Tag Archive: Step 2

Best Books for USMLE Step 2 Clinical Skills (CS)

This list is part of a series of articles about the best books for medical students. Click on the Med School Books Main Page to see other lists including the best books for each year in medical school, the best books for each clinical rotation, and the best books for USMLE Steps 1, 2, and 3.

As many of you know, the pass rate for USMLE Step 2 CS is very high, usually 97% or 98% for first-time test takers from the USA. Many will take that to mean that they don't need to study, but I think it means something slightly different. Here is a 2% that you really don't want to be part of! Studying for Step 2 CS is really not difficult, you already know the material, you just have to learn about the test. I don't think you need to spend much time studying, but reading one or two review books will prepare you in three ways 

  1. what the test will be like,
  2. what you will be tested on (it's NOT just the medical content!)
  3. a review of the most commonly tested cases. 

I will list the two most widely used books and highlight some subtle differences. You really only need one of these. Good Luck.

  • Updated June 2015

1. First Aid for Step 2 CS:

This book will prepare you for what to expect in the testing center. I felt much more comfortable just know what was going to happen, step by step, after reading this book.I think this is the strength of this book, it lays out the nature of the exam very well. There is also a good review of some of the highest yield cases you might encounter during the clinical skills test. This book prepares students very well for the Integrated Clinical Encounter (ICE) portion of the exam. For most people, reading through this book one time would be sufficient prior to taking the USMLE Step 2 CS.

 

2. Kaplan USMLE Step 2 CS Core Cases:

Like the First Aid book, Kaplan's USMLE Step 2 CS book is a great resource and one quick read through it would be sufficient for most students. The one thing that Kaplan's book has is a better explanation of how to act during the exam so you can maximize Communication and Interpretation Skills (CIS) portion of the exam. Browse the format of each book, you probably just need to choose one.

 
 
 

When should I schedule USMLE Step 2?

Calendar

One of the important questions all medical students have to answer in their fourth year of medical school is when to take the USMLE Step 2 exams. The answer to this question depends on each student's individual circumstances. Let me list a few pointers that might help you in making your decision. At the onset let me state that I do not know of a good reason to not release your scores to residency programs. Everyone should release scores, to do otherwise suggests you are hiding something. If you don't want your scores to be known by potential residencies, you simply need to schedule the test after your information is sent to programs, this is a much better alternative. 

After you have decided on a time to take the test, check out my list of the best resources to study for Step 2 CK.

  • The only nationwide deadline facing medical students is that prior to obtaining a license and starting internships and residencies, students will have to pass the USMLE Step 1, Step 2 CK, and Step 2 CS. So all medical students will have to pass these exams before July 1st after their fourth year. However, most medical schools have their own deadlines. If your school requires both Step 2 exams to be done before January 1st of your fourth year, you need to plan accordingly.
  • The next question you must answer is whether or not you need your Step 2 CK score to be available when you are applying for residency. There are two situations where this might be the case. If you are applying to a competitive residency and your Step 1 score is not impressive, most people recommend doing everything you can to obtain a great Step 2 CK score to send to residency programs. Alternatively, no matter what residency you are applying to, if your Step 1 score is below the national average (usually ~218 or below), most people recommend sending a Step 2 CK score to potential residency programs so they know you have passed the boards and will be eligible to start residency on time. If you fit into either of these situations, you should take Step 2 CK before the end of September in order to have the score available during residency application.
  • If you have a deadline from your school but you do not need to send a Step 2 CK score report to your potential residency programs, there are still some scheduling conflicts to consider. Students applying to early match residencies or other competitive residencies will spend most of the months of November and December interviewing. Available interview dates in these situations are usually sparse and difficult to manage. The last thing you want is to miss the only available interview date at a top choice residency because you have Step 2 CK or Step 2 CS scheduled the same day. If you can move your Step 2 dates earlier or later, I would recommend doing that. If you have a January 1st deadline like many schools but will be interviewing in November/December, consider taking your Step 2 exams in the September/October time period.
  • It is important to remember that Step 2 CS is not a very important exam for most fourth year medical students. The vast majority of students pass the exam and there is no numeric score released to students and residency programs. Therefore, it is in your best interest to simply schedule this exam when it interferes the least with your interviewing and clinical rotations.
  • If you are trying to cram your Step 2 CS or Step 2 CK in December before a deadline, beware of unpredictable winter weather. I have known a number of students who missed clinical duties or interviews as they were stuck in the airport after the Step 2 CS exam. Many of you will be traveling to cities prone to snowfall (Chicago, Philadelphia), so bear that in mind when scheduling.

If you have any other advice for the four year students reading this, please post below. Good luck to everyone and don't forget to check out my list of the best books for Step 2. 

