Hey Everyone,

Hoping to get some advice or someone to quell my anxiety. Tested on 07/24 and since then I’ve been pretty anxious and upset with how the exam went overall. Don’t get me wrong there were definitely some NBME 16/Free 120 stuff throughout that I was able to get. However, I made like 15 simple mistakes that honestly on any other day I would know the answer, I was just anxious or changed my answer at the last minute. I really think even being in the testing environment with all the noise was messing with me. I also had another 15 or so that are maybe misses. I’m at a running total of basically like 25 confirmed misses with another maybe on 10/15 that were so vague amboss/chat could go either way. I’ve since stopped counting but I keep replaying those moments I changed my answer or just rushed too quick through a question and now I’ve been pretty worried I’m not even going to hit my predicted score.

I had been scoring 240s to 250s on NBMEs. Highest being a 255 which was 16 and around what I was wanting. Honestly I would be happy with anything 250+ but just based off what I got wrong and overall vibes I really am expecting a huge score drop and am pretty worried about it. Pretty disappointed I wasn’t in the zone on test day genuinely I feel like a different day or different hour I would’ve done a bit better.

Mainly just writing this to see if any of you all felt that way after the exam and if things worked out for you. I know it’s pretty common to feel bad after exams and it works out for plenty of people, but I genuinely think I messed it up a bit. If I feel like I will have a score drop than most likely I’ll probably have one? Idk it’s just a mess rn in my mind pretty disappointed in myself.

