Guide to Using UWorld For Step 2 CK

This blog was originally posted on January 17, 2023, and updated in December 2024.

Growing up, my studying always seemed to follow a natural sequence: learn new content, review that content, and then quiz yourself on that content with practice questions. The idea of beginning with the end, i.e., using practice questions in order to both learn and review content, seemed counterintuitive. Yet after making it through my clinical shelf exams and USMLE Step 1 and Step 2 CK using UWorld, I now recognize that students often falsely gravitate towards the first approach because it provides a sense of safety; by contrast, the second approach is the fastest way by which to expose the gaps in one’s knowledge. 

Perhaps the prerequisite step to using UWorld to study for any exam is preparing oneself to confront what they do not know. This humbling experience makes UWorld an ultimately love-hate relationship. It is the bane of many medical trainees’ existence, yet they swear by it as a guaranteed path to improvement.

People often cite score improvements of over 15 points using UWorld as a primary study tool. Despite its effectiveness, UWorld is only as good as the user’s ability to harness it. Many often embark on their study period asking how to use UWorld and if they are using it correctly. Given all of the lore around UWorld, one might assume that there must be some secret recipe outlining how to use UWorld correctly. One need not overcomplicate matters; indeed, a simple guide to getting the most out of this resource can be broken down into three parts: planning questions, answering questions, and reviewing questions. 

Planning Step 2 CK Questions in UWorld

Question Count

The Step 2 CK question bank consists of 4090 questions and counting, as new questions are always being added. Something that greatly aided my studying was recognizing that concepts repeat themselves on UWorld; this dramatically reduced my stress that I was 1) never going to see a topic again and therefore had to learn it perfectly the first time around and 2) that I was missing entirely new content in whatever questions I could not get to. If you get a question on pheochromocytoma incorrect, trust that you’ll be guaranteed to get another question on that same topic. And know that, in the 30% of the QBank that may remain untouched by test day, there’s bound to be a question on pheochromocytoma in there. 

Shelf vs. Step 2 Review

You’ll also see that you can toggle between “Shelf Review” and “Step 2 Review.” The questions in each mode are the same. However, “Shelf Review” organizes them by clinical specialty, whereas “Step 2 Review” does not. For example, the “Medicine” category on Step 2 Review may contain questions spanning the IM, FM, Ambulatory, and Neurology blocks on Shelf Review. Choose the mode that matches your exam to get the most realistic simulation of test day.

Number of Passes

Individuals often ask how many times they should get through the question bank. If you’ve kept up with your studies and had one solid pass through the bank during your clinical rotations you’re off to a good start. Getting through as much of the QBank as possible during your Step 2 study period should be sufficient. I made it through almost all of the questions during my core clerkships and then through 80% of the QBank during my Step 2 dedicated 4 months later. Remember, it’s not just about getting through questions, but about learning from them. Are your average scores on each block increasing? Next, we’ll review how to approach answering questions on UWorld. 

Answering Step 2 CK UWorld Questions

Now that you’re in Step 2 Review, it’s time to create your practice question blocks. There are a couple of selections to choose from:

Question & Block Count

It is generally recommended to set up your question blocks with 40 questions each to most closely match the length of blocks on test day. UWorld is a go-to study tool for the USMLE. As such, it should take center stage in your study plan. Students generally aim for 2-3 blocks of 40 questions per day, followed by question review and some manner of spaced repetition to ensure that you are learning from both current and previous mistakes. 

Tutor Mode vs. Timed Mode

In tutor mode, you receive feedback immediately after each question with the correct answer choice and explanation. In timed mode, you must answer all of the questions in a given block before receiving that feedback. Timed mode is the best way to simulate the actual exam. However, tutor mode can be helpful for students who are just starting out.

Be cautious with Tutor Mode: it can lead to excessive time spent reviewing correct answers, in addition to incorrect ones. Remember, you learn more from your mistakes than your correct answers. As a result, over-reviewing can lead to diminishing returns.

Subjects and Systems

Here you have the option to select isolated or all core disciplines that are tested on Step 2 (Medicine, Surgery, Pediatrics, OB/GYN, Psychiatry) as well as isolated or all content areas. Again, the actual exam is not going to signpost “This is a Pediatric Dermatology question,” so I recommend making blocks “undifferentiated,” i.e., spanning all subjects and systems. 

