Step 2 dedicated & Residency Application Timeline

Aug 25

Written By Rainee

Can you believe it? We’re taking Step 2 already!

Step 2 Dedicated

Step 2 CK is generally taken after your cores or in your third year. However, you are not required to complete all cores prior to taking it. In fact, SGU doesn’t moderate when you take Step 2 nor is it a requirement for graduation. SGU has different clinical starts so when this happens depends. I started my clinical rotations in May and I didn’t have a Family Medicine rotation in my third year so I ended my third year in March. Most sources recommend taking Step by August so you have the report for residency applications. You can submit your residency application around early September and programs are able to access applications in late September. The Step results usually take around 2-3 Wednesdays to receive.

How to sign up for Step 2

I applied for the permit on the ECFMG website during my 3rd rotation of 3rd year. It was sent to SGU to verify that I was a student. Then an approved permit was emailed to me about 2-3 weeks later and I was able to register! The $1000 fee is paid to ECFMG. This buys you a seat reservation via Prometric.

How to build your Step 2 study plan

Anyways, how to make a plan. It depends largely on how much time you have to study and your goal score. Some can afford a 2-3 month dedicated, a lot only 4-6 weeks, and some have to take it during rotations. The biggest difference from Step 1 dedicated, is that you’ll likely need to minimize content review So this is my approach to making a time-crunched plan:

Target weak spots. I used the NBMEs to find my weak topics. When I reviewed NBMEs, I'd write a list of topics I missed. With that list, I’d divide them into body systems. Example: Under Neuro, I’d “strokes” and “lewy body” or under Renal I’d have “aldosterone” or “PTH vitamin D phosphate calcium”. I would focus on 2-3 systems per day by brief overview with OME. Then I’d do topic-specific qbanks to solidify the topics. Prior I was just doing random selection and my weak topics would just not come up enough to improve. Lastly, I'd add the specific concepts to a filtered "incorrect" deck on Anki. This also helped boost my score because I frequently missed similar things.
Schedule weekly NBME practice exams. Taking one exam on Friday or Sunday helped me track progress, gauge weak spots, and get test-taking practice. I tried to take more than one a week and it induced too much burnout. Unlike Step 1, there isn’t a high-yield image document but some NBME topics did show up on my Step.
1. Side note, if you reach out to SGU. They pay for one practice NBME to be proctored at the prometric center or over Zoom. It’s the exam that other schools use as Comp.
Have one system for reviewing and taking notes. I wasted a lot of time establishing how I wanted to write notes that were searchable, time-efficient, and easy to access. Google docs is too lengthy. Spent too much time adding things to review books because nothing was quite comprehensive like Step 1 first aid. What I ended up doing was writing my notes in Anki cards’ note section. It’s CTRL+F-able and on all my devices! So the biggest advice is to spend the time upfront deciding this if you don’t have a tried and true way already.

So all together, my daily schedule looked something like this. I always started the day with some “me” time because if left to the end, I’d be too tempted to skip it for more studying.

I also leave a lot of space because things often take longer than expected.

Lastly, it helped to treat studying like my job. I clock in at this time and clock out at this time. Dedicated studying is like a highway to burnout for me.

Shoutout to all my fellow F1 fans (:

Test Strategy

Of course, things didn’t go according to plan. My first NBMEs weren’t even passing! It was a shock because my shelf scores were decent. I didn’t feel completely lost so I thought I’d at least be in the passing range. Stuck in my bubble, I thought it was a lack of hard work. And that’s how I wasted 3 weeks of prep. I didn’t realize I wasn’t that great at taking tests. In retrospect, it feels like an outcome of everything becoming pass/fail except one thing. I was able to avoid confronting my deficiencies.

So I had weeks of a plateau. In the last 2 weeks, things trended up and became stable. I was running out of time, so I had to take the risk with only a couple of comforting data points. My prediction from this website was an accurate gauge.