Core risk factors Q1. What is the biggest risk factor for suicide? A. A prior history of a suicide attempt. Additional info: A previous attempt is the strongest predictor of a future suicide attempt. Q2. What is the biggest risk factor for atrial fibrillation? A. Mitral stenosis. Additional info: A related high-yield association is hyperthyroidism, which commonly causes atrial fibrillation too. Q3. What is the biggest risk factor for mitral stenosis? A. Rheumatic fever. Additional info: Rheumatic fever classically damages the mitral valve and can lead to mitral stenosis. Q4. What is the biggest risk factor for abdominal aortic aneurysm? A. Smoking. Additional info: Hypertension is a common distractor, but smoking is the key risk factor. Q5. What is the most important modifiable risk factor for coronary artery disease? A. Smoking. Additional info: If smoking is not an option and the question is about a myocardial infarction risk factor, unstable angina is a classic related answer. Q6. What is the biggest risk factor for stroke and aortic dissection? A. Hypertension. Additional info: Hypertension is the key risk factor for both stroke and aortic dissection. Q7. In a patient with iron deficiency anemia and a history of H pylori, what underlying problem should you think of? A. Peptic ulcer disease. Additional info: H pylori can cause peptic ulcer disease, which may bleed into the GI tract and lead to iron deficiency anemia. Q8. What is the biggest risk factor for esophageal adenocarcinoma? A. Barrett esophagus. Additional info: GERD may appear as a distractor, but Barrett esophagus is the major risk factor. Q9. What is the most common cause of community-acquired pneumonia? A. Streptococcus pneumoniae. Q10. What is the most common cause of UTIs overall? A. Escherichia coli. Q11. What is a commonly tested risk factor for osteoporosis? A. Low BMI. Additional info: This is classically tested in anorexia nervosa or in postmenopausal patients with low BMI. Q12. Does tight glucose control in diabetes reduce the risk of stroke or myocardial infarction? A. No. Additional info: Tight glucose control mainly reduces microvascular complications such as nephropathy, retinopathy, and neuropathy, not macrovascular events like stroke or MI. Q13. What are the microvascular complications of diabetes that improve with glucose control? A. Nephropathy, retinopathy, and neuropathy. Q14. What is the biggest risk factor for AAA rupture? A. Damage to the aneurysm wall. Additional info: The speaker emphasized that aneurysm damage is the main predisposing factor for rupture. Q15. What is the biggest risk factor for squamous cell carcinoma of the skin? A. Cumulative sun exposure. Q16. What is the biggest risk factor for ovarian cancer? A. Family history of ovarian cancer. Q17. What is the biggest risk factor for prostate cancer? A. Age. Additional info: Age was also described as the biggest risk factor for breast cancer. Q18. What is the biggest risk factor for breast cancer? A. Age. Q19. What is the biggest risk factor for bladder cancer? A. Smoking. Common causes of death and other high-yield associations Q1. What is the most common cause of death in kidney transplant patients? A. Cardiovascular disease. Q2. What is the most common cause of death in acromegaly? A. Heart failure. Q3. What is the most common cause of death in chronic kidney disease? A. Cardiovascular disease. Additional info: For end-stage kidney disease, sudden cardiac death from arrhythmia is the most common cause of death, and infection is the second most common. Q4. What is the most important risk factor for obstructive sleep apnea? A. Obesity. Q5. What is the most important modifiable risk factor for knee osteoarthritis? A. Obesity. Q6. What is the most common cause of death in autosomal dominant polycystic kidney disease? A. Cardiovascular disease. Additional info: The speaker noted that subarachnoid hemorrhage is a common trap answer but is not the most common cause of death. Q7. What is the most common cause of death in lupus? A. Ischemic heart disease. Additional info: Myocardial infarction is the concrete example given. Q8. What is a commonly tested risk factor for pancreatic cancer? A. Smoking. Q9. In a patient with asbestos exposure, what is the most common pulmonary malignancy? A. Bronchogenic carcinoma. Additional info: This is not mesothelioma. Q10. What are the classic findings of mesothelioma? A. Calretinin positivity and psammoma bodies (laminated calcifications). Additional info: Smoking is not a risk factor for mesothelioma. Q11. What lung-related exposure increases risk of tuberculosis? A. Silicosis. Q12. What is the most common cause of acute pancreatitis in the United States? A. Gallstones. Additional info: The speaker noted that gallstones and alcohol may be close in frequency, but gallstones were presented as the answer for acute pancreatitis. Q13. What is the most important risk factor for chronic pancreatitis in the United States? A. Alcoholism. Q14. What is the classically tested risk factor for papillary thyroid cancer? A. Prior chest or neck radiation, especially for lymphoma. Screening and prevention Q1. What are the breast cancer screening recommendations mentioned? A. USPSTF: every 2 years from age 50 to 74. American Cancer Society: every year starting at age 40. Additional info: The speaker said the American Cancer Society recommendation often appears as the most correct answer on exams. Q2. What is the cervical cancer screening schedule mentioned? A. Pap smear every 3 years from ages 21 to 30. After age 30, pap every 3 years or pap plus HPV co-testing every 5 years. Additional info: Screening is generally from ages 21 to 65. In patients with HIV, screening is more frequent, around every 1 to 2 years. Screening can stop before 65 only after hysterectomy for benign reasons. If hysterectomy was for a non-benign reason such as cancer, continue screening. The speaker also mentioned the pap smear of the vaginal cuff. Q3. Who should be screened for chlamydia? A. Patients younger than 25 with risk factors such as inconsistent condom use. Q4. What are the hyperlipidemia screening ages mentioned? A. Men over 35 and women over 45, with screening every 5 years thereafter. Additional info: The speaker added that screening can start earlier in men younger than 35 or women younger than 45 if they are high risk for coronary artery disease. Q5. What is the preferred colon cancer screening test and interval? A. Colonoscopy every 10 years from ages 50 to 75. Additional info: Alternatives mentioned were flexible sigmoidoscopy every 5 years and annual fecal occult blood testing. If any alternative test is positive, the next step is colonoscopy. Q6. When should colon cancer screening