Three pillars:

Retention: People hate on Anki but you need some form of retention from preclinical/rotations until you sit for the exam. I missed ~20 days of Anki from the first day of M1 until I sat for the exam almost three years later. At the end of the day, the test is about what you know and you simply cannot fake that. In my opinion, if you start dedicated with zero form of retention you are already significantly behind. It doesn't matter what you do but you cannot expect to get a killer score without some form of long term retention.

Review: In a similar vein, you cannot just read through question explanations and move on. This is another point for Anki because you can add specific cards based on your incorrects in AMBOSS/Anki. I kept a document with short explanations of all my wrongs throughout dedicated and reviewed it every morning and every night. By the end of dedicated, it was ~140 pages.

Practice: There is no replacement for grinding questions. On the exam, I didn't know the answer to many questions but through practice I was able to frequently eliminate to the correct answer. Passivley watching videos and listening to podcasts is a waste of time in my opinion unless you're doing it at off times (ie exercising, driving, relaxing at the end of the day). People complain about the 50/50 questions (which do suck) but the only way to move them to 80/20 is to practice as many as possible. I was doing 160 questions per day during dedicated.

Resources:

Anki: Number one resource. Irreplaceable in my opinion.

UWorld: Started and finished during rotations for shelf exams. ~74% first pass.

ABOSS: Started and finished in dedicated. In my opinion, superior to UWorld for USMLE prep. Much better explanations and questions difficulty was equal to slightly harder than test day. Only timed, untutored 40 questions blocks. ~79% first pass.

Divine Intervention/Emma Holiday

I have tried second passes through UWorld and found it to be a waste of time. Plan ahead and try to purchase the other qbank prior to dedicated. Repeating questions isn't nearly as helpful as working through new questions and dealing with 50/50s.

Practice Scores:

NBME 12-15: High 250s, low 260s

NBME 16: 272

Free 120: 93%

People overcomplicate this with a billion resources and question strategies. I give general advice because there are many different ways to be successful.

Happy to answer questions.

Best song to remember Maple syrup urine disease thought ill share :)

Hi everyone,
My exam is in 19 days and I’m aiming for 240+.
My recent practice scores:
NBME 13 230
NBME 14 (2 weeks ago): 230
NBME 15 (today): 221
Preparation background:
Long prep (~2 years, somewhat inconsistent)
Still going through UWorld but unsure if I should switch focus!
Would really appreciate any advice on:
Best strategy for final 2–3 weeks
How to fix “forgetting topics” issue
Whether UWorld or Amboss or CMS forms is better at this stage?
Thanks in advance 🙏

Please

I know there's a new format and all that, but how similar is the exam to the free 120s? Is there more HPI questions now?

I did this for the MCAT years ago and folks found it helpful, so I wanted to try to share back some of the advice that I found most useful on this sub for Step2

Scores:
5/12 NBME 9 = 215
5/18 NBME 10 = 216
5/24 NBME 12 = 220
5/28 NBME 13 = 223
*started full time dedicated*
6/1 NBME 14 = 219
6/7 NBME 11 = 229
6/9 Old Free 120 = 73%
6/12 New Free 120 = 85%
6/15 NBME 15 = 222
6/17 NBME 16 = 248

6/20 Real Deal = 260

About me: USMD, took step2 after a year LOA where I did nothing medical, struggled with step1, low to average shelf scores, ADHD so anki is my flirtatious lover that I never ended up in a relationship with, aries aries cancer

My dedicated schedule: First 4 weeks very light every other day studying 3-4 hours to try to refill some of my old knowledge back (I had to do it light because of health issues, needed to regain endurance). Then a “dedicated” of about 8 weeks of inconsistently trying to study 6 hours a day but with huge gaps of several days with days off until the last three weeks when I was doing 6/7 days a week about 10 hours a day. So I’d say a “full time” dedicated of maybe 4 weeks if you total up the partial time.

