KhayriShalhoub

AnNajahNationalUniversity,Palestine
Graduation:May2014
Step1:266(Feb.18.15)
Step2CS:Pass(March.19.15)

USMLEStep2CKExperience

Durationofpreparation:
FromApriltillAugust19th,roughly4.5months.

Studyschedule
:
Averageof
68hours\day
.Usedtohitthegym5times\week.ThursdaysIwasmostlychilling,
studiedacoupleofhoursatthebeginningoftheday.

Materials&journey
:
Firstofall,Ididstep1onFeb18th,andthatofcoursehelped.

IstartedbygivingMTB2InternalMedicineaquicklook,justtogetintothemoodofStep2,
andgetoutofStep1wayofthinking.

IusedtodotheblocksofeachIMchapterfrom
UW2013(offline),
totrainmyselftoquestions
moodfromthebeginning.

IdidnotreallyretainthatmuchfromMTB.Forme,itwasjustanintroduction.IonlydidtheIM
partatthebeginninginlike23weeks.

ThenIquicklywentoverKaplanObGynin34days,torefreshitinmymind,asthereisnota
lotofcommonalitiesbetweenObGynstep1andstep2.

Ijumpedrightawaytothepediatrics,surgeryandObGynpartsofUW13,withoutreadingthe
MTB.

IthenboughttheUWOnlinefor3monthsandstarteddoing2blocks\dayandtakedown
notes.

IreadalltheexplanationscarefullyandIoftenwentbacktoUptodate.comspeciallywhen
somethingwasnotverycleartome.

Uptodatehelpedmealot.WhenIhaveaquestion,itwaseasytofindtheanswerinone

source.WhenIjustwanttoknowwhatthistopicisallabout,Iwouldonlyreadthesummaryat
theendofanarticle,whichistypically612bulletpoints.Iftherewasaninterestingideathere,I
wouldgobacktothetextandreadabitmoreaboutit.Ialsousedtocheckifthereareany
algorithmsortablesthatcouldhelp.

MyaverageinUWwasaround
90%
.IusedtoanswerthequestionsIdidwrongintheoffline
UW13withthesameanswerandgetthemwrongagain,soasnottheskewmy%.

Myplanwhiletakingthenoteswaslikethis:

1)
Iamnotallowedtomarkmorethan10questions\block
2)
ThequestionsthatIwasnotgoingtomark,IwouldtakeallthenotesthatIneedfromthem,
becauseIknewthatIamnotgonnacomebacktothem

3)
Iamonlygoingtoredothewrong\markedquestionsafterthefirstroundofUW

Preventivewasbuggingmysoul,soImadeaseparatepartforitinmynotebookandusedto
visititagaineverynowandthen.

AfterfinishingthefirstroundofUW,IwentbacktoMTB3.Iquicklyreadthepediatrics,
surgeryandpsychiatryparts.Roughlygave12daysforeachone.Iuseditmainlytoknowthe
tricks,andforittoguidemeastowhattolookforonUptodate.Tobehonest,therearealotof
informationthatIfoundwaswrongandoutdatedinMTB,thatswhyimostlyusedittoguideme
astowhattolookforonUTD.

Afterthat,Iwentbacktomynotesandreadthemagain.

Tookmyfirstassessment,
NBME4
,onaugust2nd(
2+weeks
beforemyexam).Igot
286
and
wasthrilled.Iknewitwasoverestimating,butIwasconfidentIamdoingtherightthing.Tome,
andtomanyothers,thisassessmentwasreallyeasyandlookednothingliketherealexam.

IstarteddoingClinicalMasteryseries,roughlyablockaday.Iwoulddotheblockin1hour,
andthenmeetwith2ofmyfriendsat10pmandwewoulddiscussthequestionsin2hours.

Iwentbacktothethemarked\wrongquestionsandfinishedthem.Therewasatotalof
roughly500questions.

Secondassessmentwason
August14th(5days
beforemytest),
NBME7,andgot267
.I
knewitwasunderestimatingandkepttellingmyselftobelieveinnumbers.Ihatedthis
assessment.Thekindofquestionsandtricksaskedareverysimilartotheonestheytrytotrick
youinintherealtest.

