USMLE Step 2 CK for Canadians

One of my resolutions this year (and sadly the only one that I actually fulfilled) was to write the first two USMLEs this year. A while back I wrote a summary of how I approached Step 1; here comes a similar post about Step 2 CK (and I'm sorry, it's not the most inspiring topic...hence my putting off writing about it for a good two months).

Why would a Canadian bother writing the USMLEs? What are the downsides of writing the USMLEs? So why am I writing them?

Answered in the Step 1 post! I will not bore you a second time around :)

When is the best time to write Step 2 CK?
The USMLE Step 2 CK is roughly equivalent to the Canadian LMCC MCCQE Part I. Therefore the most efficient time to write it would be at the end of fourth year of medical school, when you've just studied for your MCCQE Part I.

If you're like me and missed the boat on that one, not to worry -- many Canadians catch up on writing the Steps during residency (preferably in first or second year while the waters are calm(er)). I wrote both Step 1 and Step 2 CK in June of my PGY-1 year, while on my family medicine block. Writing them in close sequence was probably strategic; a lot of of what I'd studied for Step 1 seemed relevant to Step 2 CK.


How much does Step 2 CK cost?
590 USD (which amounted to 725 CAD)


What is the format of Step 2 CK?
From the USMLE website:
"Step 2 CK is a one-day multiple-choice examination. The test items are divided into eight 45-question blocks; 60 minutes are allotted for the completion of each block. On the test day, examinees have a minimum of 45 minutes of break time and a 15- minute optional tutorial." The exam is taken on a computer.

From my experience:
Long, but better than Step 1!

so long, Prometric testing centre

How high do I need to score on Step 2 CK?
Step 2 CK is marked out of 300 with a passing score presently being 209. Fortunately us Canadian residents need only to aim for a pass.


How I Studied for Step 2 CK:
The clinical basis of the Step 2 CK questions (each presented with a case vignette) made them easier for me figure out than the basic science questions of Step 1. There were less (but still some) trivia-based questions and I was able to work through some of the questions by relating them to cases I had seen in clerkship and residency. That being said, most of the questions required multiple levels of thinking and there were certainly plenty that I had to guess on.

As I was on family medicine in the weeks leading up to my exam, I wasn't very productive on the weekdays and ended up doing most of my studying on the two weekends prior to the exam -- fortunately that was sufficient to pass (though you'd probably cringe at my score). Here are resources I'd recommend to a Canadian resident approaching the exam (who has limited study time and would be happy to accept a mediocre pass):

1. Qbooks -- Qbooks were really all I used to study. I skipped paying for an online Qbank subscription and stopped by the university library to pick up two Qbooks (NMS and Kaplan). I also found a PDF copy of the First Aid Qbook online.
   
   While I wasn't partial to the NMS book I found the Kaplan and First Aid ones all right. I printed out spreadsheets to write my multiple choice answers in (mostly to hold myself accountable!).
   
   Unfortunately I only finished the NMS Qbook and just got partway through the Kaplan and First Aid ones.
   
2. First Aid for the USMLE Step 2 CK -- Although I ran out of time and never got around to rereading this book prior to Step 2 CK, I'll keep it on this list because I think it is a great resource -- if you can spare the time. Reading First Aid for Step 2 CK is probably less essential than reading it for Step 1 because its clinical content is already somewhat familiar when you've been doing rotations. I'd previously read and highlighted it to study for my LMCC MCCQE Part I at the end of fourth-year medical school and probably will look it over again come Step 2 CS and LMCC MCCQE Part II time next month.
3. First Aid "rapid review" pages -- I once again reviewed the "rapid review" chapter at the end of First Aid for the USMLE Step 1, which I had printed out when studying for Step 1. It features high-yield questions and answers in two separate columns on each page; I folded each sheet longitudinally to hide the answers and quiz myself. First Aid for the USMLE Step 2 CK has a similar rapid review section, which I failed to get to.
   

Hmm I guess the moral of this brief study resources list is that if I could pass with half-assed studying, I'm sure you'll do just fine on Step 2 CK! All the best :)