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 What to Do in Step 2 CK  

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do I need to do first aid or "secrets" for step 2 ck, if yes please help me pick one ..


thanks doc..waiting for the next post.


thanks man for the help. when you have a break from interviews please come back


Wow, shocked This is an amazing post, I really appreciate your advice and the time you took to write and organize this great advice and info.
You should write a book, like first aid, trust me, you will sell!
Thank you for caring about us all,
good luck to you and May the Lord bless your heart and give you the program you desire!smiling face


Thanks so much Askdoc.Waiting anxiously for your next posts.God bless.


Hi, Askdoc,

I've just read your posts regarding Step 1 and Step 2 prep. Noticed you have not posted your parts 2 and 3 for Step 2 prep.

Is there any chance that you can post the missing parts?



hi everybody,i just found that amazing post,so i want to put it in the front so u can read it.


nodnodnodAgree toatally with you salma a bible for people like me and am sure all are waiting for next post from askdoc. Everyone taking the exam must go thru it atleast once!!


please tell me how to download form 3 and 4 for step ck


Hi ! I was wondering if you guys could help me out!
I'm planning on taking my CK exam in 2months and was wondering if any of you who have done it in that amount of time could let me in on a study plan!!

I'm currently off work for a good 2-3months so have all the time available for studying!! Thank you so much in advance for all the help, please message me or post here, or email me at thanx alot!!!


hey guys! someone give me some direction/motivation.. i'm avging 70% or so +/- 5%.. but really dont feel like my mind is into this. Any good strategy for remember this stuff well? Just need a good strategy to apply each day.. feeling lost. Have four weeks!



Hi everyone. Been a long, long time since I've visited. Actually wrote an article "Most Common Mistakes in Step 2 CK Prep" In my blog at It covers part of what is supposed to be part III of this post. Anyway, will try to visit here at least once a week. As everybody knows, this is my forum I call home.nod


Hi Everyone,

OK, I've decided to post my post on "Common Mistakes in USMLE Step 2 CK Prep" directly here so you don't have to go to my blog. It is part of what is supposed to be part 3 of this post.

People have been badgering me for sometime now on writing more about how to prep for Step 2 CK. Some even wants me to start a Step 2 CK prep course. However, due to time constraints and the Step 1 Prep Course, it has not come to pass.

Lately there had been too many people asking questions about their Step 2 CK preparation and problems they are encountering. Although I still don't have time to write a full article on it, I have decided to tackle the 4 most common reason that people do poorly in the Step 2 CK. I am also reposting an article about "What to do for Step 2 CK" an older post that needs some rewriting but is still relevant

1. Not Studying Enough Detail. The most common mistake people make in studying for Step 2 CK is not studying enough detail. You see so many reviewers in the market that purport you can ace the exam by studying the little material it contains. That is a lot of bull. Medicine is a very broad subject and Step 2 CK covers all the most common and even some rare cases.Those little reviewer just does not give you enough detail to do well in this exam. An exception is Kaplan Notes. Very good detail. However, you need to know 85% of it in order to know enough to pass. Higher if you want a higher score. And that is impossible to do unless you do a minimum of 3 revisions. I will discuss the various study materials you can use in another post.

2. Difficulty with next best step in management type of questions. Next best step in managment type of questions acount for about 20% of Step 2 CK. This type of questions involve cases that describes the management done on the patient so far and asks what you think is the next best step in dealing with this particular patient. Remember the next best step depends on what was the result of a previous diagnostic workup or response to treatment. There is a big difference between knowing how to treat and managing a patient. There is also a big difference between knowing what lab tests to perform and working up a patient. Treating a patient involves knowing what drugs and treatments to use. Managing a patient takes into consideration patient response, adverse reactions and other factors and altering the treatment accordingly. Working up a patient involves knowing implications of positive and negative results of previous tests and what lab or diagnostic test should be ordered next.