If you identify a weak area, consider supplementing your studying with dedicated question blocks on that topic. This can help you focus on improving your knowledge in that area. For example, because I wanted more practice with Biostatistics, I completed a few dedicated question blocks in just that System. I left some Biostatistics questions for later, to be mixed in with other topics, so I could continue testing my knowledge.

Reviewing Step 2 CK Questions in UWorld

Having a system in place for reviewing questions is likely the most important part of using UWorld. It allows you to make sure that you are learning from the countless questions that you are powering through. Fortunately, UWorld offers some tools for this. 

Flashcards

Easily clip text and images into flashcards as you review topics and find your weak areas. It utilizes spaced repetition similar to that of applications like Anki. If you like making your own flashcards or just want to make sure you remember a few really tricky topics, you can do it right within the question bank.

Notebook

Lots of functionality here. You can build out a robust collection of notes on topics you find really challenging or particularly high-yield. You have a place to store all those classic UWorld tables and advanced organizers for future use. In fact, you can link the notes that you take for Step 2CK to your Step 3 account. This is a pretty big deal. There is significant overlap in content between Step 2CK and Step 3, so your future intern self can benefit from any notes you make as well. ***To link notes between Step 2CK and Step 3, you’ll need to have active subscriptions for both. Make sure to plan ahead and activate your Step 3 Qbank subscription before your Step 2CK subscription expires.

Your Approach

Alternatively, you can tailor your question review to best suit your learning style. Some might elect to use resources like Anki for making new flashcards on their incorrects or for selectively unsuspending cards from corresponding topics on a premade public deck. Additionally, some might choose to make and organize their own “Notebook” on a separate platform. Whatever method you choose, ensure that it involves some form of spaced repetition so that the information that you learned at the very start of dedicated continues to stay relevant in the days and weeks that follow. 

Time for Review

Many students ask how much time to spend reviewing questions. A general rule of thumb is to let the percentage assigned to each question guide review. 

• If you miss a question that <35% of people get correct, then review it. Learn what you can from the explanation, then move on. Spending tons of time on these types of topics is unlikely to yield a significant change in your score.
• If you miss a question that 35-69% of users get right, it’s a good topic to review in more depth. These would be higher-yield topics for you.
• If you miss a question that >70% of users get correct, it’s a high-priority area to study. You’ll get the most return on your study time by focusing on this material.

Identify topics that need extra review and jot them down on a sticky note. Then, revisit them during your scheduled content review time in your study plan.

Final Thoughts on Using UWorld for Step 2 CK

A former teacher of mine once told me, “If your brain isn’t asking you, ‘When is it time for Netflix?’ then you probably aren’t studying hard enough.” This quote stuck with me during my dedicated study period, especially when I’d reluctantly start another UWorld block. I’d often think, “Can I do something else?” But then I’d realize, if I’m not feeling challenged, I’m likely just reviewing familiar topics. The fact that I was wondering when I could take a break meant my study strategy was working – UWorld was pushing me to fill the gaps in my understanding.

To close things out, here are some final quick tips on how to use UWorld for Step 2 CK:

• Shelf Review mode for Shelf exams, Step 2 Review mode for Step 2 CK.
• Step up the number of questions per day (80-120 per day).
• Take practice blocks of undifferentiated topics.
• Keep an eye on your performance scores in each specialty and in the core disciplines.
• If starting off with Tutor mode, aim to transition to Timed mode as early as possible. 
• Identify why you missed each question.
  • Pacing and problems with your approach are common reasons to miss questions, not just knowledge gaps.
• Practice like you play. Start your study days around the same time you will be taking the exam.
• Build out your practice exams with extra UWorld blocks so you build up your stamina to be able to complete a 9-hour exam. And do it well.
• Review systematically. Spend time reviewing topics that others are getting correct, and have a system in place for spaced repetition of missed information. 
• Practice highlighting within the question stem like you will on the real thing.

You have the opportunity to use UWorld in a manner that most closely simulates the test day experience. Doing so repeatedly will not only build your stamina, but it will also boost your confidence as you develop a clear picture of what to expect.

For more help studying for your shelf exams, USMLE Step 2 CK, or other medical exams, schedule a complimentary consultation with Elite Medical Prep to hear more about how 1-on-1 tutoring can help you succeed!