Caveats: Like all the other advice on this thread, I am just one person who has my own strengths and weaknesses. In addition to working hard, I also have seen that for prometric tests I usually score higher than all my average practice tests with a pattern of low score plateau to sudden surge on test day (MCAT, step1, step2) - that doesn’t invalidate this advice for you, but just wanted to fairly say that it’s not just how I studied it’s also how my brain works. Which brings me to point 1:

1) Half the advice on this sub will not apply to you. Don’t try to force someone else’s study solution to your own just because their post has high scores. You need to figure out what works with your brain and body- thankfully I feel like M1-M3 taught me how I learn, but it was still hard to trust that when there’s so much conflicting advice on this sub. It’s not that one person is right and the other wrong, it’s that people are saying what worked and didn’t work for them.

1b) Don’t waste time trying things that you know don’t work for you. You have a limited amount of time. I found myself wondering often if I needed to give Anki another try or do 120 random UW q’s a day when that wasn’t helping me because everyone talks about it and I didn’t want to be wrong. But I KNEW anki has never been something that worked for me because fact recall or system switching is something I can’t absorb. I am big picture and I need big picture learning. That’s okay. Whatever you need to *get it* is okay.

2) Trust your gut. Not just for the answer choices, but I know that you know where your weaknesses are. I know you know after all this time in medicine that there are some systems or types of questions that just make you ???? on test day. You have one of two choices: either make those systems your strengths so they don’t trip you up again or allow yourself to take the L on that system or question type and just allow that, forgive yourself for it, and move on- don’t waste time wringing your hands about your weak points if you’re not going to do anything about it.

I don’t recommend the latter for high yield stuff. Here’s an example: I found that I absolutely suuuucked at pancreas/biliary/hepatic and I would constantly confuse issues or not be able to tease stuff apart using symptoms or lab clues. But I knew that was going to show up repetitively on my examand I was sick of feeling clueless or uncertain on those questions. So I think I spent a full day determined to learn them repetitively so well that those questions went from “?? ah fuck!” to muscle memory. I used a combo of Boards & Beyond, UWorld systems based, Amboss systems & keyword based, and ChatGPT to come up with questions targeting my weaknesses. I answered almost every question in those banks on cholecystitis vs cholelithiasis vs pancreatitis vs pancreatic cancer vs yada yadda. I learned all I could about symptoms, treatment, markers, differentiators until I was now excited to get those questions like a little puzzle to be solved because I knew I had prepared for them (still got scattered by a few toughies on test day but we try what we can.

On the flip side, I also knew I was going to get auscultation questions. We know it. They tell us. I tried listening to dirty medicine’s auscultation video and I just slammed my laptop shut after 5 minutes in frustration. Instead of wasting time agonizing over it though I just accepted it and on test day when I couldn’t pick apart the murmur based on the text itself, I clicked my best guess and moved on to pick up more points elsewhere.

3) Step2 is an adult game of pick up sticks. There are a certain amount of points/sticks on the ground. you don’t have to get all of them - you have to get enough to get the score you want. On test day, keep that mentality and tell yourself there are still points to get even after a rough block. Still so many sticks on the ground! I literally said this to myself in the mirror in the testing center bathroom after a nightmare section.

4) Focus on systems and big picture. Example: instead of memorizing lists of murmurs that are systolic or diastolic or increased/decreased with whatever maneuver I would try to understand the why behind those - knowing that if I understood the mechanism it would help on high yield cardiac questions. It seems so simple to not have learned before but I found that some things I had memorized categories for instead of why a murmur was diastolic or systolic. I went over things like RAAS and coagulation stuff not to memorize factoids but to really be able to walk through the body process and identify the breakdowns - this helped a ton.

Like I said before, I can’t process random factoids or system switching for learning so even though that’s how the test is it’s not how memory works. So I did UW systems based only for weak points to hammer (I never got close to finishing UW, I think I did 60% total during M3 and maybe 500-600 questions during dedicated?) I couldn’t do disconnected learning, even though I panicked at times wondering if I was studying wrong - see point 1b

5. Listening to Divine Intervention during outings really really helps. I tried finding high yield playlists on spotify and listening to them when I was driving or mowing or doing woodworking. I absolutely picked up points just from these.