Top Ten Books for the USMLE Step 2 CK Exam

This list is part of a series of articles about the best books for medical students. Click on the Med School Books Main Page to see other lists including the best books for each year in medical school, the best books for each clinical rotation, and the best books for USMLE Steps 1, 2, and 3.

There is a lot of weight placed on the USMLE Step 1 exam as it has a significant effect on how competitive you are as a residency candidate. I submit to you that the UMSLE Step 2 CK is far more important in the long run because it will test you on things that are actually relevant to your future practice and your patients. You take Step 1 for yourself, you take Step 2 for your patients. This is stuff that we all just need to know. So, don't worry about score and just worry about the material, your patients will be greatful.  Below is a list of the books I found most helpful for USMLE Step 2 CK. 

  • Updated May 2015

1. First Aid for Step 2 CK:

There are a few brands that have never let me down in USMLE test preparation: First Aid, Kaplan, and USMLE World. I swear by First Aid for Step 1, and I found First Aid for Step 2 to be nearly as concise and comprehensive. A great resource

 

2. USMLE Step 2 Secrets:

This is a fantastic summary book that does not take long to read. Rather than a list of all the facts, like First Aid give you, Secrets gives the reader a great review of high yield information. This would be a great book to read the week or two before the exam to help you pick up a number of extra nuggets.

 

3. Crush Step 2:

Crush Step 2 is written by the same author as USMLE Step 2 Secrets (#2). The content of the two books is mostly the same. Crush Step 2 is written in prose and paragraphs rather than in clinical scenarios and question format. Decide which format you prefer, because you certainly wouldn't need both books.

 

4. Master the Boards, USMLE Step 2 CK:

This book induces a borderline personality disorder. Some students love it, some students hate it. The book does not attempt to be a complete review, it tries to hit hard only the high yield points. Students who are looking for a more complete review of the information should probably not purchase this book.


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5. Step-Up to Medicine:

This is a tried and true book for many aspects of the second half of medical school. A great book for many rotations and shelf exams, it is also a fantastic preparation USMLE Step 2 CK. Much of this board exam will rely on basic internal medicine knowledge. The book is also great for Step 3, so you can kill two birds with one stone. 

 

6. Kaplan USMLE Step 2 Qbook:

If you frequent this website, you know that I believe STRONGLY that the best way to prepare for a board exam made up of hundreds of questions is to do thousands of questions. I really like both Kaplan's online QBank as well as USMLE World's online QBank. However, you are not always at a computer and you will find that question books are a nice rest from the screen. Kaplan's Step 2 Qbooks one of the best on the market.

7. First Aid Cases, USMLE Step 2:

Like Kaplan's Step 2 Qbook (#6), the First Aid company has also produced some great print question banks. The 'Cases" book is a case-based approach with great review questions. In addition, they also publish First Aid Q&A for the USMLE Step 2 CK which rivals Kaplan's Step 2 Qbook as the best print question book on the market.

8. Kaplan USMLE Step 2 Lecture Notes:

Recently, Kaplan has allowed students to purchase their complete Lecture Notes for board exams, including these Step 2 notes, without actually taking their in-person classes. This was not always the case. I have used these texts and I was very impressed. Altogether these review books are very long and very expensive. However, they come from a company that knows very well how to get students good exam scores.

 

9. Step-Up to USMLE Step 2:

It may seem counter-intuitive, but I prefer Step-Up to Medicine (#5) as a Step 2 study resource to the book that Step-Up wrote specifically for Step 2. I used the second edition of Step-Up to USMLE Step 2 and it was good, but from what I am hearing the third edition has a poor layout and not well updated. 

 

10. Travel Book du jour:

You need to study for Step 2, it will help you be a better intern and resident. However, you are probably a fourth year student getting ready to fly around the country. You may not ever travel this much in this short of a time. Here is some unsolicited advice, take an hour to enjoy the city you are in…so see some of the stuff in this book.

 
 
 

Histology Websites

Image from "Ed's Histology Review"

Histology is an extremely important topic during medical school, both in the pre-clinical years as you study anatomy and pathology, and during the clinical years when you are diagnosing patients. Many questions during school, including all three parts of the USMLE or COMLEX test will include histologic slides and ask for diagnosis or interpretation.  It is imperative that all medical students get a solid foundation in histology.  Years ago, most student would purchase histology textbooks.  However, recently, a number of medical schools have created free and easy-to-use websites for studying histology.  If you are still a book person, let me suggest Histology: A Text and Atlas which has great slides and explanations.  Otherwise, if you are like me and would like to save the money, let me outline some of the best histology review sites on the internet.

If you don’t want to spend the money and don’t mind using websites to study, let me recommend two fantastic  histology websites

If you know of other great websites, please let me know.

