I just got my Step 2 score back and ended up with a 265! I spent a truly unhealthy amount of time reading other people's Step 2 write-ups while I was studying, so I wanted to make one with what actually worked for me.

Obviously this is just one person's experience, but hopefully this helps someone, especially if you're starting in the 230s and trying to figure out how to structure the last couple months.

Scores

CCSE: 237 (141 days out) (school provided during rotations)
NBME 11: 236 (60 days out)
NBME 13: 242 (56 days out)
NBME 14: 242 (50 days out)
NBME 12: 250 (36 days out)
NBME 15: 247 (24 days out)
UWSA2: 252 (16 days out)
NBME 16: 265 (10 days out)
2023 Free 120: 88% (4 days out)

AMBOSS Score Predictor: 257
ChatGPT Prediction: 263

ACTUAL Score: 265

I started seriously studying around May and took Step 2 at the end of July.

1. UWorld: aka what NOT to do, at least for me

This was probably my biggest mistake in the beginning.

Everyone says UWorld is the gold standard and that finishing it is a must, so I completely bought into that. I had only completed about 40% of UWorld by the time I started dedicated. My original plan was basically:

Month 1: finish UWorld
Month 2: grind full-lengths/NBMEs

This was my absolute downfall lol.

The problem wasn't necessarily UWorld itself. The problem was that I had never really learned how to learn from UWorld effectively. I was doing questions, reading the explanations, and moving on. I wasn't analyzing why I got things wrong, recognizing patterns in my mistakes, or expanding beyond the exact question that was asked.

I spent basically a month grinding UWorld and only got myself from around 40% to 70% completion.

Then I took NBME 11 as my baseline and got a 236.

My CCSE, which I had taken MONTHS earlier before dedicated, was a 237.

So after a month of studying, my score had technically gone DOWN one point.

Naturally, I spiraled.

That was when I dropped UWorld as my main resource.

I'm definitely not saying UWorld is bad or that nobody should use it. It clearly works incredibly well for a ton of people. My takeaway is more: if you know a resource or study method has never really worked for you, don't anchor yourself to it just because everyone on Reddit says you have to.

2. NBME 11 was basically where my real dedicated started

After NBME 11, I took about 3 days to review it extremely thoroughly.

And when I say thoroughly, I mean I basically picked apart every single question, whether I got it right OR wrong.

For every question, I wanted to know:

Why did I get this right/wrong?
What clue in the stem was actually important?
Was there something I misread?
What concept was the NBME really testing?
What else could they ask me about this same topic?

I used Inner Circle notes and ChatGPT heavily for this.

The biggest change was that I stopped limiting my review to the exact question.

For example, if a question tested recognizing atrial fibrillation, I didn't just learn how to recognize A-fib. I wanted to know the whole concept: management, rate vs rhythm control, anticoagulation, complications, etc.

Basically, if the NBME showed me that I had a hole in a topic, I tried to fill the entire hole rather than patching the one fact that happened to show up in that question.

Then I took NBME 13 and got a 242.

That was the first sign where I was like, okay... maybe this is actually working.

So I did the exact same thing with NBME 13.

Then I took NBME 14 and got another 242.

And that was when reality hit me a little bit. My original exam date was coming up in less than 2 weeks, and as someone trying to match derm, this was nowhere near the range I personally felt comfortable testing with.

So I pushed my exam to the end of July (1 month back from the original date, giving me 1.5 months total).

Best decision I made.

3. Learning how the NBME asks questions was HUGE

One thing I realized during this period was how important NBME wording is.

UWorld and NBME absolutely test many of the same concepts, but to me, their questions feel very different.

UWorld can be extremely detail-oriented. Sometimes one tiny detail in the stem changes the entire answer, so you get trained to scrutinize everything and think, "Okay, but what if they're trying to trick me with this one thing?"

That mindset was hurting me on NBMEs.

NBME questions, in my experience, were much more about recognizing the overall clinical picture and answering what they were actually asking.