6. CMS & NBME are king. Yes some of the questions are easier/harder than what’s on the real deal BUT if you focus on the topics themselves and not just the factoid you got wrong, you will learn what the NBME wants you to know. I did systems based most recent CMS after B&B review for each topic. Then I focused entirely on NBME questions. The score switch you see at the beginning of June for me is when I started tracking my topic weaknesses in the NBME and hammering everything I could possibly learn about high yields for that topic (like if I got a vasculitis question wrong not for just a dumb reason I would go back over the vasculitides and learn the pathophys, treatment, differentiators, and then practice with 10-20 questions just on that topic to cement it , then move onto review the next question. While I reviewed my NBMEs I kept a running list of all the topics I got wrong which helped me track which ones showed up repetitively- I tackled those using the strategy listed in point 2 until I wasn’t getting them wrong

EDIT: For example if the NBME says “what’s asthma exacerbation treatment” and you *just* review the asthma treatment then you will have holes. If you instead say “okay NBME is for sure testing asthma- let me go and review PFTs, asthma management and when/how to escalate, what’s the physiology and some of the high yield complications” that’s the approach that helped me jump way higher

6b. Give yourself grace. Each practice NBME is a learning experience, I visualized it as patching holes in a ship - every question wrong was an opportunity to turn that topic into a strength. But really really try to forgive yourself for dumb mistakes, know this is a hard test, be proud of yourself for all your hard work every single day no matter how your scores are, and give your body the care it needs by resting, sleeping, eating well. Your brain is working hard for you, be kind to it. You are doing amazing things ❤️

7. Test day - the day before I took entirely off. I read fiction and rested in a hammock half the day and worked on a carpentry project the rest. I let my body and brain rest the same way marathon runners do before a race. On test day, I had my go-to snacks & meds that I’ve used for every standardized test. I called my friend in the middle for a pep talk and I tried to stay positive for the whole day even though I felt like I was getting wrecked. I kept saying “you’re in this now, you can’t change how much you studied, you can only pick up as many points as you can”. Attitude was the only thing I had control over at that point, so I worked to use it to my advantage.

Thank you to this sub for all the help!! Best of luck to everyone.

Hi everyone!

I recently received my Step 2 CK score report, and I'm excited to share my journey. This subreddit helped me tremendously throughout my preparation. Reading others' write-ups, comparing scores, and learning different study strategies played a huge role in helping me achieve a good score.

Preparation Overview

**Total preparation time:** 8 months

* **Pre-dedicated:** 6 months * **Dedicated:** 3 months

Pre-dedicated Period (6 months)

During this period, I was balancing medical school classes and tutori for USMLE Step 1.

**1. UWorld Question Bank**

This was by far my most valuable resource.

I completed **25–40 questions daily**. Consistency was the key during this phase. I reviewed every question as thoroughly as possible.

My strategy was:

* Complete about **50% of each system in system-wise mode** * Leave the remaining **50% for random mode**

Before pausing for my medical school exams, I had completed **85% of UWorld with 78% correct**.

**2. UWorld Library**

Whenever I identified weak topics through UWorld, I read the corresponding articles in the UWorld Library. These articles gave me a much deeper understanding of diseases and helped improve my overall performance.

At this point, I took **NBME 9** and scored **242**.

I then paused my Step 2 CK preparation for **2 months** due to medical school exams.

Dedicated Period (3 months)

These resources helped me improve from **242 on NBME 9** to consistently scoring in the **low-to-mid 260s** on subsequent practice exams.

1. UWorld Second Pass

For the first 1.5 months of dedicated, I completed a second pass of UWorld entirely in **random mode**.

I solved **80–100 questions daily**.

My goal wasn't memorization—it was **pattern recognition** and building quick clinical reflexes. I believe this was the biggest contributor to my score improvement.

2. Divine Intervention Podcasts

I listened only to the high-yield episodes that are frequently recommended on this subreddit, especially the **Social Sciences** episodes.

I also watched the **Divine Intervention Shelf Review YouTube playlist**, which I found extremely high yield.

3. AMBOSS High-Yield Study Plans

I completed the AMBOSS study plans for:

* Ethics * Quality Improvement * Risk Factors * Screening * Vaccinations * HOPI * Biostatistics

These were incredibly helpful, especially Ethics and Quality Improvement, which make up a significant portion of the actual exam.

4. NBMEs

During the final month, I focused almost entirely on taking and thoroughly reviewing NBMEs. I made Anki cards from my mistakes and reviewed them regularly.

