Post a Comment

How does Step 2 compare with Step 1?

Activity Forums USMLE Step 2 CK Forum How does Step 2 compare with Step 1?


This topic contains 2 replies, has 2 voices, and was last updated by Dr. David Delnegro MST USMLE Tutor Dr. David Delnegro MST USMLE Tutor 2 years, 3 months ago.

Viewing 4 posts - 1 through 4 (of 4 total)
  • Author
  • #170

    As a Step 2 tutor, I am often asked how the exam compares to Step 1.

    The structure and style of Step 2 doesn’t change drastically from Step 1. The questions are hard, the writing is confusing, and the pressure is on. Where it does change is the length of the vignette, the complexity of the pathology, and that change in distribution of question stems.

    Step 2 vignettes tend to be very long, and as such there tends to be additional time per question to answer them. Unlike step 1 where the illness script is usually absolute, step 2 likes to mix in normal findings to throw off students who aren’t familiar.

    Also, many more questions have to do with management than in Step One. Most of these questions throw students into the middle of a management algorithm at a decision point, and make them choose the correct way to proceed from that point.

    Last, whereas step 1 was mostly about understanding the basic sciences, step 2 begins to focus more on clinical sciences. My school’s academic advisor once called it ‘the acute vs. chronic exam’ because of how often the right answer lied in understanding whether you were treating existing disease or something novel.

    If you have any follow up questions I can help you with on this front, please comment below.

    Dan S., MST USMLE Tutor
    Reputation: 30
    USMLE ExpertMD or DOContributor

    David, this is great! Perhaps for a different post, but one thing lots of folks ask about is how the resources compare. In particular, FA is such a key component of most peoples’ Step 1 study plans. Do you feel like there is any role for FA in Step 2 preparation, or is it all about the UWorld?


    A good question! I will expand on that in a different post, but the short answer is that First Aid takes a diminished role (in my opinion) for Step 2 CK. Every pass through the material means you should be moving from a higher proportion of passive studying to a higher proportion of active studying.

    The first pass (preclinical class) and even the second pass (Step 1) require lots of First Aid typically because so many of the concepts are brand new. The third pass (shelf studying) requires some review to see the algorithms again, but by the fourth pass (CK studying) you should move First Aid from a primary to a secondary resource to look through as needed because you should be cranking through questions at this point.

    Reputation: 2

    (Awaiting moderation)

Viewing 4 posts - 1 through 4 (of 4 total)

You must be logged in to reply to this topic.