Obviously details still matter. But if a stem is absolutely screaming DKA, for example, I eventually learned to stop inventing a convoluted reason why maybe it was secretly HHS because of one weird detail.

I had to basically untrain myself from overthinking everything.

4. Don't shy away from content review!

After NBME 14, I took a longer break from full-length NBMEs. In the beginning, I had gone into dedicated with the mindset that you cannot know everything, thus, focus on solidifying strengths and test taking skills rather than chasing zebras. However, I had to eventually accept that I was missing more than just zebras. I basically didn't know anything about imaging or treatment, which is most of Step 2 LOL.

For about two weeks, I went pretty hard on Divine Intervention Podcasts.

I listened to essentially all of the episodes on the Reddit "must-listen" playlist, plus additional episodes for topics I knew I struggled with, like PFTs and trauma. His 4 IM shelf videos are so long but an absolute must for Step 2 concepts imo.

I also used the DIP Anki deck for the episodes I listened to. I did not keep up with reviews after these 2 weeks, just used the podcast as a first pass and Anki to make sure I didn't miss anything important while zoning out from the podcasts.

This took FOREVER.

But I learned so many things that I genuinely did not even know that I didn't know.

Divine is incredible at connecting concepts and explaining the way NBME likes to test them. I cannot recommend his podcasts enough.

After the initial two-week grind, I still listened to his rapid review episodes here and there, but I stopped making it an active part of studying. It became mostly something I listened to while driving.

During this period I was also casually using NBME 10 as a question bank whenever I had extra time. I eventually ended up around a 255 on it, but I do NOT count that as a real practice score because I wasn't taking it under timed or standardized conditions.

Then I took NBME 12 and got a 250.

That was the first time I finally broke into the general range I wanted to be in.

5. I started categorizing WHY I missed questions

After NBME 12, my review changed again.

Instead of only asking, "What concept did I get wrong?", I started asking:

Why did I miss THIS question?

I made an Excel spreadsheet for my missed questions and started categorizing mistakes.

Was it:

A true content gap?
Misreading the question?
Overthinking?
Changing a correct answer?
Knowing the overall concept but missing one specific detail?
Not understanding what the question was actually asking?

This ended up being extremely important because at some point, your problem isn't always "I need to learn more medicine."

Sometimes you already knew the answer and still managed to get the question wrong.

And those are much more fixable points.

6. NBME 15 taught me to STOP changing answers

Then I took NBME 15 and got a 247.

Obviously, going from 250 to 247 wasn't catastrophic, but I was frustrated because I felt like I knew significantly more than I had before.

So I went back and looked at what happened.

By this point my timing had improved a lot. Earlier in dedicated, I was basically answering questions and moving on because I barely had enough time to finish.

Now I would finish a block with maybe 8 to 10 minutes left.

And what did I do with those extra 8 to 10 minutes?

I went back through the block and changed a bunch of answers.

Terrible idea.

I calculated what my score would have been if I had simply never changed an answer at all, including the answers I changed from wrong to right, and I would've scored around a 260.

That was one of the biggest eye-openers of dedicated for me.

From that point on, I made myself follow a rule:

I would only change an answer if I found a specific piece of information that clearly proved my original answer was wrong.

Not:

"Hmm... this other answer suddenly feels a little better."

Not:

"What if they're trying to trick me?"

I needed an actual reason like noticing a buzzword I had missed the first time around, remembering a specific mnemonic, or making the specific connection to figure out this exact clinical syndrome.

I also tried to limit myself to flagging only questions where I had absolutely no idea what was going on and, when going back to those, changing maybe 1 to 2 answers per block at most.

I think fixing this habit contributed significantly to my eventual score jump.

7. UWSA2: personally would not recommend

Next I took UWSA2 and got a 252.

I know this is controversial because a lot of people consider UWSA2 a must-do, but if I had to do dedicated again, I honestly don't think I would take it.

Again, this is purely personal.