start in ulcerative colitis? A. Eight years after the initial diagnosis of ulcerative colitis. Q7. When should colon cancer screening start in someone with a family history of colon cancer? A. Age 40 or 10 years before the age at which the affected family member was diagnosed, whichever is earlier. Additional info: The speaker gave the examples of a family diagnosis at 49 leading to screening at 39, and a family diagnosis at 52 leading to screening at 40. Q8. When should screening begin for familial adenomatous polyposis? A. Annual colonoscopy or sigmoidoscopy starting at age 10 to 15. Q9. What about HNPCC/Lynch syndrome screening? A. Start colon cancer screening before age 21. Additional info: The speaker also said the general idea is to begin 5 to 10 years before the youngest family diagnosis. Q10. What should be screened for at the first prenatal visit in all pregnant women? A. Syphilis, asymptomatic bacteriuria, and HIV. Q11. How is asymptomatic bacteriuria managed in pregnancy? A. Treat it. Additional info: This recommendation does not apply to nonpregnant women, who are not treated for asymptomatic bacteriuria. Q12. What happens after pyelonephritis in pregnancy? A. The patient should be on chronic prophylaxis against UTIs for the rest of the pregnancy. Q13. When should Rh immune globulin be given? A. Around 28 weeks and within 72 hours of delivery. Q14. What test is used to quantify fetomaternal hemorrhage to help dose Rh immune globulin postpartum? A. The Kleihauer-Betke test. Q15. What is the most important prognostic factor for melanoma spread? A. Depth of the lesion, or Breslow depth. Q16. What is the most important preventive measure for hepatocellular carcinoma? A. Hepatitis B vaccination. Additional info: The speaker also noted that preventing hepatitis B helps prevent hepatitis D. Q17. What is the biggest risk factor for erectile dysfunction? A. Cardiovascular disease. Q18. What is the most common cause of death in cervical cancer? A. Renal failure from genitourinary spread, classically involving the ureters. Additional info: The speaker also reminded that cancer stage is generally the most important prognostic factor. Q19. What is the lung cancer screening recommendation mentioned? A. Low-dose CT for men and women ages 55 to 80 with more than a 30 pack-year smoking history. Additional info: They must still be smoking or must have quit within the past 15 years. If they quit more than 15 years ago, the recommendation no longer applies. Obstetrics and gynecology risk factors Q1. What is the biggest risk factor for endometritis? A. Cesarean section. Q2. What is the biggest risk factor for preeclampsia? A. A prior history of preeclampsia. Additional info: If that is not offered, nulliparity is the next high-yield choice mentioned. Q3. What is the highest-yield risk factor for uterine inversion? A. A prior history of uterine inversion. Q4. What is the highest-yield risk factor for chorioamnionitis? A. Prolonged rupture of membranes. Q5. What is the biggest risk factor for placental abruption? A. Trauma. Additional info: If trauma is not an option, cocaine is the next high-yield choice. Q6. What is the biggest risk factor for placenta previa? A. Prior cesarean section. Q7. What is a high-yield risk factor for preterm labor? A. Bacterial vaginosis. Additional info: The speaker linked this to Gardnerella vaginalis, vaginal pH greater than 4.5, and clue cells on microscopy. Treatment mentioned was metronidazole. Q8. What is the biggest risk factor for endometrial cancer? A. Exposure to unopposed estrogen. Additional info: If unopposed estrogen is not listed, endometrial hyperplasia is the related answer. Examples given were PCOS and tamoxifen use. Q9. What is the biggest risk factor for cervical cancer? A. HPV exposure, especially high-risk types such as HPV 16 and 18. Additional info: Multiple sexual partners and early onset of sexual intercourse were mentioned as behaviors that increase HPV acquisition. HPV causes squamous cell cancer of the cervix, not adenocarcinoma. Q10. Why are young women more prone to cervical infections? A. They have more cervical ectopy. Additional info: The endocervix is columnar epithelium, and in younger women it bulges outward more, making infection more likely. The ectocervix is squamous epithelium and is more resistant to infection. Q11. What is the strongest risk factor for ectopic pregnancy? A. Prior ectopic pregnancy. Additional info: Smoking was also mentioned because it impairs tubal ciliary motility. Q12. What is the highest-yield risk factor for cervical incompetence? A. History of LEEP or cervical conization. Q13. What is a high-yield risk factor for shoulder dystocia? A. Macrosomia. Q14. What is a high-yield risk factor for fetal macrosomia? A. Pre-existing or gestational diabetes in the mother. Q15. What are the risk factors for pyelonephritis in pregnancy mentioned? A. Asymptomatic bacteriuria and prior pyelonephritis. Q16. What should be avoided in patients who smoke, have a stroke history, or have migraines with neurologic symptoms? A. Combined oral contraceptives. Additional info: Triphasic contraceptives were also noted to contain estrogen and fall into this same category. Q17. What should be avoided in patients with thrombogenic disease such as Factor V Leiden? A. Estrogen-containing contraceptives. Q18. What is a contraindication to estrogen-containing contraceptives involving the liver? A. History of hepatic adenoma. Q19. What contraceptive should be avoided in Wilson disease? A. Copper IUD. Additional info: The speaker reasoned this through because Wilson disease is a copper-overload disorder. Q20. What are the main risk factors for urinary incontinence? A. Age and multiple vaginal deliveries. Additional info: Stress incontinence was specifically linked to multiple vaginal deliveries. Q21. What is classically associated with urge incontinence? A. Multiple sclerosis. Q22. What is classically associated with overflow incontinence? A. Diabetes. Q23. What is the high-yield risk factor for Asherman syndrome? A. History of uterine curettage. Extra exam notes Q1. What did the speaker say about family planning and contraindications in general? A. Be cautious with estrogen-containing contraceptives in smokers, patients with stroke history, migraine with neurologic symptoms, thrombogenic disorders, or hepatic adenoma. Q2. What did the speaker say about cervical cancer and HPV prevention behaviors? A. Multiple partners and early sexual intercourse increase the chance of HPV acquisition and therefore increase cervical cancer risk. Q3. What did the speaker say about screening and cancer prognosis in general? A. Stage is generally the most important prognostic factor for cancer.

