USMLE Step 2 CK Exam – FOUR Mistakes That Can Hurt Your USMLE Score

The USMLE Step 2 CK exam is thought to be the easiest of the USMLE exams, and for this reason, many of us fail to prepare adequately, and as a result our scores are not as strong as they should be. There are many things you can do to ensure you get a strong score, but there are also many things that many medical students fail to realize, which can dramatically impact the strength of your score.

Here are four of the top reasons why many medical students do poorly on the Step 2 CK exam:

1. Failing to adequately study both mechanisms of disease and pathophysiology

When we study for the Step 1 exam, these two categories are at the top of our priority list because they are the most high-yield. Unfortunately, many of us don’t realize that mechanisms of disease and pathophysiology are still extremely high-yield for the Step 2 CK exam. The difference between this category from Step 1 to Step 2 is that it is more “clinical” on the CK exam, meaning the test-writers will link pathophysiological processes to different clinical scenarios.

Therefore, to ensure you don’t fail the CK due to lack of preparation, be sure to include the basics of pathophysiology and mechanism of disease in your Step 2 CK preparation.

2. Forgetting the details

The problem here comes from the fact that all of the study guides on the market are “review”, and are not meant to go into detail. When you fail to use a study source that is anything beyond a topical review, you are seriously risking not only a low score on the CK exam, but you are risking a failure. Many questions on the CK exam will be secondary, tertiary, and even quaternary questions, and if you do not have a detailed knowledge of the high-yield concepts, you may be putting yourself at risk.

Avoid this problem by attacking the “high-yield” concepts, and then learning everything you can about them. For example, if a review book tells you that Parkinson’s disease is a high-yield subject, then only gives you 4-5 facts about it, go that extra step and dig deeper and learn as much as you can about this certain subject. Doing this will allow you to know the “high-yield” information, but on a much deeper level, which I ensure you will help you on your exam.

3. Not fully understanding how to answer the “next-best-step” type of questions

These types of questions are GOLD on the Step 2 CK exam. You will encounter “what is the next best step”, “what is the most appropriate next step”, “what is the best step to reduce mortality”, and many more. It is crucial that you pay very special attention to exactly what the question is asking, because the patient may be bleeding to death and you may be thinking the patient needs emergent surgery, but the question may be asking you “what is the most important immediate step?”, which is going to likely be airway security, not an emergent laparotomy.

So you see how understanding exactly what to do in each situation is highly important for the CK exam. The best approach in preparing for this type of question is to develop your own algorithm charts for each medical scenario. Not only will this enable you to visualize each step, but it will help you become better at problem solving and situational management.

4. Realizing that there are different types of presentations for disease entities

This one is kind of tricky, but it is important that you realize, as a test-taker, that there will be both typical and atypical presentations of common and uncommon diseases. Therefore, you will get many “common presentations” of many common diseases, such as a patient with ataxia who has a cerebellar lesion. You will also get scenarios where the presentation is completely atypical, and you will have to use things such as patient history and patient risk factors in order to figure out exactly what is being asked of you.

For example, cystic fibrosis is most commonly thought of as a disease of males, however the exam might throw you a trick and give you a female patient. Keeping in mind that not every case will be ideal in presentation can help you think in a more abstract manner, which will help you go a long way in attacking difficult exam questions.

You have now been educated about the FOUR most common mistakes that medical students are making that is hurting their Step 2 CK exam scores. Do yourself a favor and make yourself fully aware of these errors, be sure to avoid making them yourself, and you will be well on your way to scoring very well on the USMLE Step 2 CK exam.