Most people study for step 2 CK by reading reviewers or books. And that is the appropriate way to study the clinical content for the Step 2 CK exam. But one needs to do the extra step of constructing algorithms in order to be able to master next best step in management style of questions. You can answer the next best step in management type of question without using algorithms but it will take longer and more analysis to be able to answer them. And as we know, in the USMLE time is what you lack. I will write more on how to write algorithms in another post

3. Knowing too little pathophysiology or mechanisms of diseases. One of the biggest reason why I emphasize pathology and pathophysiology in Step 1 aside from the fact that it is the biggest subject in Step 1 is that it is also very important in Step 2CK and Step 3. This accounts for 20% of Step 2 CK and covers mostly systems pathology unlike in Step 1 where the main emphasis is in general pathology. Also in Step 2, the pathophysiology tested are more clinical in nature, ie how they account for various signs and symptoms and complications of diseases. Cases will also include what I would call "Applied pathophysiology". I have written examples of this in an earlier article. This is usually a problem for those older grads who decide to take Step 2 CK ahead of Step 1 and did not bother to brush up on pathology. Also for those who took Step 1 first but did poorly in pathology. The solution is therefore to make sure that you are solid in pathophysiology. Goljan's Rapid Review for Pathology is a short but good book to brush up on pathophysiology, although it covers general pathology as well which is not needed in Step 2 CK.

4. Atypical presentation of common diseases. According to Cecil's Textbook of Medicine, there are four types of cases you normally encounter in clinical practice. In order of frequency, they are (1) common diseases with typical presentation, (2) common diseases with atypical presentation, (3) rare disease with typical presentation and (4) rare diseases with atypical presentation. They also occur roughly in the same number in Step 2 CK with slightly more type 2 cases than normal

In Step 1, most of the cases you encounter presents classically. But in real life you rarely see classical cases where all the key signs and symptoms are present. Even in Type 1 cases, not all the signs and symptoms will be there. However, enough will be present so diagnosis is not so difficult. The big problem in Step 2 CK for most people is type 2 cases where common diseases presents atypically. For example, although sarcoidosis is most common in young, black female. They do occur in males, older people and other races. So in Step 2CK a sarcoidosis patient may be an old, white male instead. You need to be able to diagnoses the case even with atypical presentation or you won’t be able to answer the questions. These is usually a problem with medical students with limited clinical experience and old grads who have not practiced medicine for some time.

Other ways clinical cases are tougher in Step 2 CK is the addition on both relevant and irrelevant normal findings. The addition of irrelevant abnormal findings that will not change the diagnosis. You need to be able to discern what facts are important and what are not. Remember in an actual live patient, they may present with symptoms that is irrelevant to their main complaint and you need to decide what is relevant and what is not.

The best way to correct this problem is to study classical cases and know what symptoms and signs are absolutely essential in making a diagnosis. When doing qbanks and you misdiagnose a case, it may make sense to find out where you got it wrong and write down the minimum symptoms and signs you need to make the diagnose, so you don't make the same mistake again.

These 4 are the most common reason for getting low score. Although there are other less common weak points that can cause lower score, they will be discussed in another post.


how imp is it to do conard fischer Qbook?


Thanks good man.


Truly excellent post. Kudos to you.


Hi, thanks for all your advice and tips askdoc! I am following your lead and been studying for step 2 ck the past 2 weeks. However, I finished the Q book questions for the latest kaplan book (around 100 questions) on surgery and still I am not above the 80% range. So where should I get extra questions from? Should I solve old kaplan Q book questions or register for a Q bank till i get above the 80% range? Waiting to hear from you sooon! Thanks!


i just finished my step 1 one month back and got my scores 97/225. As for background am a IMG 2010 grad.
starting off with my step 2 preparation. Reading the different forums i have made a study plan but i still think step 2 ck is far less researched than step 1 and we need more contributions.
My primary doubt is
1. whether to use MTB ?
2. how to use it ?
3. when to use it it?
4. which one to use step 2 or step 3 .
5. Is MTB to be used the same way as FA for step 1.

I have read a couple of forums and they say the step 3 book should be used for ob gyn , peds and neurology.

as far my study plan :

1. Read kaplan notes and listen lectures starting with IM >peds>obg>surgery>psych and ethics.

2. incorporate u world and MTB after each chapter.

3. u world 1000 questions in tutor mode and then timed mode.

4. use kaplan q book.( not too keen on kaplan q bank).

I am backing myself to finish it in 10 weeks.


hii ask doc..i need help ..n i mean serious help..i feel like i am sinking deep pls help me..i am appearing for step2ck in a mnth's time..this is my first frind who was in the same boat as me..gave step 2 ck few days back n said she did very badly coz step one was heavily tested in step 2 i amin a hyper panicked i wan tto step one material really tested on step 2 ck..n can we score in 99 in step 2 ck with out giving step one before??


This is really helpful doc. Waiting for more of your posts...

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