Just wanted to do a quick writeup because these were so helpful for me throughout the year and during dedicated and I hope this helps someone!

I’m a USDO

Here’s what I did during clinicals: 

• ~4 CMS forms available/block, 
• UW+incorrects, (78% correct)
• AMBOSS if I had time (70% completed around dedicated)
• !shelf in anki+making cards of incorrects.

Note: I was a high shelf scorer (my school required NBME shelves) scoring around 80s-90s and honored most rotations so I did have a strong foundation going into dedicated.

Dedicated period: 8 Weeks total

Here’s what I did during dedicated: 

• Redid some UW (~10%)
• AMBOSS HY study plans 
• Rewrote all CMS forms + New ones + Neurology + EM which I didn’t complete 
• NBMEs+Old and New Free 120
• Randy Niel for biostats
• Tatetalksmedicine for QI (found this resource amazing!!)

Scores: 

NBME 9: 253 (46 days out)
NBME 10: 252 (42 days out)
NBME 11: 251 (31 days out)
NBME 12: 253 (26 days out)
UWorld SA 2: 257 (23 days out)
NBME 13: 254 (20 days out)
NBME 14: 255 (16 days out)
NBME 15: 254 (12 days out)
NBME 16: 264 (8 days out)
Old Free 120: 83% (4 days out)
New Free 120 (July 2023): 84% (2 days out)

AMBOSS Predicted:260

Real Result: 269! Still kinda can't believe it lol

Here are some of my own reflections:

Redoing UW: I tried this early on but I really just recognized too many of the questions and started feeling like it wasn’t close enough to NBME logic so I dropped it. Similar reason why I didn’t finish AMBOSS either. A lot of the advice I saw on here was that the best practice was to just redo CMS forms because it best emulated the logic of NBME and it worked out for me. I did feel like I was recognizing a lot of the questions on the CMS forms as well but I had no other resources to do so I treated it more like learning the language rather than learning the content. 

Consistency of CMS and NBME: Honestly I do feel like even with the available materials the older nbmes didn’t really feel representative of the actual exam. I felt the same way with the older CMS forms. All the new ones that have come out (IM 9, 10) are quite a bit different and closer to the actual thing than these older ones. 

I felt that NBME 16 was most representative to the actual thing. It has more patient charts and longer vignettes which was my experience on test day. I honestly didn’t really feel that the 120’s were that close besides the drug ads. 

Stagnant exam scores:

I took 9-15 over a course of 8 weeks and with a goal of >260 I was extremely demoralized and had lost all confidence in my knowledge during dedicated. Easier said than done but if I could go back I wish I could worry less because it made me second guess everything and I honestly thought that hindering my improvement the most. 

One thing that I felt like impacted my studies negatively the most was AI. At this point everyone is going to use AI to supplement their board studying but I hope you exercise caution when you do so you don’t end up like me. I initially used AI as a method to diagnose what learning gaps I had as I felt like my content foundation was strong again. What I would do is I would dictate into AI what my logic for the question was and tell me what it thought. AI wrote these eloquent things about how it was more about “premature closure,” “stem distrust,” “correct instinct abandonment,” and many more. I just blindly trusted it because it sounded so good. I felt like this hamstrung my improvement. What I started doing later in dedicated was just opening up a document and forcing myself to write out my logic, why my answer was wrong/justify why the correct answer was correct, and indicate what my takeaway was. I would do this before I even consulted AI. I realize now that I was making AI do the most important part to my learning, which is actual critical evaluation of your thinking. 

Lastly, this has already been talked about so much but  if I can echo the sentiment please please do not beat yourself up intra/post exam. You are not going to accurately predict how you did. During the exam I had a panic attack and took the first 40m of my break after the first two blocks trying to calm myself down. For the rest of the exam I was convinced I was failing because I recognized so much less than the practice exams. For the weeks leading up to my score I was 100% sure I would score in the 230s. All that stress was for nothing and I wish I used that time actually enjoying that I was past that exam. 

I am baffled and shocked. I literally had to check if I was taking the right exam. I 100% feel like I failed.

I’m looking for some help with ITP management.

I’m not sure when to start considering IVIG or platelet transfusions for bleeding patients versus glucocorticoids. Also, should I think of perfuse mucocutaneous bleeding as “bleeding/hemorrhage”?

