5 Mistakes to Avoid While Studying for Step 2 CK

When I was a medical student, I felt like I spent most of my time wandering around the hospital trying to be in the right place at the right time. Studying for Step 2 CK can feel the same way. No medical student wants to make mistakes; the consequences of making any number of common study mistakes can be huge. In this guide, I will discuss common mistakes students make while studying for Step 2 CK and how to avoid them.

1. Using too many resources

Not many students use too few resources to study for Step 2 CK. I commonly see students trying to study from every high-yield recommended resource. You might be asking yourself, “but, isn’t more always better?” Not always. I have found that my students who study from many resources tend to know each resource relatively superficially, and don’t have the depth of understanding needed to answer many questions correctly. By limiting yourself to two to three study resources, you decrease the amount of redundant studying you’ll do. It’s better to know a few resources very well than many resources only partly well. Pick a question bank, an Anki deck, and use another reference (UpToDate, AMBOSS, etc.) to keep up with current practices and diagnostic criteria and resist the temptation to do too much at once.

2. Not approaching questions systematically

Some questions on the USMLE Step 2 CK are made to play into confirmation bias. This being said, if you don’t approach each question the same way every time, you’re bound to make mistakes and miss important details. I go through questions the same way every time, and you should too.

My process

1. Read the last 2 sentences of the question stem.
2. Go through the stem, starting at the beginning, and highlight buzzwords, abnormal findings, or anything seemingly out of place.
3. Make a diagnosis and form a differential (if I could) before looking at the answer choices. 
4. Eliminate answer choices. If I am unable to eliminate all the answer choices, I move on and leave the question unanswered.
5. After finishing the block, I go back through the exam and try to parse out the correct answers from unanswered questions. If I don’t know on my second pass, I flag the question for later. I have a habit of reflexively selecting answers and falling into traps, so this method helped me slow down enough to think critically.
6. As a rule, I skip my own weak areas (e.g., thyroid, biostats, questions with multiple answers). I use any extra time at the end of the block to go back over flagged questions and make sure I didn’t miss something glaringly obvious. I rarely, if ever, change my answers.

3. Not trusting your gut

Your “gut” describes the inexplicable feeling you get that points you towards one answer or another. Have you ever had an answer to a question pop into your head seemingly out of nowhere? It can be scary when your mind latches on to an answer, especially when you can’t quite remember why it’s the correct answer. But sometimes, you just know.

However, when your gut points you in the wrong direction, and you get a question wrong, it can make you doubt yourself. From that point on, many students – myself included – begin to distrust their intuition. What these students don’t realize is that your gut feeling can help narrow down answers or choose between two similar answers when used correctly. For example, should you do a pericardial window or a second pericardiocentesis on a 4-year-old girl with cardiac tamponade who doesn’t respond to pericardiocentesis? There are questions on Step 2 CK without clear answers, and you need to get good at choosing between the two if you want to score above a 260.

How do you train your intuition? A properly trained intuition is a fantastic way to help you get those tricky questions right where other students might get them wrong. I trained my gut by trusting it, even when it led me astray. If it got me to the right answer, then I’d make sure it got me there for the right reasons. If it got me to the wrong answer, I’d review the question and try to identify gaps in my clinical decision making. Step 2 CK tests your knowledge and your clinical decision making. You won’t score a 270+ without both.

4. Not preparing for test day conditions

Practice makes perfect, right? Wrong. Perfect practice makes perfect. Many of my students are very good at acquiring and retaining knowledge, but very few of them score as well on practice exams when they’re tired as they do when they’re well rested. Studying for Step 2 CK is a marathon, not a sprint.

Emulating testing conditions is potentially one of the most beneficial practices a medical student can do leading up to taking USMLE Step 2 CK. Each time you sit down for a study session, you should be imagining yourself in the testing center on test day. That is not to say that you should be anxious while you study. The opposite is true, actually! Emulating testing conditions is a great way to overcome test anxiety and make your test day feel just like any other forty question UWorld block. I recommend practicing upright posture and healthy eating habits while studying. That means no snacking during question sets!

While the perfect testing environment is not always possible every time you study — maybe your dog is barking or your neighbor is mowing their lawn — you should do you best to study in a quiet place with minimal distractions. Your test day should feel like any other study day.

5. Not taking care of yourself

I see far too many people neglect their physical and mental health during their dedicated pre-exam study period. In my opinion, this is the biggest mistake you can make. Even though you have question sets and flashcards, while also walking the dog and remembering birthdays, your life doesn’t stop. Include time for good hygiene, exercise, eating well, and leisure time in your dedicated study plan. Your UWorld percent correct won’t matter on test day if you are burnt out. In the words of someone I respect greatly, “all sentient beings deserve respect, and you are also a sentient being.” Take care of yourself first.