Save 10% Off Kaplan Step 2 CK Prep Now!

As some of you third and fourth years gear up to take USMLE Step 2 CK, it is a great idea to both study from a review book like USMLE Step 2 Secrets, 3e or First Aid for the USMLE Step 2 CK, Eighth Edition (First Aid USMLE). However, it is equally important to actively utilize a qbank such as the ones offered by USMLEWorld or Kaplan Step 2 CK Qbank.

This would have worked before the USMLE became computerized!

If you purchase the Kaplan Qbank for Step 2 CK by September 30, 2012, use this link to save 10% on your purchase: USMLE- Step 2 CK Qbank

 Good luck! You're almost there!

Top Medical Titles On The Amazon Kindle

The last few posts have covered the various advantages of the Kindle (Should iPads Be Mandatory?, The $99 Kindle), but as we all know: content is king. So, you may be rightly asking yourself, what titles can I find on the Kindle?

Here are some key medical textbooks / titles already available on the Kindle specifically for the USMLE exams:

• First Aid for the USMLE Step 1, 2010
  The standard textbook for studying for Step 1 on your ereader. And before you fret, remember the Kindle version still lets you highlight, annotate, and even search the text.
  
• First Aid Q&A for the USMLE Step 1, Second Edition
  
• First Aid- Cases for the USMLE Step 1 : Second Edition
  
• First Aid for the USMLE Step 2 CK, Seventh Edition
  
• First Aid Q&A for the USMLE Step 2 CK, Second Edition
  
• First Aid Cases for the USMLE Step 2 CK, Second Edition
  
• First Aid for the USMLE Step 2 CS, Third Edition
  
• First Aid for the USMLE Step 3
  

Additionally, there are many general medical books / medical titles available as well, including journals:

• The New England Journal of Medicine
  The flagship American medical journal
  
• Harrison's Manual of Medicine
  The premier comprehensive textbook of internal medicine in the palms of your hands
  
• First Aid for the Medicine Clerkship, Third Edition
  
• Case Files Internal Medicine, Third Edition
  
• First Aid for the Surgery Clerkship
  
• The Gawande Collection:
• Complications: A Surgeon's Notes on an Imperfect Science
• Better: A Surgeon's Notes on Performance
• The Checklist Manifesto: How to Get Things Right

Poke around the Kindle Store and you'll be amazed at what you can find. The medical section is surprisingly more complete than one might expect. Have fun Kindling!

Updated 2015-12-20

USMLE Step 2 CS Books And Study Strategy

Three days ago, I took USMLE Step 2 CS. The CS stands for Clinical Skills. Unlike the other exams, this one is not computer-based and instead involves live, standardized patients. Relative to USMLE Step 1 or even USMLE Step 2 CK, preparing for Step 2 CS is a much shorter, much more straightforward process. Since Step 2 CS is graded on a pass / fail basis, the goal here is also much simpler: pass!

USMLE Step 2 CS Exam Format

The basic format of Step 2 CS is a patient encounter. A patient encounter consists of a focused history and physical exam conducted in 15 minutes, followed by a patient note, for which you are given 10 minutes. The note includes pertinent positives and negatives from the history and the physical, as well as a differential and plan. The differential and plan can have up to 5 items on them, each. There are 12 patient encounters throughout the day. The first five are followed by a thirty minute break for lunch, the next 4 are followed by a 15 minute break, and then the day ends with the last 3 encounters. The exam is only given at 5 locations throughout the United States: Atlanta, Chicago, Houston, Los Angeles, and Philadelphia. On top of that, it costs over a $1000! The USMLE site has a more extensive description of the clinical skills exam here.

USMLE Step 2 CS Study Schedule

I'd say I spent about a week studying for the exam. I read through First Aid for the USMLE Step 2 CS, first familiarizing myself with the format of the test and basic differentials for common complaints. Then, I recruited one of my medical school friends to play the standardized patient for me and went through some of the cases at the end of the book. Even though I was unable to complete all the cases, I felt pretty comfortable going into the exam.

As far as preparing goes, my advice would be to take Step 2 CK before CS. If you have a good fund of knowledge for CK, you will be more than prepared for CS. Also, when writing the patient note, use the computer as it will be faster and easier to edit than pen & paper. Oh, and bring your own lunch and snacks. They provide food, but your own food will probably be better. Other than that, just remain calm and you'll do just fine.


Updated 2015-12-18

USMLE Step 2 CK Books And Study Strategy

I recently took USMLE Step 2 CK, which explains my absence from blogging on here. While I do not have my score yet, I figured I would share my study strategy as well as the books and resources I used to prepare for the exam. Relative to USMLE Step 1, preparing for Step 2 CK is a much shorter, much more straightforward process. Of course, people may have different goals and needs for their Step 2 score, but I think for most people it ends up being a test you simply have to pass to continue with your training as a physician in the United States.