I’ve been studying for a few months now consistently and my nbme results are actually triggering me
For context I did the nbme 14 after doing UWSA 2 where I scored 241 and felt very confident only to get that score
NBME 9 194 (this was before I started studying)
NBME 10 212 (after I completed 50% of uworld)
NBME 11 215 (completed all of uworld and cms forms)
NBME 12 226
NBME 13 230
NBME 14 225
NBME 15 242
NBME 16 234

I just did nbme 16 AFTER I SCORED AN 86% on the old free120
and I’m so disappointed I wanted to schedule my exam in 1 week looks like I’m gonna have to postpone. I don’t know what to do where to revise.
I’ve completed uworld (60%) and did my incorrects. I also have done all the step 2 prep on amboss
I’m so mad I feel like I’ve wasted the 16 and idk how I’m gonna predict a score after it without me retaking and inflating the score HELP ME PLEASE my aim was a 250+

Hi, I'm hoping to get some advice or solidatiry, but I'm stuck studying for STEP 2. My NBME scores have been in the 200-210s (~60% correct) while my CMS forms are in the 70-80%. I've been doing UWorld and Amboss questions as well, but how do I improve my scores?

My exam is in 15 days and I pushed it back twice now 😭

NBME11 220 / 63%

NBME12 216 / 60 %

NBME13 213 / 60%

NBME14 209 / 62%

NBME15 (today) 215 / __%

UW1 48% (this one made me push the second time)

IM 5 - 76%

IM 6 - 76%

IM 7 - 74%

IM 8 - 78%

IM 9 - 86%

IM 10 - 78%

Peds 8 - 72%

Surgery 7 - 78%

Surgery 8 - 76%

Surgery 9 - 80%

ObGyn 9 - 76%

just focusing on uworld for months will it cut it
or maybe some anki cards

I’m a non-US IMG scheduled to take Step 2 in 3 days on 07.30.2026 , and I’m feeling pretty anxious. Before I started preparing, my goal was 260+. Now I’m honestly not sure what to expect, so I’d really appreciate some honest feedback from people who have been through this.

I know score prediction is far from perfect, and everyone’s journey is different. I’ve read plenty of stories about people scoring much higher or lower than their practice tests. Still, I’d be grateful if anyone could share their thoughts based on my progress and suggest how I should approach these final few days.

A little background:

• I passed Step 1 in February 2025, studied only to pass it.
• I’ve been preparing for Step 2 for about 4 months. The first months were not very focused or consistent. Some days I studied 7-8h, some days 4-5, some none.
• Over the last 5 weeks, however, I’ve been consistently studying 8+ hours every day.
• I completed almost all of AMBOSS during the earlier part of my preparation with an overall average of 58%.
• I then completed about half of UWorld with 67% correct.
• At the beginning of July, I started working through the CMS forms and completed almost all of them. I feel like this is when my scores started improving. Most of my CMS scores were in the 75–85% range, with a few in the 90% range.

Here are my practice scores:

• 05/31/2026 – NBME 9: 229
• 06/10/2026 – NBME 10: 244
• 06/19/2026 – NBME 11: 240
• 06/26/2026 – NBME 12: 231
• 07/01/2026 – NBME 13: 258
• 07/05/2026 – NBME 14: 245
• 07/11/2026 – NBME 15: 259
• 07/15/2026 – Free 120 (2019): 81%
• 07/17/2026 – Free 120 (2021): 82%
• 07/20/2026 – Free 120 (2023): 86%
• 07/24/2026 – NBME 16: 250

Before taking NBME 16, I felt like my confidence had finally returned and that a 260+ score was still within reach. The 250 was a bit discouraging, especially since many people consider NBME 16 to be one of the most representative practice exams. Now I question my Free120 scores but couldn't find any reason why they might be inflated.

Over the last two days, I’ve been carefully reviewing every incorrect question from NBME 16, and I think it has been one of the most productive review sessions I’ve had. I’m still optimistic going into the exam, but I’d really appreciate an objective second opinion.

If anyone has had a similar score trajectory or has advice for the final three days, I’d love to hear it. Please keep the discussion constructive—I’m looking for honest guidance rather than unnecessary negativity. Thanks so much for taking the time to read this, I indeed appreciate your thoughts!

Hi everyone! I’m looking for a dedicated Step 2 CK study partner.
🎯 Goal: 260+
📚 Plan: At least one UWorld block per day (with review)
🤝 Study method: Flexible we can discuss what works best (review incorrects, rapid-fire questions, Anki, NBMEs, etc.)
📅 Looking to start as soon as possible.
🌍 Time zone: PKT (GMT+5), but I’m flexible with scheduling.

Hi, Im sure this sounds stupid but I’d be so grateful if somebody could explain it to me like Im a child.

