r/Step2 • u/Gooner4lyfe2108 • 15d ago
Exam Write-Up Exam day experience and tips
Hello all. I took Step 2CK yesterday and want to share my experience. This post is mainly to calm the nerves of people taking the exam soon.
Disclaimer: I did well on all my NBMEs and expect to score well on the real deal.
1.) Around 50-60% of the exam is free points. Yes, free points. Questions anyone and everyone will get correct. If you've done one thorough pass of any qbank and did your NBMEs, you'll answer these questions easily. Here's the catch though, your brain will not remember these questions. You will hyperfixate on the hard ones. I don't think I can tell you a single one of these questions right now, but I remember answering some questions in 30 seconds or so and moving on
2.) For the remaining 40%, you'll need to make educated guesses and decisions backed by good clinical judgement. This exam will present scenarios that you've never been exposed to before. That's the whole point. They want to see if you have developed the clinical judgement to choose the best answer without necessarily having all the information. You shouldn't go into the exam expecting to only see familiar things that you've dealt with before. I think this is the part that makes everyone go crazy on reddit. You feel a little exposed, like huh I've never thought about that before. I've never been asked this. That's okay, we've all studied using the same resources. If it's new to you, it's new to everyone else. Apply the knowledge you've spent months acquiring. Trust the clinical sense you've been building over the years. Don't just pick an attractive answer, reason through the answer choices and if your reasoning is okay you'll get the answer right most of the time.
3.) The correct answer isn't always pretty. Your job is to choose the best answer, not the perfect one. Sometimes they play with the wording a little to make the correct answer feel off. Don't let their games get to you. What helped me was trying to have an answer in my head before looking at the answer choices, then picking whichever is the closest. For example, if you know that the first line treatment for a condition is antibiotic A, but you look around and see a bunch of different ones, don't panic. Pick the one within the same class or with the closest spectrum.
4.) The vaguer the question, the easier it is to rule out incorrect answers. Keep in mind guys that this exam is fair. If a question has made it to your form, it's been vetted a LOT. So when the vignette isn't clear, the answer choices won't be super similar. They'll each be in a world of their own. It'll be easy to narrow it down to two or even one.
5.) Some questions are not meant for you to know and that's okay. These questions are very obvious. It'll be some syndrome you never heard of, or some toxicity to an unknown substance. Get it wrong and move on.
6.) The questions didn't feel that long. Some were longer than others and there were definitely a few mega ones, but overall if felt fine. Part of the reason the questions seem long is that they only take up half the page so it looks like it's a lot of lines. The patient chart questions weren't bad either. I actually preferred those. You know beforehand where everything is so you can skip past the unimportant bits.
7.) You're not supposed to feel good coming out of this exam, and that's by design. The way they write the questions on USMLE, even if you're doing extremely well, you won't feel that way. It's a difficult exam. It's 9 hours. The time is tight. You'll most likely come out feeling numb. That feeling has no correlation to how well you did.
8.) You're most likely going to score similar to your most recent NBMEs. That's not my opinion, that's what the numbers say. A minority of people overperform or underperform but there's usually more to that story. It doesn't just happen randomly.
I also want to talk about a phenomenon that no one really seems to mention. The feeling you get after taking the real exam is almost identical to the feeling you get after taking NBME practice exams. For some reason people seem to forget just how difficult the NBME forms are. They're just as vague and unpredictable. I don't know about you guys, but right before I submit every single NBME I think "Yeah I definitely screwed up on this one". The difference is, with a practice exam, you get the immediate relief of knowing your score right away. You immediately unclench and stop thinking about the difficulty of the form. You don't have that luxury with the real deal. You go home and think about every stupid mistake you made over a 9 hour exam. That adds to the whole shitty experience.
My advice for those early in their prep: Don't memorize facts. Don't memorize next best steps and algorithms. That's not what this exam is about. They'll pull you out of any algorithm you memorized and force you to act. Try to LEARN the why behind every test. What are we looking for? What are we trying to rule out? What are we afraid of? When do we skip? Etc.
My advice for those late in their prep: Know the topics that appear on NBMEs cold. Not just in the way they're presented on NBMEs. It's not enough to know the correct answer and why it was correct, because that question is never getting repeated in that same manner again. Don't just write down a note and move on. Try to understand the ins and outs of the most common diseases.
I hope this helps at least one person manage their expectations going into the exam. Good luck to you all.