How Long Should You Study for Step 2?

Preparing for Step 2 raises many questions, but one of the most pressing ones is: how long should I study for Step 2? The answer, unfortunately, is not one-size-fits-all. It depends on various factors, including your baseline knowledge, the time you’ve spent preparing throughout medical school, and your personal study habits. In this blog post, we’ll cover the most common questions about study time for Step 2 CK, helping you create a plan that works best for you and ensures you’re fully prepared without burning out.

What is the importance of scoring highly on Step 2?

USMLE Step 2 CK is a very important exam nowadays for residency applications. Scoring highly is extremely important given the change in Step 1 scoring to pass/fail and also the elimination of Step 2 CS. Residency programs only have one good arbitrary measure of your didactic knowledge, and that is your Step 2 CK score. Many programs will also have a predetermined score as a “screening” metric for evaluating prospective residents. Especially if you are applying to a competitive specialty or competitive program, bypassing that screening score is going to be critical in you receiving an interview invitation.

From what we have seen, this cutoff generally lies around the 230-240 range of scores.  Getting a “good score” on Step 2 CK requires hard work! This is also extremely relative based on which specialty you are applying for and many other factors (location of the program, community vs. academic structure, university-based affiliations, etc.). A “poor” Step 2 CK score is also relative. However, aiming to score at or above the average is a good goal to have! In 2023, the average Step 2 CK score was a 247 with a standard deviation of 15. 

Is it hard to pass Step 2?

The passing score for Step 2 is 214 out of 300, which was recently increased from 209 after the dissolution of Step 2 CS. According to the USMLE, in 2023, the overall passing rate for U.S. M.D. and D.O. seniors was 97%, while Non-U.S. seniors had a passing rate of 86%.

While Step 2 is undoubtedly a challenging exam, it’s essential to understand what it entails. The exam covers material from didactic lectures as well as clinical knowledge. You’ll also encounter more fundamental concepts like anatomy, biochemistry, and metabolism, although in smaller quantities than on Step 1.

Many students find Step 2 to be an easier exam compared to the NBME Shelf exams. However, it’s crucial to remember that everyone’s preparedness levels and exam questions will vary. Despite this, the data suggests that most medical students who take Step 2 do end up passing it.

How much time is enough for a dedicated period for Step 2?

The average dedicated period for Step 2 is 4-6 weeks, based on informal reporting data. However, many medical schools have students take Step 2 at the end of their 3rd year of clinical rotations, which means they’ve already been informally “studying” for about a year beforehand. This prior exposure is extremely valuable, as it minimizes the amount of new information to digest before the exam.

So, what’s the focus of the dedicated period if you’ve already studied the content and taken exams? This period allows you to:

• Finish your UWorld question bank, possibly even reviewing it twice
• Master time management during the exam
• Focus on small details and facts using Anki
• Build your stamina to sit for the 9-hour exam

For most medical students, 4-6 weeks of dedicated study time is sufficient. In fact, taking more than 8 weeks to study for a USMLE exam is generally not recommended. There are two main reasons for this:

• Longer dedicated periods can lead to forgetting material learned at the beginning, which can be mitigated but is still a risk.
• Long gaps or breaks in medical education are reported on your Medical School Performance Evaluation (MSPE) and may be questioned during residency interviews.

The best strategy is to diligently study for NBME Shelf exams and then take a 4-6 week dedicated period for Step 2. Keep in mind that every medical student and situation is unique, so we recommend discussing your schedule with a residency advisor or Step 2 tutor to create a plan that works best for you.

How many hours a day should I study for Step 2?

During your Step 2 dedicated period, we recommend devoting 8-10 hours a day to studying. This includes all studying tasks, such as Anki, UWorld, content review, reading First Aid, and more.

While 8-10 hours may seem like a lot, remember that your dedicated period is only a few weeks long. Maximizing your study time is crucial to achieving your goals. You can break up your day according to your study plan, but we suggest prioritizing “active learning” tasks in the morning when your energy levels are highest. This includes:

• Practice questions
• Active annotations during content consumption
• Reviewing practice questions or practice exams
• Taking practice NBMEs

In the afternoon, when your energy levels may be dwindling, focus on “passive learning” tasks, such as:

• Flashcards
• Reading
• Image review

Using a study planner can help you effectively fill up your 8-10 hours and keep track of your tasks.

Additionally, we recommend taking a “rest day” once a week during your dedicated study period. This can be any day of the week, but we suggest scheduling it on a weekend (Saturday or Sunday). On this day, reduce your study hours to 4-5 and focus on light review, such as:

• Daily Anki review
• Some First Aid reading
• Anatomy review

This break will give you and your brain a chance to recharge for the upcoming week of challenging study days.

What resources should I use to prepare for Step 2?