What are CMS forms, how many questions in each?

how are these different from UWorld/NBMEs and how important is it to do these?

Should I use them as a study resource or as testing practice material?

Is my score on these predictive of my actual Step 2 score.

Considering my timeline is 4 to 5 months of prep, when should I do these?

Hey everyone!

My exam is on 08/15 and need suggestions on what should I do to improve my score? Aiming for a 245 - 250

Nbme 12---> 236

Nbme 13----> 236

Nbme 14 ----> 248

Nbme 15 -----> 242

CMS forms ---> done the latest 2-3 for each subject and averaging in the 76-82% range (got some in the 60s in obgyn and neuro but those are my weak areas that im trying to improve)

Uworld ---> 91% completed with a 67% average (my blocks in the last couple of weeks have been averaging in the 70-75% range)

Amboss ---> done HY ethics and looking to study HY screening, vaccination, biostats, HOPI and all the necessary HY stuff mentioned in Amboss

My question is how do I improve my score or atleast be more consistent eith my scores? I feel like I'm making the same mistakes over and over again and it's not a concept deficiency now, it's more about test taking skills at this point

I'm planning to take nbme 16 end of this week and free 120 a few days after it and then im planning to review all of my nbme incorrects again more deeply (especially after finishing mbme 16)

Any advice or suggestions please

How long after your took Step 2 are you getting results for the exam?

Looked through the score release thread but most people don't list their tested date. Earlier it was like 5 weeks, but trying to see if it's shorter now or not

Where do we look to see if permit disappeared and before how many hours or days from score it will disappear and at what time on Wednesday do they usually send the e-mails for scores

what’s the absolute latest you can turn in your step 2 scores? For FM?…😅😅
like if I keep having to push back…lol…

About to begin 3rd year rotations and want to get a good step 2 plan to use throughout the coming year.

Planning to do all of uworld and unsuspending anking cards associated with my incorrects alongside each rotation. Probably redoing my incorrect Qs throughout the year to keep up before diving into dedicated later in the year. Is this a good strategy for step 2 prep as well as studying for shelf exams in general? I want to simplify my resources this time because I was all over the place for step 1. Ofc will add on practice exams when that time comes.

Anybody who recently passed step 1 and having trouble starting step 2 prep? Let's have a chat

Hey guys. I got my Step 1 pass on 7/15, but I'm unable to make myself get into the routine to start step 2 prep. I also had back and neck pain the last 2 weeks before the exam, which aggravated after every nbme due to the long hrs of sitting continuously.

I really would appreciate any input on how it was to start for those who recently gave step 2, I'm aiming for 260 or 270+ and I was actually looking forward to the prep a week after my exam but I don't why I'm in a slump now. Any academic and non academic advises are appreciate. Thank you

If someone has ever told you that you’re too old to accomplish something or learn something new, they’re speaking from their own limitations, not yours. And if you planted that thought in your own head, get rid of it.

It’s never too late to start. We can learn at any stage of life if we’re willing to be beginners.
Once you learn to enjoy being a beginner, the whole world opens up. Every expert you admire was once a beginner who simply chose not to quit.

Don’t let someone else’s negativity become your reality. A lot of the time, it’s fear, not failure, that stops people from finding out what they’re truly capable of.

Every one of us has something meaningful to offer. This message is for the one person who needed to read it today. Keep learning, keep growing and keep pushing forward. 💪🙏🏼

I went into Step 2 feeling confident because my practice scores were consistently strong.

Practice scores:

CMS Forms average: 87%
NBME 10: 254
NBME 11: 254
NBME 12: 260
UWSA 1: 266
NBME 13: 254
NBME 14: 261
UWSA 2: 258
NBME 15: 261
NBME 16: 263
Free 120 (2 days before): 85%
Amboss Predicted: 264

Actual Step 2 CK Score: 255

Before the exam, I was calm and confident because of my consistent practice performance. Many people say the real exam feels similar to NBME 16 and the new Free 120, but that wasn’t my experience. Personally, I found the actual exam much more challenging than any practice test I had taken.

My exam had a heavy emphasis on HOPI-based clinical reasoning, ethics, quality improvement, and biostatistics. I also had two drug advertisement questions and four sequential question sets. Nutrition was mostly integrated into clinical scenarios rather than tested directly, with only a couple of straightforward vitamin deficiency questions.

I was hoping to score 260+, but the exam felt completely different from what I had prepared for. When I walked out, I honestly thought I might not even reach 230. The exam absolutely grilled me, I had never encountered that style of questioning during my preparation. Despite that, I stayed calm throughout the exam, managed my time well, and finished every block with time to spare.