My scores were:

* NBME 9: **242** * NBME 10: **263** * NBME 11: **264** * NBME 13: **270** * NBME 14: **255** * NBME 15: **265** * NBME 16: **256** * New Free 120 (2023): **88%** (1 week before exam) * AMBOSS Predicted Score: **264** * **Real Step 2 CK: 26X**

Exam Experience

The real exam felt **vague**, and **time management was one of the biggest challenges**. Overall, I thought it was fair and very doable if you had prepared well.

After the Exam

Like many others, I felt terrible after finishing the exam. I kept remembering mistakes—probably around **40 questions**, many of them very silly errors.

It definitely made me anxious while waiting for my score, but in the end, my actual score was very close to my practice assessments.

**My biggest advice:** Trust your NBMEs. They were the best predictor for me.

I hope this helps someone preparing for Step 2 CK. Feel free to ask any questions—I’ll be happy to help. Good luck to everyone!

Wanted to do a quick write-up because I spent way too much time reading these while studying, and they were honestly helpful for calibrating where I stood.

Score: 265
Test date: May 13, 2026

Practice scores:

• NBME 9: 253
• NBME 10: 251
• NBME 11: 244
• NBME 12: 253
• NBME 13: 256
• NBME 14: 255
• NBME 15: 251
• NBME 16: 261
• UWSA2: 253
• AMBOSS SA: 244
• New Free 120: 81%
• Old Free 120: 86%

I ended up scoring higher than most of my practice exams, which I think came down to having a strong foundation from clerkships/shelves and improving my test-taking approach late rather than learning a ton of new content at the end.

Background / baseline

My shelf scores were generally in the 80s. I did not feel like I had some crazy perfect knowledge base going in, but I had seen enough clinical scenarios throughout clerkships that Step 2 felt more like pattern recognition + judgment than memorizing random facts.

My practice scores were pretty stable in the 250s for a while. I had one lower score with NBME 11 and AMBOSS, but otherwise I was mostly sitting around 251–256, with NBME 16 being my highest right before the exam. I was hoping for 260+ but honestly was not consistently scoring 260+ on practice exams.

Main resources

• UWorld throughout clerkships / dedicated
• NBMEs, especially the newer ones
• Free 120
• AMBOSS selectively
• CMS forms / shelf-style review as needed
• My own notes from missed questions and recurring mistakes

I did not try to use every resource. The main thing was using questions to figure out where my reasoning was breaking down.

How I studied

The biggest thing for me was moving away from “I need to know more facts” and toward “why am I picking the wrong answer?”

For every missed question, I tried to figure out which category it fell into:

1. Knowledge gap — I genuinely did not know the disease, guideline, or management step.
2. Misread / missed clue — I knew the concept but skipped over a key phrase.
3. Wrong illness script — I anchored on the wrong diagnosis early and forced the question to fit.
4. Management sequencing error — I knew the diagnosis but picked the wrong next step.
5. Overthinking — I talked myself out of the simple/common answer.

That was probably the highest-yield change I made. A lot of Step 2 is not “what is the diagnosis?” but “what is the next best step given the exact context?” Stable vs unstable, pregnant vs not pregnant, child vs adult, first-line vs confirmatory test, outpatient vs inpatient — those modifiers matter a lot.

I also started making more algorithmic notes instead of long content notes. For example, instead of writing a paragraph on PE, I would write something like:

• Suspected PE + stable → CTA
• Suspected PE + unstable → bedside echo / empiric treatment depending context
• Massive PE with shock → thrombolysis unless contraindicated

That kind of note helped me much more than rereading full explanations.

NBMEs / practice exams

The NBMEs were the most important resource near the end. I reviewed them very carefully, especially the explanations for questions I got wrong or got right for the wrong reason.

I do think the real exam felt closest in style to the newer NBMEs and Free 120, but longer and more tiring. UWorld is great for learning, but the real exam felt less like UWorld-style “gotcha” questions and more like long clinical vignettes where the answer depended on prioritizing the most relevant detail.

My takeaway: do not ignore stable NBME scores. I was mostly in the low/mid 250s and ended up with a 265, so there is definitely room to outperform, especially if your misses are more about strategy than content.

Exam day

The exam felt long and honestly kind of weird. There were plenty of questions where I narrowed it down to two and moved on. I did not walk out feeling like I crushed it.