I felt like I missed a lot of questions because of the particular UWorld style of wording, and after spending so much time reviewing UWSA2, I noticed that when I went back to CMS forms, I had slipped back into the overthinking mindset I had been trying so hard to get rid of.

For me, that was counterproductive.

If UWorld-style questions work well for you, obviously ignore me. But if you notice that UWorld makes you second-guess straightforward NBME questions, I think that's worth paying attention to.

8. CMS forms were probably one of the biggest reasons my score jumped

After NBME 15, I really started grinding CMS forms.

Throughout third year, I had already done CMS forms before my shelf exams. Usually I tried to get through four or five of the most recent forms for each rotation.

During dedicated, I went back through some of those and, more importantly, did the newer forms that hadn't existed when I originally took some of my shelves.

These were a GODSEND.

The concepts were good, the explanations were good, and most importantly, the wording felt like NBME wording.

The newest forms I found particularly useful were:

IM 9 and 10
OB/GYN 9 and 10
Surgery 8
Pediatrics 8
Psychiatry 9

I also did Neurology 9 because neuro was a weakness of mine, but personally I thought that form was way harder and more detailed than the neuro I actually saw on Step 2. If neuro isn't a major weakness for you, I don't think it's nearly as important as the others.

I didn't have time to do every CMS form ever created.

Some days I got through one, maybe two.

But I would prioritize the newer forms because the question style, length, concepts, and explanations felt the most representative to me.

9. NBME 16: 265

Then I took NBME 16 and got a 265.

My first 260+.

I was SO happy.

More importantly, it was probably the first full-length where I genuinely felt different while taking the test.

My timing was good.

I wasn't second-guessing every answer.

I recognized most of the concepts.

I wasn't changing a million answers.

There were obviously still questions where I was like, "What the actual hell is this?" But at some point I accepted that those questions are going to exist no matter how much you study.

You cannot know everything.

You just have to get comfortable letting those questions go.

And, funny enough, NBME 16 ended up predicting my exact Step 2 score: 265.

10. Free 120

Four days before my exam, I took the 2023 Free 120 and got an 88%.

Depending on which random internet calculator you use, people will tell you that corresponds to various scores, some around 270-ish, but I wouldn't put too much weight into converting a Free 120 percentage into a specific three-digit score.

I mostly used it as reassurance that I was still in a good place.

Then I made one final mistake lol.

I reviewed the Free 120 the next day, which left me with about two days before the exam. I wanted to take the day immediately before Step completely off.

So two days before, I thought:

"Oh, I have some extra time. Maybe I'll casually do the old 2021 Free 120."

I did it untimed and reviewed questions as I went because I absolutely did not want to sit for another full simulated exam.

And I was getting around 80 to 81%.

Which, naturally, freaked me out.

In retrospect, this was completely unnecessary stress two days before my exam.

Interestingly though, and I know other people may completely disagree with this, my actual Step 2 felt more like the 2021 Free 120 to me than the newer 2023 Free 120 did.

Take that for what you will.

11. Other resources I loved

ChatGPT

Chat is amazing for asking question-specific questions. For anything I was remotely unsure on, I would screenshot the question and paste it into ChatGPT.
Ex 1: For this question I thought it was not pancreatitis because their amylase is normal, why is this wrong?
Ex 2: I know that their seizures are because of hyponatremia, but why is their sodium so low?

AMBOSS Ethics, QI, and Safety

I agree with everyone else that this is a MUST-DO! Not just doing the questions, but really sitting down and reading every word in the articles. They were so long and tedious because I'm ADHD AF, but even I with my debilitating ADHD am telling you it is worth it!

The actual exam ethics questions were all very long and wordy, but the concepts felt copy and pasted from AMBOSS Ethics. Knowing the concepts like the back of my hand cut down a lot of time because there were many questions where I could tell what the answer was from just glancing over the answer choices, before even reading the question!

Inner Circle Notes

I used Inner Circle when I wanted to take a concept from an NBME question and actually understand the entire topic surrounding it.