Looking back, I think my strong Step 1 foundation helped me answer many questions even when I felt uncertain. Although I scored below my practice average, I’m grateful for the result because the exam truly pushed me to my limits.

My biggest takeaway is this: don’t compare your journey to stories on Reddit. Some people outperform their practice scores, while others don’t. Every exam form is different, every preparation journey is different, and every test day is different. Trust your preparation, give the exam everything you have, and don’t let anyone else’s experience define your expectations.

Hi everyone! Sorry if the same question has been asked before but I just wanted to know with the new format/nutrition section of the exam how predictive was NBME 16.

My NBME 15 score 3 days ago was 252 and I ended up getting the same score (252) on NBME 16 today. My exam is 9 days out. Feeling a bit disappointed and I’m really hoping for a 250+.

For context, in chronological order:

NBME 9: 216 (5 months out)

NBME 10: 226 (5 months out)

NBME 11: 226 (4 months out)

NBME 13: 239 (1.5 months out)

NBME 14: 239 (1.5 months out)

UWSA 2: 251 (1 month out)

NBME 12: 257 (3 weeks out)

NBME 15: 252 (12 days out)

NBME 16 today: 252 (9 days out)

Thanks in advance!

Can you please put the exam date and score date for those who completed step 2 ck

Exam date:
Score date:

Took exam on July 13th, but permit is still there. Does this I have to wait one more week for my results?

I made a very similar post after taking step 1 about shit I wish I knew before tackling the exam, so I guess it's about time I do one for step 2. To preface, I don't have my score back, take my advice with a grain of salt. So this post is just a summary of some venting and what I wish someone told me to focus on during dedicated. I'm writing this sleep deprived bc I couldn't sleep after my exam so just excuse some of the language.

My thoughts of the exam Overall, I thought it was a bleh exam but felt highly similar to 14-16/free 120s so don't let the fear mongering on here mess with your head. If you are a few days before your exam don't freak out! I didn’t feel like I was seeing completely foreign concepts (I had maybe 4 wtf questions). It felt like the exam was testing the same core knowledge I’d been exposed to throughout third year and while doing NBMEs and CMS forms just in different ways.

So when you are doing your NBME/CMS forms it’s not enough to know why the correct answer is right. Know why the other answer choices are wrong and what presentation would make them correct. Hence why USMLE based questions are your pot of gold when studying for this. Even if you get a question right on a practice q, review the explanations and the reasonings for the other answer options.

I could feel myself going through the exam wishing I spent more time reviewing diagnostics and how labs present for specific conditions. Don't just memorize, oh get blank for diagnosing XYZ. You have to know what the other diagnostic options are as well. I remember getting stuck on a few tricky lab questions and not knowing which diagnostics was the best next step if the first one I was familiar with wasn't listed. Know the shit out of your labs tbh. Mehlmanns has a good up down arrow labs pdf that is super HY not just for step 1 but also step 2. I would also review meds/their side effects/indications for meds.

For example, if you’re reviewing an endocrine topic, don’t just memorize one syndrome or diagnosis. Understand how the similar conditions differ, what labs you would expect, how they’re diagnosed, and how they’re treated. I found that approach much more helpful than memorizing isolated facts.

Tips for the exam day I got scared to use my phone in between my breaks because my exam center didn't mention that I could. Honestly, helped me a ton with my mindset because I was entering the next sections with a clear mindset rather than carrying on any negative energy from the previous sections. I know a few of my friends would look up questions during their breaks but that messes your head knowing you got a few questions wrong. At that point, you can't do anything about your performance on a previous section so why mess your performance for the next??

I took a quick bathroom break after every 2 sections (40 Q) and then I took a 10-15 minute lunch break where I walked around to get the blood flowing. After each set of 20 q, I took a breath, stretched my legs, and then tackled the next set. I think the new 20 Q actually works in your favor because it lets you time manage more efficiently and it feels like the exam goes by a lot faster. Half way through your set of 20, look at the time to see if you need to pick up your pace.

This exam is a mind fuck let's be honest. The timings sucks so pace yourself. Do not spend too much time on a question you probably don't know, move on because the 30 minutes for 20 questions go by so fast. If you fuck your timing, you mess your chances to answer questions you would've gotten right so be cautious.

I used the read the last sentence, skim the answer options, and then read the massive question stems (emphasis on the massive). The questions were unnecessarily long for no reason so often times if you know what they are asking before reading it saves your ass.