USMLE Step 2 CK Study Schedule

With regards to a study schedule, someone mentioned the saying "2 months, 2 weeks, 2 days" to me, meaning that one should take 2 months to study for Step 1, 2 weeks for Step 2, and 2 days for Step 3. And, from what I know so far, I think that is roughly correct. I'd say I spent about 2 and a half weeks studying for the exam. For the first week or so, I simply read through a review book on Step 2 concepts (more on that below). For the remainder of the time, I simply did qbank questions. The schedule was pretty packed, but it worked out well in the end. I don't think spending any time over 3 weeks would have been worthwhile. Some people may be considering taking a review course. If you feel like your basic science and clinical knowledge are not as strong as you want them to be, or feel like passing may be a challenge, then it is worthwhile to consider. However, for most test takers, a Step 2 review course should not be necessary if you simply are studious, read a bit, and complete a qbank.

USMLE Step 2 CK Books

As with any major exam, everyone always wants to know what is *the* book to use to study. When I was looking, the main options people seem to gravitate towards were First Aid for the USMLE Step 2 CK, Crush Step 2, and USMLE Step 2 Secrets. Honestly, any of the three books would be fine, I think. However, I first narrowed it down between Crush and Secrets. You may note that both books are actually written by the same author, Adam Brochert. I can't imagine they would contain very different information, so I went with Secrets over Crush (I guess I like having Secrets more than Crushes? I don't know). Then, I compared First Aid for the USMLE Step 2 CK and USMLE Step 2 Secrets. Initially, I thought I would go with First Aid, given how much I liked First Aid for the USMLE Step 1. As I read through the comments though, I noticed that many people found that First Aid for the USMLE Step 2 CK was not clinically-oriented enough for their tastes, which matters as Step 2 CK is more of a clinical exam. Therefore, I ultimately decided to go with USMLE Step 2 Secrets.

USMLE Step 2 Secrets was indeed well-written. The book follows a format of questions and answers a la the Socratic method. The material is divided into chapters based roughly on organ systems, but with a few exceptions thrown in (such as preventive exams and smoking). For students who feel a bit rusty on their clinical material, the book provides a good, broad refresher. However, if you were recently on clinics, or feel generally comfortable with your knowledge base, I think it is debatable whether one needs to read a book to prepare for Step 2 CK at all. What no one is debating though is the value of doing a question bank.

USMLE Step 2 CK Q-Banks
While there are many qbanks for USMLE Step 1, I think the right choice is much clearer for USMLE Step 2 CK. Sure, there are still just as many options, but I think there is much more broad consensus about using USMLE World. Similar to Step 1, the Step 2 CK UW software is a downloadable application written in Java that mimics the FRED Software used by CK. It contains approximately 2300 questions (which translates into about 50 practice sections). It took me about 2 weeks to go through all 50, although I must admit I was rushing a bit at the end. If you were to do 4 sections a day and review each one, then it would take about 6 to 8 hours per day, and about 12 to 14 days to complete the entire qbank. Clearly, doable, but it requires you to be very committed to finishing. I wish I had budgeted a little more time to review the questions I missed, but I think it was fine.

USMLE Step 2 CK Test Day
Again, just as with Step 1, the exam is on a computer at a Prometric Testing Center. Registration is done months beforehand, similar to USMLE Step 1 registration. While Step 1 had 7 sections of 50 questions each, Step 2 CK has 8 sections with 46 questions each. After signing in at the test center, you can place your belongings in a locker. The proctor then calls you into the anteroom, check your ID, takes a photograph, and gives you a laminated sheet and dry erase marker for notes. After entering the testing room, you are assigned a computer and the exam begins. You have a total of 9 hours from this point. The first section is a tutorial that is budgeted at 15 minutes, but you can skip through this if you are familiar with the FRED software, giving you 15 extra minutes of break time. The next 9 hours are just... tedious. You can take up to an hour of breaks, scheduled however you want them, in between any of the sections. I chose to take a 15 minute break after section 2, a 30 minute break for lunch after section 4, and a 5 minute break after section 6 just because my eyes were getting tired. Although Step 2 is longer than Step 1, the test day felt much better simply because I was not as stressed. You'll be tired at the end of the day, but glad to be done. Good luck!


Updated 2015-12-18

25 Things I Learned From Studying And Taking USMLE Step 1 and 2 CK

Excuse my absence the last few weeks, but I was busy studying for USMLE Step 2 CK. Going through review books and practice questions, I came to realize that I had learned many important stereotypes and other truisms from this exercise, of which I'd like to share a few with you. 