This was especially helpful when I realized I didn't just need one random fact. I had an actual knowledge gap.

First Aid Clinical Algorithms

This book was AMAZING for me.

I didn't read it cover-to-cover.

Instead, I used it as a reference whenever I kept missing a particular type of problem.

For example:

Thyroid nodules
Trauma
Workups
Differential diagnoses
Management algorithms
Next best step questions

It was really helpful to look at one algorithm and see:

Here are the possible diagnoses → here's how you distinguish them → here's what you do next → here's how you treat them.

And Step 2 is so heavily based on next best step/management that this style of review was extremely useful for me.

12. If I had to rank what helped me most

If I had to do dedicated all over again, my priorities would probably be:

1. Newer NBMEs, especially 14 to 16
2. Newer CMS forms
3. Thoroughly reviewing EVERY NBME/CMS question
4. AMBOSS Ethics, Safety, QI
5. Divine Intervention
6. Inner Circle for filling content gaps
7. First Aid Clinical Algorithms for management/workups

The biggest lesson for me was that doing more questions wasn't automatically equivalent to learning more.

My score started improving when I slowed down and asked:

Why did I get this wrong?

And then eventually:

Why did I get this wrong even though I knew the medicine?

Those are two completely different problems.

13. How the real exam felt

Honestly?

Awful lol.

There were so many questions where I knew immediately afterward that I had made a careless mistake.

Sometimes I finished blocks early and just ended them instead of reviewing everything. Then two minutes later I'd suddenly think:

"WAIT. Oh my god. I know what that answer was."

I was nervous pretty much the entire time.

There were definitely weird questions.

There were questions I had seen a million times.

There were questions I had no idea about.

There were questions where I narrowed it down to two and just had to pick something.

I walked out feeling extremely icky about the whole thing.

I didn't actually think I failed, but I genuinely thought I had probably dropped into the high 240s/low 250s.

Then my score came back:

265.

The exact same score as NBME 16.

So if you walk out feeling terrible, please remember that apparently you can feel like you got hit by a truck and still have done completely fine.

TL;DR / things I wish I knew earlier

Don't force yourself to study the way everyone else does.

UWorld is an amazing resource, but grinding through it just for the sake of reaching 100% completion did not work for me.

Once I stopped obsessing over completing resources and started learning NBME concepts, NBME wording, and my own mistake patterns, my scores finally started moving.

The biggest things for me were:

Learn from every NBME question, not just the incorrects.

When you miss a concept, learn the entire concept, not just the one fact being tested.

Figure out whether your mistakes are actually content problems or test-taking problems.

Don't change answers unless you have a concrete reason.

Do the newer CMS forms.

Divine Intervention is incredible.

And maybe most importantly:

There are going to be questions on the real exam where you have absolutely no idea what is going on.

That's okay.

You don't need to know every question to get the score you want.

Hopefully this helps someone who is sitting in the 230s/240s wondering whether they can still make a big jump. I definitely spent a lot of dedicated wondering the exact same thing.

u/Frosty_Honeydew9567

In This Life, Do Not Find Me

Moonlight Pavilion, Crimson Thread

[FIN] New Novel!

New Novel!

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Step 2 Study Strategy: 237 CCSE → 265 Step 2

Scores

1. UWorld: aka what NOT to do, at least for me

2. NBME 11 was basically where my real dedicated started

3. Learning how the NBME asks questions was HUGE

4. Don't shy away from content review!

5. I started categorizing WHY I missed questions

6. NBME 15 taught me to STOP changing answers

7. UWSA2: personally would not recommend

8. CMS forms were probably one of the biggest reasons my score jumped

9. NBME 16: 265

10. Free 120

11. Other resources I loved

ChatGPT

AMBOSS Ethics, QI, and Safety

Inner Circle Notes

First Aid Clinical Algorithms

12. If I had to rank what helped me most

13. How the real exam felt

TL;DR / things I wish I knew earlier