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The Absolute Best Predictor of Step 2 CK Scores


This is an article about Step 2 that is useful long before dedicated test prep! Whether you are in the midst of your dedicated study time or more than a year out, read on to find out what the best score predictor is for USMLE Step 2 CK!

Some would argue that one of the most important–and often challenging–aspects of preparing for Step is knowing when you are ready to sit for the exam. When deciding how long to prepare for Step 2 CK it is important to consider a few factors that might predict your performance including:

  • How exam prep has gone in the past.
  • How you are hoping to score and how that compares to prior performance.
  • How you have performed in medical school.



How Has Exam Prep Gone in the Past?


If you were able to breeze through 80 to 100 UWorld questions daily during your Step 1 preparation, you might need less study time compared to those who benefited from a more deliberate pace. If you experienced early burnout in your dedicated study period, consider initiating your studies earlier, incorporating test prep alongside clinical responsibilities to potentially shorten your dedicated study time. Having an established Anki deck or annotated Step study materials may reduce the required study duration compared to starting from scratch.


Although I already had an anki deck that I built throughout the course of my clinical rotations, I knew from studying for Step 1 that I tend to move slowly through UWorld. So I would need more time to get through all of the questions than some of my classmates who were able to cruise through several blocks in a day. Knowing this ahead of time helped me plan out my study schedule better for Step 2.



Using Past Examinations as a Score Predictor: What is Your Goal Score and How Does That Compare to Your Prior Performance on Exams?


Although we no longer have your Step 1 as a predictor of your Step 2 performance, medical students usually have a broad sense of their test-taking abilities relative to peers. Take a moment to honestly assess the average percentile you typically achieve in medical school examinations, encompassing NBME shelf exams, UWSAs, and similar assessments. While this metric may be less reliable with varied percentiles, consistently landing around, let’s say, the 65th percentile could be a reasonable predictor of your potential rank on this exam.



How Have You Performed So Far in Medical School? How Well Do You Remember Specific Clinical Cases?


The reason that this article holds value long before your dedicated study period is that studies have shown that the best predictor of Step 2 CK performance is your performance in medical school. Now, I should mention that of course these are correlational studies. It is reasonable that people who may have a natural skill in test taking would perform well on medical school examinations as well as Step exams. With that said, there is also undeniable value in spaced repetition of learning and application of knowledge in clerkships.


Students with better performance on preclinical exams, shelf exams, and clinical evaluations all tended to perform better on Step 2 CK. It can be easy to fall into the trap of viewing your clinical work as a distraction from your studying. However, your time with patients is invaluable because it helps you to be a better doctor (after all, this is the ultimate goal) and it provides context for these challenging concepts. I still remember the patients in medical school who helped me to remember neurological pathways, surgical complications, and endocrine feedback loops. When it came time for me to study and answer questions on these topics it was my clinical time, not the anki cards, that helped me.


Interestingly, there is also a relationship between test scores and extracurricular activities. Some studies have even found a correlation between participation in free clinics or peer tutoring programs and higher test scores. Put simply, all of your efforts over the past few years hold value in preparing you for this exam and perhaps the efforts with meaning are even more effective than rote memorization.



Best Predictor to Help You Know When You Are Ready to Take Step 2 CK


These are all ways to predict the general range of where your Step 2 CK score may fall. However, these metrics fall short in determining when you are ready to sit for this exam. Scores are fluid and are certainly related to your study efforts. Just because you scored within a certain percentile range on previous exams does not guarantee that you will fall within that range on all exams moving forward. When I was studying for Step 2, the scores on my practice exams were variable but showed an overall trend in the direction of my final score on Step 2. Because of this, it is also important to have markers of your progress and performance during your study period and leading to the exam.




Your score on UWorld questions may feel like a marker of your progress. However, your percentile on UWorld is not an accurate predictor of how you should expect to perform on Step 2 CK. As a reminder, UWorld is a learning resource, not a testing resource. There is such a broad spectrum of how students use UWorld (some complete it twice, some take blocks on timed mode, some take blocks on tutor mode… you get the picture). So the percentiles do not hold any appreciable meaning.


Practice Exams


In addition to daily UWorld blocks, your study plan should also include practice tests in the form of NBMEs (CCSSAs — Comprehensive Clinical Science Self-Assessments)  and UWSAs (UWorld Self Assessments). These practice exams are essential for improving your stamina for test day and also for providing a more meaningful predictor of how you may expect to perform on Step 2 CK. There are benefits and shortcomings to each of these testing formats.




CCSSAs are released by the NBME and many people feel that these questions more closely resemble the question format that you will see on test day. These question stems are generally somewhat shorter and the software is nearly identical to what you will see on test day. There are several NBMEs available and the more data you have, the more accurately you will be able to predict your score. With that said, based on informal student reporting, the best NBME predictors seem to be forms 11 and 13 (however some feel that form 13 underscores slightly).




UWSAs also have their strengths. Most notably, there are two UWSAs that are included in the price of your UWorld subscription (compared to the $60 cost of each NBME practice test). These tests are also somewhat longer (although still not as long as the official test), which helps to more closely simulate your test day. If time allows, you should complete both UWSAs, but UWSA2 seems to be the best predictor of your Step 2 CK score. When comparing NBMEs and UWSA, UWSA 2 seems to correlate most closely with test-day performance.


When I was preparing for Step 2, I was also concerned about improving my stamina for test day. For this reason, I felt that it was important to progressively increase the number of questions I would sit down to do at any given time. In order to have a more accurate representation of what test day would feel like, I added 1-2 additional blocks at the end of my practice exams. 


Score Predictor Calculators


Beyond just completing the practice exams, there are several calculators that allow you to input all of your practice scores to come up with a conglomerate prediction. Like I said, more data is generally better but keep in mind that these are based on self-submitted data from prior years and are not validated or regulated by any official body. You should also consider the fact that some of these assessments were likely taken earlier on in your study period and, therefore are not the most accurate prediction of your current performance.


As a rule of thumb, you are ready to sit for the exam when you are performing on practice tests within a score range that you would be satisfied with on test day. Despite what you may read online about over-prediction and under-prediction of certain exams, these exams are getting closer and closer to accurately predicting scores and you should not expect your test day performance to be significantly different. So go out there and give it your all! Take each practice test seriously and make sure to congratulate yourself on all that you have done to get here today!


Get prepared today! Schedule your free consultation with Elite Medical Prep to learn more about how we can help you make the most of the time you have to study for your Step 2 CK exam!

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