3daysbeforethetest,Idid
UWSAandgot265+
,ialsodidthe3FREDblockswithit,trying
tosimulateanexamexperience.UWSAwasalsowaytooeasyandlookedlikenothinglikethe
test.

ThepageImade:
ImadeapagecalledUSMLEAbusersonFacebookbackinJanuaryorso.Iusuallypostalot
ofhighyieldstuffandquestions.Feelfreetofollow.Iamconsideringtakingthenextstepby
startingtogivelittletalksonSkypeorPeriscopesoon,andIllputtheupdatesthere.

Hereisthelink:
https://www.facebook.com/USMLEAbusers1555609858011167/timeline/

Step1experience
:
HereisalinktomyStep1experience
https://docs.google.com/document/d/1ST05s5_IDnO6A0D3rJDEYlmvybfB5wJ24v6YZ4uZpI/e
dit?usp=sharing

Examday
:
Theexamwassolong.Itsmentallytiring.Thequestionsrangedfromdirectonestothe
WTHoneswhereyouhavenoideawhatsgoingon.

Directquestionswerenotthepredominantpattern,likeitsthecaseinUW.Thething
abouttheexamisthattheythrowinalotofdistractors.

Itookthefirst2blocks,8minblock,2blocks,10minutesblock.Thenroughly10
minutesaftereachblock.

Topicsaskedweremostlytopicsthateveryoneknows.Itisjustaskedinaparticular
situation,andyouhavetoapplyyourcommonsenseandgoahead.Nobookcan
guaranteeyouarightanswer,butyouknowledgewouldhelpyouintotalintryingtoapply
commonsenseandchoosingananswer.

TopicsthatIfeltwereheavilytested:Postopcomplications,Psychiatry,traumaand
emergency.

GotmediathatIfoundwasOK.Icouldn'tfigureitoutfromthestem,butlisteningwas
notanissueforme.

Afterthetest,Ihadnoideahowitwent.IliterallytoldmyfriendIcanget240andIcould
get270.Iwillhavetowait!

Importanttips
:
IbelievethedurationisnotthemostimportantfactorinpreparingfortheUSMLEs.Idid
mystep1in5monthsandthisin4.5.Ibelieveitsallaboutstudyingeffectivelyandnot

diveinthelowyieldmaterials.MyStep2CKpreparationwashelpedbymystep1
preparation,butIbelieve56monthsshouldsuffice.

Booksarefine.
Questionsarethebest
.Yousee,booksaregreat,onceyouredone
withachapter,youfeellikeagod.But1weeklater,itsallgone.Ifknowledgewasnot
applied,itwillbeforgotten.Therecomestheroleofquestions.

Trytounderstand
theWHY
behindeverything.Dontjustmemorizeifthepatienthad
backpainwiththisthenthenextstepisanXR,andifwiththatthenMRI.Rather,know
theWHY.Thereasonforthisisthatintheexam,youwillhavetothinkinsecondsand
therearemanydistractors.UnderstandingtheWHYcanhelpyougettheanswersright
andsaveyoualotoftime.

Thereis
noRecipe
forStep2CK.Everyonehashisownwayofstudyingand
understanding.Ididthisanditworkedforme,youcandowhateverworksforyou,as
longasyouarenotscrewingupinyourresourcesorthewayyouprepare.

Learnthe
differentialdiagnosis
verywell.Notjustknowthenameofit,NO,goand
lookafterhowisitdifferentfrommymaindiagnosis.Thereasonforthisisthatthe
distractorsthrownintheexamareusuallystuffthatwillhelpyouruleout\inthose
differentials.Makesureyoumasterthispoint.ThiscomesinreallyhandyinPsychiatry.If
youjustgowithwhatisthereinthebooks,yourenotgonnabeabletoanswerwith
confidenceinthetest.Theycaneasilymakeyougocrazywiththeirdistractors.

MasterthecriteriaforPsychiatry.Knowwhateverywordmeans.Again,
UNDERSTAND,andnotjustmemorize.Theywillbeabletotrickyouinanyofthese
points.Itsallaboutmasteringthecriteria.Knowingthedifferentialhelpstremendously
too,again,notjustthename,butwhyitsthisandnotthat.