The biggest thing was stamina. I tried not to let any one block affect the next one. If a block felt bad, I just assumed everyone else probably thought it was bad too and reset.

For breaks, I tried to be deliberate: quick breaks early, longer break/lunch later, and enough time to reset before the final blocks. I think protecting mental energy was very important.

What I would do again

• Take the NBMEs seriously
• Review wrong answers by mistake type, not just content area
• Focus heavily on management algorithms and “next best step” reasoning
• Use Free 120 close to the exam
• Trust clerkship/shelf foundation more
• Avoid panic-studying random low-yield facts at the end

What I would change

I probably would have started organizing my incorrects earlier. For a while I was just reviewing explanations and moving on, but I think the real improvement came when I started noticing patterns in why I was missing questions.

I also would not let one low practice test freak me out as much. NBME 11 and AMBOSS were lower for me, but they did not end up representing my final score.

Advice

If you are scoring in the 250s and aiming for 260+, I think the difference is often not a massive content gap. It is usually cleaner test-taking:

• Do not anchor too early
• Identify what the question is actually asking
• Pay attention to stable vs unstable
• Know the next step, not just the diagnosis
• Do not overrule obvious answers unless you have a very good reason
• Build stamina so your last blocks are not dramatically worse than your first ones

Overall, I think Step 2 rewards clinical pattern recognition, management sequencing, and being calm under uncertainty. I never felt like I had mastered everything, but I got better at making the most reasonable choice and moving on.

Happy to answer questions.

I’m trying to understand what happened here because honestly I’m confused.

My recent scores:

• NBME 11: 236 (4 weeks ago)
• NBME 12: 259 (3 weeks ago
• NBME 13: 243 (2 weeks ago)
• NBME 14: 228 (1 week ago)

The NBME 14 score absolutely destroyed my confidence.

What made it worse was that I didn’t feel particularly tired or distracted. The questions just felt much longer, more vague, more ambiguous, and I struggled to extract the diagnosis. I also ran out of time and left 6 questions unanswered. After the exam I did those 6 questions and got all 6 correct, but obviously I don’t count them because in the real exam they would have been wrong.

After NBME 14 I was mentally exhausted and honestly did almost nothing this week.

My “study plan” after that disaster was basically:

• Watch FIFA World Cup matches.
• Go to the beach.
• Do Anki cards for about 1.5 hours per day.
• Very superficial review of NBME 14.
• No major content review.
• No heavy UWorld.
• No intensive studying.

Today I took NBME 15.

Result: 255 (42 incorrect).

So I improved from 228 to 255 in one week while essentially not studying.

That makes me think the difference is not knowledge. My medical knowledge simply cannot increase that much in seven days doing almost nothing.

My current hypothesis is that my score is extremely sensitive to question style. Whenever questions become very long, vague, and diagnosis extraction becomes difficult, my score drops dramatically.

Has anyone experienced something similar?

How would you interpret a sequence like:

236 → 259 → 243 → 228 → 255

Three weeks out from Step 2.

I’d appreciate any honest feedback.

Nbme 9: 210

Nbme 10: 218

I want to score around 250+ but, a lot has been going on with my life (became a father, wife needed my help post-partum, baby is in NICU) and wasn't able to study all that well the past month. I have only managed to complete 25% of uworld.

What should my strategy be like? I feel like just doing Uworld doesn't help me fill in the knowledge gaps I have. Should I do more CMS forms? More videos?

Any help is appreciated.