There are many different resources available to study for Step 2 CK. The key is to identify the resources that best fit your learning style. Each resource is tailored to a specific learning approach, whether you’re a didactic learner, visual learner, or something in between. Use the following list as a framework to guide your resource selection, and explore the various options available to you.

Practice questions 

The gold standard for a practice question resource is UWorld and at EMP this is what we suggest you use as well!UWorld questions mirror the format and structure of NBME-style questions, allowing you to practice dissecting each question effectively. They also focus on high-yield facts, building questions around them, which helps solidify your knowledge base and didactic concepts. We suggest completing UWorld at least once before sitting for Step 2, and then reviewing your incorrect questions. Ideally, you’ll have already made significant progress on UWorld through your NBME Shelf exams. If your medical school curriculum doesn’t include NBME Shelf exams, we recommend starting UWorld a few months before taking Step 2 to get a head start.

Aside from UWorld, we also recommend Amboss as a valuable question bank. While Amboss questions don’t always follow the NBME structure, they cover a lot of high-yield content. The questions can be challenging, but this complexity can help you approach content in a less traditional and more nuanced way, potentially enhancing your understanding of complex concepts. When to use Amboss? We suggest using Amboss for targeted question blocks and content review. For example, if you struggle with questions about transudative vs. exudative pleural effusions, do a 10-15 question set on this topic to solidify your understanding. However, we recommend completing UWorld entirely before relying on Amboss for daily question review.

Reviewing practice questions the right way is crucial. We recommend using the Educational Objective at the bottom of the answer explanation to guide your studying. Review the facts, images, and charts provided to supplement your understanding of the concept. If you got the question wrong, review the answer choice you selected to understand why it’s incorrect. Annotate important information in your First Aid book to make this process as active and engaging as possible!

Content review

As mentioned earlier, there are many different forms of content you can engage with during this process. There are video resources, books, PowerPoints, podcasts, audiobooks, YouTube videos, you name it! The goal before your dedicated period is to know which resources work best for your learning style.

For Step 2 specifically, we find the Online MedEd and Boards and Beyond are great resources for video content. Online MedEd uses more pictures and diagrams to illustrate material whereas Boards and Beyond is more geared towards a didactic learner. 

While reviewing content, it is imperative to make the process as active as possible. This entails annotating the content in your First Aid book or making Anki cards to go along with the material presented in the video. In this way, you are not just watching the video and leaving with no study product to utilize afterward. 

We recommend that you take a baseline NBME and use the score breakdown to identify your lowest 5-6 performing systems. After you have identified these, watch the corresponding video series for each of these systems before your Step 2 exam. This will allow you to fill in those knowledge gaps and improve your scores dramatically. 

Flashcards

Our #1 recommended flashcard resource is Anki. Anki uses a spaced repetition algorithm to make sure that you retain the information as efficiently as possible. We strongly recommend creating your own flashcards using the Cloze feature to maximize active learning. This approach allows you to tailor your flashcards to specific systems and subjects, such as microbiology, pharmacology, and pathology, which require rote memorization. However, the beauty of Anki lies in its flexibility, so it’s up to you to decide how to utilize this resource.

During a dedicated study period, we suggest aiming for 30-50 new cards per day and 200-300 reviews per day. Consistency is key when using Anki. Missing days can disrupt the spaced repetition algorithm, rendering the platform less effective. Make sure to stay committed to your daily Anki routine to get the most out of this valuable resource.

Textbook 

Having a central resource as a text is crucial. You can use this book to annotate notes from your video content resources, and UWorld as well as an organizational tool while reviewing massive amounts of material. We have written a detailed blog post breaking down the top recommended study books for Step 2 CK so I definitely recommend giving that a read! Here is a breakdown of the suggestions: 

• Step-Up to USMLE Step 2 CK is a great resource with lots of tables and figures to help you digest the information in a more efficient way.
• Master the Boards is a book that is geared directly towards preparation for the exam and will tell you exactly what you need to know to get questions correct; therefore, it is not extremely comprehensive and will miss some more nuanced details that you may need to know.
• First Aid for the USMLE Step 2 CK unfortunately is not as beneficial to use as First Aid for the USMLE Step 1. It is not comprehensive enough for Step 2 CK so you may find yourself annotating content in more than any other book on this list. However, it is extremely organized and has many tables, figures, and mnemonics to aid your studying.

Study planner 

The last, and arguably most important part of the USMLE Step 2 dedicated period is having a reliable study planner that can organize all of the tasks outlined above. EMP has created a 4-week Step 2 study planner template that is customizable for your individual needs. The most important thing is that you create a routine that is organized and that you can stick to for your entire dedicated period. 

We wish you the best of luck in your Step 2 CK studying endeavors, and if you need some extra assistance, feel free to schedule a consultation to learn more about our tutoring and residency advising services!