 

Goljan Audio Lectures and High Yield Notes

As you begin to prepare for USMLE Step 1 you will likely something about the Goljan lecture series and the Goljan pathology review book.  Dr. Edward Goljan is a pathologist at Oklahoma State University Medical School (you can read more about him at his university website or on Wikipedia.) In my opinion, there is no one in the country who knows more about what student need to learn for Step 1 than Dr. Goljan.  There are currently a number of board prep materials available to medical students thanks to Dr. Goljan, let me discuss a few of them.

1. Audio Lectures: Years ago Dr. Goljan taught a prep course for both parts of the boards, both Step 1 and Step 2. Somehow, these lectures were recorded and are now shared between medical students across the country and across the globe.  While I do not endorse illegal file transfers, these files are available for download on the internet and there is no other possible way to obtain them.  From everything I have read and after countless requests of my own, I do not believe it is even possible to purchase the audio files. I will provide a couple of links, but they will, inevitably, not always work.  

Your best bet is to google "Goljan Audio" or ask students in your school if you can use their copies.  As you know, it is always risky to download data from websites you don't know. Link 1: This is a skydrive directory that seems to have all the lectures available for download individually Link 2: I used this website, filstube.com.  It looks a bit shady but it worked well for me. Again, the best method would be to find some on a friend's computer. I wanted to mention what makes these lectures most useful.  I do not believe that listening to them early in your first or second year of med school is helpful.  They are not a great review for your school tests because they are only an overview.  Also, when you begin to make your study plan for Step 1 you are not going to have 40 hours to sit and listen to lectures.  Frankly, you will fall asleep and get nothing out of it.  I found that listening when I exercised every day was a fantastic way to use them.  That way I didn't feel guilty about taking an hour to exercise (which, by the way, is the best thing you can do when you are studying 10 hours every day) and I surely learned more from Goljan than I would have from Eminem and Coldplay.  In fact, I know that just listening in the car and while running picked me up a good number of questions on Step 1.  I still remember, word for word, one question that I absolutely would not have known if not for Goljan's lectures. I have heard that there are 'new' Goljan audio lectures since I took Step 1.  I can not verify this, and I search using my usual websites only found the same audio files that I used 3 years ago.  If anyone knows more about this, please leave a comment.

2.  Dr. Goljan's Book, Rapid Review Pathology: There is ongoing debate about what is the best pathology review book for USMLE Step 1.  The debate usually comes down to Dr. Goljan's Rapid Review of Pathology, and BRS Pathology.  Dr. Goljan's book tends to have more images, a more modern layout, and does not rely solely on text to teach pathology while the BRS book is a no-nonsense text book which attempts to teach the most important points of pathology quickly.  So, the choice depends on how you learn. While the issues at the heart of that debate will have to wait for a different post, we can all agree that BOTH books are very good.  Links to the newest additions of both books on amazon.com are shown below.  I used primarily the BRS Pathology book, but I have only ever heard great things about Goljan's book. In fact, some students believe it added double digit points to their board score.  Link to Amazon.com and the newest editions of both the Goljan's Rapid Review, and the BRS book are shown below.

Dr. Goljan's Book 

Dr. Goljan's Competition

3. High Yield Notes: Less known are the Goljan High Yield Pathology Notes.  The format that is available on the internet is not ideal, but I do think that these notes can be very useful.  The document is a very rapid review of the pathology associations that are most common and most important to Steps 1 and 2.  It is long (30-40 pages) and very dense (no pictures, small font size, all pages are full of text) but it highlights very efficiently the high points of pathology for the USMLE. Again, you can search the internet for "Goljan High Yield" and you will be inundated with places to download the file.  Alternatively, I will attempt to keep my copy on my website until someone tells me that it is illegal, which I do not believe it can be as this, too, is not available for purchase anywhere else. Click the link below to download the pdf. Goljan High Yield Pathology Notes  

Am I a competitive residency applicant?

This question starts to plague your mind the day you don the short white coat, and it never leaves until match day during your 4th year.  Although you don’t have to decide what you want to go into until the summer of your 4th year, it is a good idea to know what you would have to do to be competitive in a difficult specialty.  There are two great ways to obtain this information.

  1. For 3rd and 4th year students, speaking to a student-friendly advisor is a great idea. HOWEVER, beware of the nice guy.  Find an attending who won’t be afraid to break your heart.  Better to have it broken now, than spend thousands getting your hopes up when you really had no chance anyway.
  2. For first and second year students, the best resource in the world is the Outcomes of the Match materials provided by the NRMP.  The document is fantastic, but it is a lot to chew.  The link below is the most recent report, which summarizes the results from the 2009 match.

http://www.nrmp.org/data/chartingoutcomes2009v3.pdf

Periodically, I will be breaking down all the information provided by this document.  For the time being, look it over and study the graphs.  Everything you want to know about competitiveness of each specialty (not ophthalmology!) is in this document…here are a few to whet your appetite

Average Step 1 scores
Average Step 2 Scores
Average # matched applicants who were AOA
Average # or research projects
Percent of matched applicants with Ph.Ds