*All the exams below were taken after completing one pass of UWorld*

NBME 9 (8 May) : 230

NBME 10 (12 May) : 248

NBME 11 (26 May) : 240

NBME 12 (27 May) : 246

NBME 13 (28 May) : 251

NBME 14 (29 May) : 259

NBME 15 (1 June) : 262

NBME 16 (3 June) : 262

UWSA 1 (10 May) : 240

UWSA 2 (13 May) : 249

New Free 120 (30 May) : 77 out of 120

Actual score (Exam day : 8 June) : 249

I’ve reached a point where I honestly feel hopeless.
Here’s where I’m at:
Finished all of UWorld (64% correct).
Completed all of my incorrect UWorld questions.
Finished about half of AMBOSS with 77% correct.
Completed all CMS Forms (scores ranged from 65–85%).
I’ve been making Anki cards for every mistake since day one and keeping up with reviews.
Despite all of that:
UWorld Self-Assessment: 50%
NBME 9: 216
NBME 10: 220
I honestly don’t know what else I’m supposed to do.
I don’t feel like I’m being lazy. I’ve put in the hours and covered the major resources, yet my scores barely move.
Has anyone been stuck around 215–220 and eventually scored 240+ (or even 250+) on the real exam?
If so:
What finally made the difference?
Did you change the way you reviewed questions?
Did you stop using Anki?
Did you focus on NBMEs instead of question banks?
Was it a content issue, test-taking issue, or something else?
I’m not looking for motivation—I genuinely want to know what changed your scores because right now I feel like I’ve run out of things to do.
Any advice would be greatly appreciated.

Took the exam yesterday, solidly 10% of the exam was just very repetitive questions about Quality Improvement.

That's genuinely enough to swing from average to a very strong score just through QI. Leaving aside how crazy it is to weight such trivial stuff so heavy in the exam, why does noone talk about this? Unless I just had an especially weird form?

Swear I could have boosted myself 5% with like 1.5hrs work on QI

Genuinely don’t know how people figure out when they’re “ready” to sit for Step 2. I’ve been in dedicated for 6.5 weeks now. My scores have been pretty consistent but not moving much:

Last 4 NBMEs: 228, 231, 229, 232

UWSA2 (taken 10 days ago): 235

Free 120 (old one): 74%

I keep telling myself I should just push the exam, but then I’ll open First Aid or do a block of questions and find something I’m shaky on (usually ethics or some random micro fact) and spiral a bit. I know I’m never going to know everything, but it’s hard to tell if this is normal anxiety or if I actually need more time.

For those of you who already took it, what finally made you pull the trigger? Was it hitting a certain score on your last few assessments, running out of time/money, or just getting sick of studying? Did anyone take it while still feeling like there were gaps? I’m scheduled for mid-July but I keep going back and forth on whether to push it 2–3 weeks. Any perspective would help.

NBME 9 15/5/2026 244

NBME 10 25/5/2026 245

NBME 11 01/06/2026 247

NBME 12 07/06/2026 256

NBME 13 09/06/2026 261

NBME 14 15/06/2026 257

NBME 15 19/06/2026 261

NBME 16 25/06/2026 274

2019 F120 - 91

2021 F120 - 82

2023 F120 - 85

All CMS forms done, ranging from 70-90%

Did some HY amboss study plans, what is the most clutch in the last few days?

Been dedicated for about 7 weeks now (test in 2.5 weeks) and my scores have been completely stuck for the last 3 weeks. It’s starting to mess with my head.

Scores:

NBME 9 (start): 218

NBME 10 (week 3): 225

UWSA1 (week 5): 232

NBME 12 (last week): 231

NBME 13 (3 days ago): 233

I’ve finished UWorld once (67% correct), did most of the incorrects, went through Pathoma + Sketchy micro/pharm, and I’ve been doing Amboss questions on my weak systems. I also redid the older NBMEs I took early on (NBME 6 and 7) and got basically the same scores as before.

My main issues right now seem to be ethics/communication questions and biostats, I keep dropping stupid points there even though I know the material. Every time I review, it feels like I’m just spinning my wheels. For people who hit a plateau this late, did redoing old forms actually help you, or did taking a fresh full-length (like UWSA2 or the new Free 120) give you more useful data? I was planning to save the newest Free 120 for the week before my test, but I’m not sure if that’s the right move anymore. Would appreciate any honest input. Feeling pretty stuck.

Should we expect results this Wednesday or 15th cuz of 4th July?

I'm literally failing here and my exam is in 10 days

Tested recently and was suffering from the worst URI. Felt flushed, fatigued, and feverish the entire time, reading/thinking felt painful, and I wanted to fall asleep in the middle. I felt so, so slow, and the new format didn’t help. Took it cause I just wanted to get it over with (don’t recommend). Thought I threw my career away but was pleasantly surprised by my score (255-265). Just wanted to post in case anyone encounters a similar situation! It’ll work out!!

Unfortunately, don’t have any advice in terms of studying since I did uworld questions haphazardly and never reread my errors log like i promised myself i would. Just tried to learn nbme logic and hoped for the best lol