I scored over 260 on Step 2 CK during a pandemic. Here’s how I did it.

My USMLE Step 2 story basically began when the COVID-19 pandemic hit the US. I worked on March 15, and as states put in stay at home orders, I caught an emergent flight home the next night. I only packed for two weeks because I thought I would come back for my surgery shelf. I wouldn’t return for three months.

I spent the first month at home completing surgery virtually and honestly crying a lot because I didn’t know what to do and I felt like my world had crumbled. What rescued me was getting back into my faith again. It wasn’t like I had run away from God during my third year, but my time was occupied with rotations, friends, and studying. In retrospect, I had definitely become too busy for God. Crises have a way of turning people back to Him and that’s what happened to me. I started really getting back into God about a month into quarantine, and immediately I noticed a difference. I stopped crying every day, and I was able to clear my head and start thinking straight.

After virtual surgery ended, with not much else to do, I took out my First Aid for Step 2 CK book and started reading it from front to back. At first, I didn’t read too many pages per day; my Step 2 test, after all was scheduled for late July, and it was only the beginning of April. In mid-April, about a week after I started reading First Aid, I decided to reset my UWorld question bank. I had been using UWorld throughout my third year of medical school but I hadn’t really retained too much information, and I figured that I should do UWorld again and do it well. So I started reading roughly 30 pages of First Aid a day and doing maybe 40-80 questions in UWorld, along with my virtual elective provided by my school (which had nothing to do with Step 2).

In late April, Prometric, the company that runs most of the major standardized tests for graduate school (including the MCAT, USMLE, GMAT and LSAT), cancelled half of all their scheduled testing appointments through the summer without warning. Students who had had their standardized test dates planned since last year all of a sudden had their appointments cancelled with seemingly no hope of rescheduling. With no clinical rotations scheduled and no standardized tests to study for, many of my classmates became very stressed and almost hopeless. I remember attending a virtual town hall held by my school for our entire class. Even though I was at home, I could feel the tension through my screen—it was absolutely awful. In the midst of students throwing questions that the administration were all but powerless to answer, one student made a comment that lit up in my mind. He said that Prometric was opening up testing center spots week by week, so that people who were ready to take their standardized test within the next week could go in and take their test. He lamented that there was simply no way to be prepared to take a major exam such as Step 2 with only a week’s notice.

I carried that thought with me into the next week as I studied. The next Sunday, after watching a church service, my mother and I sat upstairs talking about Step 2, and the idea all of a sudden came alive. If Prometric was giving out test dates on a week-by-week basis to those who were prepared, then I could study for Step 2 as if I had a test date in 6 or so weeks, and then in the fifth week I would look and see what test dates were available for the next week. In this way, I would be prepared to take any opportunity that Prometric gave me.

With that, Step 2 studying began in earnest.

I finished reading First Aid for Step 2 CK at the end of April, and I took my first practice test after that. There are five main practice tests for the USMLE Step 2—three provided by the National Board of Medical Examiners (NBME) and two given by UWorld. At the end of April, I took one of the NBME practice tests and got 225, a good passing score, albeit several points below the US average of 244.

After my first practice test, I turned to UWorld in earnest. I would complete about 200-250 questions in a 14-hour day, and then I would write down 1-3 sentences of notes for questions I got wrong in a giant notebook. This notebook became my equivalent of a flashcard deck or an Anki deck. (Anki is essentially an online flashcard app beloved by medical students the world over.) I didn’t review my notes daily like I did for Step 1—there was too much information and not enough time at the rate I was going. UWorld by that time had about 3300 step 2 practice questions, so I essentially trusted it to give me the information I needed to know.

I finished all the questions in UWorld in a month, and took another NBME practice test. This time I got 244, the Step 2 average. I was very happy with the 19 point increase and with the fact that I was now no longer below average!

As far as finding the actual test date, I looked a couple times towards the end of May. Testing centers were opening up here and there, but I couldn’t find a spot in my ideal location. We decided to wait until the end of May, when governors started making announcements about reopening. When my state governor announced that my state would reopen in June, my mom got looking for some test dates. Eventually, I was able to find a spot for my preferred testing center in mid-June.

I then did a second pass of UWorld (meaning that i did all the questions in UWorld a second time) and did a third practice test, UWorld Self-Assessment (UWSA) 1 and got 246. I was disappointed that a whole second pass of UWorld only gave me two more points. I prayed about what to do in my last few weeks and got the idea to do NBME subject practice exams. The NBME, in addition to their full-on practice tests for Step 2, also offered small practice tests in each subject (psychiatry, internal medicine, family medicine, emergency medicine, neurology, surgery, pediatrics and OB/gyn). In the clerkships where I had done NBME subject practice tests before taking the shelf (end of clerkship exam), I had always done better on the shelf. I figured that if the USMLE Step 2 was an NBME exam, then the NBME practice questions would be a good resource to go through.

It was a monetary investment ($20 per subject exam, and most subjects had 4 practice tests), but the NBME questions helped me immensely. UWorld was really good for building a base of knowledge, but the NBME would ask questions on things I had never learned before. Also, unlike UWorld, which has a very detailed answer key that reads like a textbook, the NBME’s answer key only had answers without any explanations of why an answer was right or not. This could have been annoying, but it turned out to be a blessing for me because it made me find the answers myself and explain them in my own words. I mostly used UpToDate (Wikipedia for doctors) and Google (I kid you not—Dr. Google is real!) to find the answers to the NBME exams.

With my test date in place (thank God!), I gave myself a couple of weeks to do the NBME questions, but I didn’t end up needing as much time as I had thought. I used the extra time to read over my giant notebook, which essentially was a third pass of UWorld. It took me almost 2 days to read through my notebook, since I wanted to absorb every little blurb I’d written—it was the equivalent of having a flashcard deck.

After doing the NBME subject tests I did another practice test, UWSA 2, and was pleased to get 258. I was now well above average with a 12 point increase from my last exam. Five days before my exam, I did the last NBME practice exam and got 260.

For the last five days, I subscribed to another medical student education website, AMBOSS, and did part of their question bank. Their questions were very hard, harder than both UWorld and the NBMEs. This helped greatly with my weaknesses (AKA psychiatry), but it did get tiring after three months of studying.

The day before my test, I simply relaxed. 

I took the test and got my result less than two weeks later. It was greater than 260!

I give all glory and praise to God. I also have my parents and brother to thank for their massive moral support. Without God and my family, I would have been aimless, depressed and lost.

I hope this helps someone realize that even if circumstances surprise you or are working against you, you can find a way to overcome them. I also hope that it can help other medical students who are studying for Step 2, even though my story is a bit unique.

Resources I used:

-UWorld: the premier question bank for USMLE Steps 1 and 2, known for their amazing answer key which is basically like a medical textbook. Costs about $380 for a year’s worth of access.

-the NBME website for their practice tests, both the full practice tests ($60 per test) and their subject tests ($20 per test)

-AMBOSS for super-hard questions to help with weaknesses (membership for a month costs $59)

-First Aid for USMLE Step 2 CK: good for an overview of the Step 2 CK material (roughly $40 on Amazon)

-First Aid for USMLE Step 1: used mostly for reference (roughly $40 on Amazon)

-UpToDate: basically like Wikipedia for doctors, with many, many articles on different medical topics; they use and cite real biomedical research for their articles, so they are not quacks. You can sign up for an account FOR FREE!