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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, whether you have dedicated study time, and how you have performed in medical school.


How Has Exam Prep Gone in the Past?


If you were able to cruise through 80 to 100 U World questions in a day while you were studying for Step 1, you may require less study time than someone who benefitted from moving a bit more slowly. If you were someone who felt burnt out very early on in your dedicated study time, you may want to start studying earlier, mixing in some test prep among your other clinical obligations so that your dedicated time can be shorter. If you are someone who already has a dedicated Anki deck or annotated Step study materials, you may require less time than someone who is starting from a blank slate.


Using Step 1 as a Step 2 CK Score Predictor: What is Your Goal Score and How Does That Compare to Your Prior Performance on Exams?


Your Step 1 percentile, although not the “be all and end all”, and certainly not the best, is generally a good ballpark score predictor for Step 2 CK. This is somewhat more challenging now that Step 1 has become pass/fail, however you can take into consideration your performance on the NBME exams and UWSAs you took leading up to your test date as well as your typical performance on shelf exams. This may be a less reliable metric if your percentiles are all across the board, but if you generally end up around, say, the 65th percentile, you can imagine that this might be a good predictor of where you may rank on this exam. 


Do You Have True Dedicated Time, or Are You Studying Alongside Other Clinical and Academic Obligations?


Many medical schools allow students to structure their schedule to allow for at least some dedicated Step 2 CK study time, however this is highly variable from program to program and from student to student. If you have a significant chunk of dedicated study time (4-6 weeks), the amount of time you need to dedicate leading up to that will reasonably be less. On the other hand, if you have only 1-2 weeks of dedicated study time, you will want to be sure to start working on Anki and UWorld in the few months leading to your target test date. 


How Have You Performed So Far in Medical School?


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. Notably, 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.


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. 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 really do not hold any appreciable meaning.

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 10 and 11. 

UWSA’s also have their strengths. Most notably, there are two UWSAs that are included in the price of your U World 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 help 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. Actually, when comparing NBME form 10, NBME form 11, and UWSA 2, UWSA 2 seems to correlate most closely with test day performance. 

There are also 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 off of self-submitted data from prior years and is 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, 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 are 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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