UTDwasofgreathelpwhenitcametomasteringthedifferentialdiagnosis,because
thereisalwaysapartinthearticlethattalksbrieflyabouteachdifferentialandhowitis
differentthanthemaindiagnosis.ThisislackinginMedscape,asitonlyputsthe
referenceforthedifferentialsarticle,withouttalkingaboutwhyandhowitisdifferent.

UTDisaHUGEreference.Ifyouseethisexperienceandstartreadingallthearticlesin
UTD,youregonnafailoryouregonnaspendtherestofyourlifepreparingforthetest.
Youhavetobecarefulandspecificwhenusingit.Unlessitssomethingyoureallywant
tomaster,Iwouldsuggestjustreadingthesummaryandalgorithmsandthengoingfrom
there.

MTBisfine,butbecarefulanddonttakethingsforgranted.Anythingthatlooksoddto
you,gobackandconfirmit.IcanttellyouhowmanymistakesIfoundthere,andthats
themainreasonIneverreallyreaditbackagain.


Theclinicalmasteryserieswerehelpful.Firstofall,Ididanextra500600questions.
Secondofall,itsfromtheNBME!Youkindofgetyourselfinthemoodoftheirwayof
askingquestions,soithelped.Butagain,thelengthofthequestionsistooshort
comparedtotherealdeal.

Theexamdaywasnotapleasantexperience.Inmanyofthequestions,Iwas
answeringwithoutanyconfidence.ImarkedALOTofquestionseachblock.Iremember
instep1Ibarelymarked510becauseInevercamebackagaintotheWTFkindof
questionsthere.ButinStep2,youknowwhatthequestionistalkingabout,butyoure
confusedaswhattodonext,andmanytimesiwaslikeMaybeifIreaditagainIwillfind
something.Ihadabout10minutesleftineachblock,butthesedidmenothing,asmost
ofthetimeIwasjuststaringatthequestionsandIdidnotknowwhattodo.Attheend,
justtrustyourgutsandtheNUMBERS.NUMBERSDONOTLIE.Ifyourassessments
aresatisfactoryforyou,DOIT.

Trytomasterthetiming.IusedtotrytofinishUWblockswithatleast1520minutes
left,becauseIknewtheexamisnotgoingtobethesame.Trytopushyourself.Learn
howtoignorethedistractors.Mywaywaslikethis:Iwouldreadthechiefcomplaint,then
quicklymovetotheendofthequestionandseewhatisthequestionaskingforandthen
quicklyglanceovertheoptions.Afterthat,Iwouldskimthroughthestem,butthistimeI
knowwhatIamlookingforandwhatshouldIignore.Itslikegoingtotakehistoryand
physicalfromapatientwhenyoualreadyknowtheirchiefcomplaint,youwillbemore
preparedknowingwhattoaskforandwhattoexamine.

UWisafantasticsource.ThereissomuchinformationthateachtimeIreadthe
question,Ilearnsomethingknew.Readitcarefullyandtrytounderstandallthelittle
detailsthrowninthere.Also,undoubtedly,masterthealgorithms.

Assessmentsarethebesttoolstoassessyourself.Donotdelaythemtillitstoolate(I
delayedmine,donotdothat).Iwouldsuggestdoingthefirstone56weeksbeforeyour
desireddateandactingaccordingtotheperformance.Onceyougettothescoreyou
want,goforthetest.Thereisnevergonnabeamomentinyourlifethatyouaregonna
feelconfidenttodothetest.Armyourselfwithnumbers,akaassessments!Delayingis
notgonnadoyouanygoodifyoureachedyourtargetscore,itcanactuallybeworsefor
you.

SUMMARY
:
Totalprep:4.5Months
NBME4(2+weeks):286
NBME7(5days):267

UWSA:265+
Sources:MTB,UW,UTD.

Finalword:
IrememberthedayIdecidedIwantedtostartpreparingforstep1.IreadMANY
experiences.Itseemsjustlikeyesterday.ThewaytosuccessinUSMLEisnotaneasy
one,butitsdefinitelyadoableone.Iremembermyselfthinkingaboutpeoplewhogets
the250sandbelikeThesepeoplemustbelongtosomewhereelse!!.Donotfallout
shortonwhatmostpeoplethinkisgood.Dreambig,workhardandyouwillgetthere.
Goodlucktoeachandeveryoneofyou.Thankyoutoeachandeveryonethathelpedme
getthereinanypossibleway.