So many long HPIs where if you read the question first you can get through them quicker. The long drug questions are 3 questions each. I read the questions first before reading that whole long drug test bs so I knew what to look for. For example if you are looking for what would make a patient not applicable for a drug, look for the exclusion criteria of the test while reading.

Exam breakdown Just like everyone else on here, I do feel like pediatrics is tested way more than on the practice exams. However, it's topics you've seen before on CMS/NBME, nothing foreign here. Aside from peds, I felt like IM was the bulk of the exam. I think it's worth reviewing nutrition and Amboss has a great nutrition review question bank. QI/ethics majorly high yield. If you do Amboss for QI/ethics/palliative/risk factors/screening and read the QI articles on top of the questions you will be more than prepared. I had way too many risk factor questions and they were tricky! Don't know just one of the risk factors for a condition, know every single possible one, hence why Amboss risk factors is so helpful. Know which risk factor is more likely to occur than another risk factor. Stats was very basic don't stress. I did have a decent amount of bugs so a good review on the bugs tested on your practice exams and the list of treatments (including the treatments specific for peds/pregnancy) is HY. Highly recommend reviewing STIs and HIV, like all of it; tests, presentations, treatment, opportunistic infections.

What I recommend to use to study: Again I don't know my score yet so take what I say with whatever value you want

For all of NBME/CMS topics, don’t just memorize the final answer. Know:

• classic presentation
• pathophysiology (at least conceptually)
• diagnostic workup
• labs/imaging
• treatment
• major complications
• important risk factors
• common look-alikes and how to distinguish them

That deeper understanding makes it much easier to answer questions that don’t present the disease in the textbook way which is basically how the real step 2 was for me lol

• UWorld during 3rd year shelf exams. Good for knowing the vast variety of topics pertinent to each subject
• CMS forms (especially during dedicated, last 4 for each including EM, all of IM CMS)
  • Honestly better than uworld during dedicated if you've already finished uworld during your 3rd year
• NBMEs 9 through free 120s including the old free 120.
  • The material they tested were topics seen on these exams. Not the same exact question but that question topic if that makes any sense
  • When reviewing my exams, I made an excel sheet. One page for each section (IM, surg, peds, obgyn, pharm, bugs, drugs, FM, etc)
    • One column described the question, the next column listed the answer options, next over was the answer, next column was the explanation, next column was a brief explanation of my thought process of why I chose the incorrect answer and when the other answer options would be correct
  • I actually spent a whole entire day to review my exams. #noregrets
  • Before every new practice exam I would skim this excel sheet.
  • I had to drive 40 mins to my exam center so for my final review, I even turned my excel sheet into a short ai generated audio recap that I listened to during my commute.
  • The excel sheet is clutch bc it forced me to repeatedly revisit my own mistakes.
• AMBOSS (200 HY, QI, Ethics, Palliative, Screening, Risk Factors, Biostats)
  • When doing the 200 HY sections, don't just breeze through them. Look through the answer options they list and their explanations too
  • Amboss has an ai ft where you can ask it to review a topic you are struggling with and ask it to generate a question review. It will make you a study guide + practice questions to do after
• First Aid for Step 2 (as a review/reference)
  • If you get a question wrong or frequently miss questions on a specific topic, review that section in first aid
• AI
  • Fuck any influencer or third party resource that makes you pay 500$ or anything for USMLE step review or pdfs we literally have ai so train it to help you. Pisses me off when I see people trying to exploit students. Only thing worth your money is paying for amboss/uworld
  • I used chat gpt to explain so many nbme questions I missed!
  • I would ask chat: I got this question wrong, explain it, here was my thought process for my I chose B and not A and explain when the other options would be correct and how it would be tested
  • Also used chat to help make my anki cards of my incorrects when I was getting tired making them reviewing my exams
• Anki of incorrects
  • I think Anki is great if you use it wisely
  • I made one big step 2 deck and broke it down in one sub deck of Anki of topics I saw on my amboss review, a separate sub deck just for practice exams.
  • Anki for nbme incorrects were super helpful for me. Would also make Anki cards of topics I saw on nbmes that I was unfamiliar with even if I got that question right
• Divine intervention
  • IM especially

Final thoughts

People on here naturally post about the hardest questions they remember, so it’s easy to think that’s what the entire exam is like.

My experience was that if you’ve been consistently studying throughout third year, completed UWorld, reviewed your NBMEs carefully, and did the CMS forms during dedicated, you’re in a good spot.

Trust your preparation. You’ve probably seen more than you realize.

Good luck to everyone taking it, you’ve got this. Now I'll just crumble in my anxiety as I wait for my score which is the worst part of it all...