical mastery series were helpful. First of all, I did an extra 500­600 questions.

Second of all, its from the NBME! You kind of get yourself in the mood of their way of

asking questions, so it helped. But again, the length of the questions is too short

compared to the real deal.

The exam day was not a pleasant experience. In many of the questions, I was

answering without any confidence. I marked A LOT of questions each block. I remember

in step 1 I barely marked 5­10 because I never came back again to the WTF kind of

questions there. But in Step 2, you know what the question is talking about, but you’re

confused as what to do next, and many times i was like “ Maybe if I read it again I will find

something”. I had about 10 minutes left in each block, but these did me nothing, as most

of the time I was just staring at the questions and I did not know what to do. At the end,

just trust your guts and the NUMBERS. NUMBERS DO NOT LIE. If your assessments

are satisfactory for you, DO IT.

Try to master the timing. I used to try to finish UW blocks with at least 15­20 minutes

left, because I knew the exam is not going to be the same. Try to push yourself. Learn

how to ignore the distractors. My way was like this : I would read the chief complaint, then

quickly move to the end of the question and see what is the question asking for and then

quickly glance over the options. After that, I would skim through the stem, but this time I

know what I am looking for and what should I ignore. It’s like going to take history and

physical from a patient when you already know their chief complaint, you will be more

prepared knowing what to ask for and what to examine.

UW is a fantastic source. There is so much information that each time I read the

question, I learn something knew. Read it carefully and try to understand all the little

details thrown in there. Also, undoubtedly, master the algorithms.

Assessments are the best tools to assess yourself. Do not delay them till it’s too late ( I

delayed mine, do not do that). I would suggest doing the first one 5­6 weeks before your

desired date and acting according to the performance. Once you get to the score you

want, go for the test. There is never gonna be a moment in your life that you are gonna

feel confident to do the test. Arm yourself with numbers, aka assessments! Delaying is

not gonna do you any good if you reached your target score, it can actually be worse for



Total prep : 4.5 Months

NBME4 (2+ weeks) : 286

NBME7( 5 days): 267

UWSA: 265+

Sources: MTB, UW, UTD.

Final word:

I remember the day I decided I wanted to start preparing for step 1. I read MANY

experiences. It seems just like yesterday. The way to success in USMLE is not an easy

one, but it’s definitely a doable one. I remember myself thinking about people who gets

the 250s and be like “ These people must belong to somewhere else!! “. Do not fall out

short on what most people think is “ good”. Dream big, work hard and you will get there.

Good luck to each and everyone of you. Thank you to each and everyone that helped me get there in any possible way.


If you liked this experience, check out the following experiences:

USMLE Step 2 CK – 255 Experience of an IMG

Paula Wendoline Soprano – Step 2 CK Exam Experience

USMLE Step 2 CK Experience – An IMG Perspective

December 11, 2017
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