1. Anyone who visits Connecticut gets Lyme disease (Borrelia burgdorferi infection).
2. Anyone who visits Arizona has coccidiomycosis.
3. Young African American female? Lupus.
4. Young African American without Lupus? Sarcoidosis.
5. Farmers have no clue how to use organophosphates properly.
6. Shipbuilders work primarily with asbestos to make ships. 
7. No matter what disease you have, quitting smoking will make it better. 
8. If you have Hashimoto's disease (lymphocytic hypothyroidism), you're way more screwed than you might have originally thought.
9. Foreigner with a cough? Tuberculosis.
10. If you are ever bitten by a scorpion, the only organ system that will be affected is your pancreas. 
11. Anyone stung by a bee goes into anaphylaxis, so everyone should have an epinephrine pen. 
12. Everyone from the Mediterranean has thalassemia until proven otherwise.
13. Every old person over the age of 65 has cancer until proven otherwise.
14. Every woman has autoimmune disease, gynecological cancer, or osteoporosis until proven otherwise. 
15. If you do not have a DSM IV psychiatric diagnosis, something's wrong with you. Don't believe me? Check out what new addiction is being added to DSM V. 
16. Children only have 4 orthopedic problems: development dysplasia of the hip, Legg-Calve-Perthes disease, Slipped Capital Femoral Epiphysis, or Osgood-Schlatter disease.
17. No matter what the ethical dilemma is, never consult your hospital's ethics committee - you know ethics better than they do, or the dilemma really isn't that perplexing.
18. No matter how ridiculous the patient is, you will never fire the patient and always respond calmly and professionally.
19. Pathology slides on questions are to be ignored because the answer is usually in the prompt. 
20. Ditto for x-rays. 
21. The number of drug interactions you need to know is the square of the number of drugs you know. 
22. Your patients will always have 5 possible diagnoses of which you choose one that seems most appropriate. 
23. Medicine is too general and too specific all at once. 
24. The test-making business is a pretty sweet racket if you can get in on it. 
25. Doctors never make mistakes.

Heh, my facetiousness aside, I do sometimes wonder how all this repetition of stereotypes affects how we ultimately end up viewing patients when we go into practice. Hopefully we're still able to keep our eyes open to things that don't fit the 'classic' picture. 

USMLE Step 1 Tips / Advice Summary

Over the past month, I have devoted this blog to posting all the advice I had for USMLE Step 1. I had found that over the year, many underclassmen had been asking me questions about the exam, so it just made sense to collect my thoughts in a series of posts and refer people here, instead of answering each questions individually. In case you missed a post, here is the entire list of posts containing my USMLE Step 1 Advice:

• 25 Things You Should Know About Your USMLE Step 1 Exam Day
  
• How To Relax While Studying For USMLE Step 1
  
• How To Register For USMLE Step 1
  
• My USMLE Step 1 Study Strategy
  
• Which USMLE Step 1 Qbank: Kaplan or USMLE World?
  
• Kaplan Qbank for USMLE Step 1 Tips 
  
• 21+ Online Resources For USMLE Step 1
  
• Books and Resources For USMLE Step 1

Additionally, I noticed a few other posts in the archive that may be of use to you as you study for USMLE Step 1:

• Tyramine and the Cheese Syndrome
  
• Pope's Blessing Vs. Claw Hand
  
• 8 Phun Pharmacology Phacts
  
• Extraocular Muscle Movements - Function Explained
• Why Monica Bellucci Might Take Atropine

I hope these posts have been helpful to you. In the coming months, I plan on doing a series on my advice USMLE Step 2 CK / USMLE Step 2 CS as well as my experiences on traveling and interviewing for residency programs. Thanks for reading!

Updated 2015-12-18

USMLE Step Exams And Residency In 2009

Happy new year! I hope everyone had a happy holiday season. As this blog enters a new year, I have decided to try to shake things up. In the past, I posted whenever I felt about topics that caught my eye. However, most of my time was spent in formatting the post, which left relatively little time for commentary. Hopefully you all still found it enjoyable, but reflecting back on how I blogged, I've come to a few conclusions. 

First, much of the information I was blogging about had already been covered ad nauseum around the "tubes." Second, since I posted whatever I wanted and whenever I felt like it, each post seemed fine to me, but taken as a whole, the blog lacked focus. Third, the blog did not have the volume of traffic to justify my style. Some people don't care to be read when they blog, but if so, why post online? You could just write in a paper journal or a Word document, right? So, if I'm going to invest the time in a blog, I should care about gaining readers and providing something valuable in exchange for their time.

To that end, in the coming year of 2009, I am going to focus more on a few main topics. Since many of my friends are taking USMLE Step 1 this year, I will be doing some posts in the next few months, detailing my advice as well as describing my experience taking the exam. For those of you who have already taken Step 1, perhaps you could comment and contribute your insights to help make the posts better. Also, since I will be taking USMLE Step 2 CK and USMLE Step 2 CS in the coming months, I will tackle those subjects as well. Finally, since Match Day looms near, residency-related posts will also likely be put up here. 

Anyway, that's my two cents for the new year. Thanks again for stopping by and reading. If you have any suggestions or ideas for posts/topics (or heck, want to submit one yourself), contact me at scrubnotes[at]gmail[dot]com. Happy 2009!