When things aren’t going right

Besides tuning up my targetted studying, my test-taking skills were holding me back significantly. I often found myself getting down to two questions. Then not picking the correct answer. In my last couple of weeks, I found a tutor. It was helpful to analyze my question sets clinically to diagnose the problem. Prior, I would keep a tab on why I got questions wrong. Was it content? Was it that I missed a key finding? Was it that I read the question wrong? The tutor helped me pin down my issues and understand what I could do to change my strategies. Step 2 is a test of knowledge, but you can’t know everything. You can get to a point where you know enough to get questions right.

For me, I needed to remind myself to pick the answer with the most supporting evidence because often answers weren’t perfect and clear. I also had a tendency to answer a different question than what was being asked. So if you notice you have a similar trend, look at the reasons why you’re missing questions. There’s often something you’re missing that will help in dividends!

Resources

Uworld: Tried and trusted. I did 1.5 passes. I feel like Step was on a similar level to these questions.
Amboss: I purchased a year subscription with the school discount.
- Positives
  - The wiki is a great and quick resource
  - You can map out a study plan
  - It’s way easier to build targetted qbank sessions
  - They have prebuilt study plans which were nice to use. I used the Step 2 one. Casually, I used High Yield Risk Factors, Screening, and Ethics which were great review.
- Negatives
  - After doing 1 pass of UW then Amboss + 2nd pass UW, some of the Amboss questions were significantly more challenging. They were more detail-focused and often highlighted exceptions instead of more high-yield concepts. If you’re still building a foundation, you might not benefit as much. If you’re going for a very high score, it might be worth your monies.
Practice Exams
- 4 NBME practice tests are available for purchase. They were offering a bundle of 3 for a slightly (very slight) discount.
- Uworld has 2 self-assessments
- In May, Amboss offered their free Self-assessment
- Free 120’s (multiple versions). Someone on reddit often posts the link to old ones and the most current version
Content review: I mostly used Sketchy and OME
Review books
- I tried many Step Up to Medicine, Master the Boards, OME notes. Nothing quite had everything I wanted and I ended up spending so much time adding to each PDF. It ended up not being worth it for me.
Divine Intervention: I can not recommend his high-yield series enough. Listening to his podcasts saved me from at least 10 questions. I could hear his voice telling me why the answer was correct. It was almost verbatim. I’d use it when I was doing something else and needed a partial brain rest. Many podcasts like he optho, I listened to multiple times.

My Step 2 Exam Experience

Yeah, it was hard. Hard in a different way compared to Step 1. Where in Step 1 I felt like it was difficult because of the amount of small details spilling out my brain and into the drain. For step 2, it was more conceptually difficult.

For me, the level of questions was closer to UW and the NBMEs. It wasn’t nearly as particular as Amboss. There were some long questions, but many were shorter than I anticipated. The concepts that people said will most likely be on the exam were. There were a lot of high-yield topics. There were only a couple that felt left-field. There was a variation of question types like HPI styled questions.

Surprises: biostats was more straightforward than a lot of qbanks. I was freaking out the weeks before trying to understand the concepts.

Breaks: I took a break after every section. Even if just to walk to the bathroom. It helped a lot to walk outside and breathe some air. I packed water, red bull, coffee, lunch, snacks, and candy. Just to cover all my bases of what I might need.

Test anxiety: Step 2 induced a lot of anxiety for me. It being basically the only objective measure on my application and what not. Before starting each section, I took 4 deep breaths. I practiced this in practice exams just to help slow me down. Every section, I also wrote a small 3-word motivational quote, my target score, and a couple words to remind me of the test taking tactics I was trying to use. It took 15 seconds and it helped to have this routine. Defintely not necessary but I was so nervous. When I could feel myself getting antsy or tired during the section, I’d circle the motivational quote or the target score to remind myself what I’m working for.

Of course when I walked out, I felt unsure if I passed. That’s a normal reaction. My result came 2 Wednesdays later and I’m happy with my score! It’s so freeing to be done with tests. I’m so excited for everyone to get to this point. It’s so much better on the other side.

Rainee