How to Study for the Boards and Wards

I've been getting a lot of questions from third-year students regarding study materials.  I will go over what books I believe were most helpful for the rotations (the wards) and what books are best for the intense review for the USMLE Step 2 CS, Step 2 CK and MCCEE.

For the Wards, it depends on the rotation.  I shuffled through quite a few textbooks before I recognized which were the most effective for end-of-rotation exams (shelf exams).  Some of my colleagues liked to use the Kaplan books along the way.  I found them a little too dense.  If you feel you can cover the entire texts during each rotation, then go for it.  For OB/GYN, a subject we learn little about during the first 2 years of medicine, I used the Blueprints Obstetrics and Gynecology , as it was well laid out, covering enough for the wards and the boards.  For Surgery, I highly recommend Surgical Recall (and I urge you to listen to the audio files that come with it – you’ll get through the material quicker).  For Internal Medicine, Step Up to Medicine is in enough depth to cover you for your rotation and at least 70% of the material on the boards (which is Internal Medicine).  In addition, you should have First Aid for the Wards and Boards and Wards, which are concise reference/review books that really help consolidate the important material for your end-of-rotation oral and written exams.  These two should also cover you for Pediatrics, Psychiatry and Surgery.  For practice questions, I liked the Kaplan Qbook for Step 2 CK.  Hang on to Boards and Wards for fourth-year and residency as a handy pocket reference. 
 

For USMLE Step 2 CS, you should take this exam either after Internal Medicine, Family Medicine or Emergency Medicine in your third year.  Don’t forget to register early for this exam, i.e. January of your third year for a March-June test date.  I recommend studying for two weeks for this exam during your core rotation (Just don’t sign up for a date too close to a shelf exam date).  The only book I recommend for this is First Aid for Step 2 CS.  Make sure you go over the logistics of the exam itself discussed in the first few chapters and the mock cases in the back of the book and role-play with a friend.   Practice doing your History and Physical (H&P) within 15 minutes, and typing up your H&P afterwards within 10 minutes. 

For USMLE Step 2 CK, depending on how much time you dedicate to some hardcore studying between your third and fourth year, I recommend choosing between either Step Up to Step 2 CK or First Aid for Step 2 CK if you only have a few weeks to study and want to limit the number of textbooks.  In addition, you should definitely pick up Step 2 Secrets, which is a very effective review book in question/answer format with high-yield tables.  I only bought this book two weeks before my exam and wish I had started reading it sooner.  The most important thing is to make sure you register for a USMLE World question bank.  Make sure you do all the questions (2000+).  Pace yourself by doing them in timed blocks with randomized questions.  If you have extra time to study, you can start by doing questions untimed and your weakest subjects first.  Dedicate one day per week in your last two-three weeks to do a full length timed practice test (8 Blocks of questions) – either from the NBME website and/or a USMLE World full-length practice test. Read the explanations to questions carefully on USMLE World, and write down some of the key points in your First Aid or Step Up review book (Writing down notes helps consolidate the information).  First Aid for Step 2 CK is not as complete as I would have liked, however, it did provide structure as an outline to my review and was a good last minute review tool, especially with the material I added while doing USMLE World questions.  I dedicated four solid weeks to study for Step 2 CK.  You may decide you need anywhere between three-six weeks to study for this, depending on how well-prepared you feel after your core clerkship rotations and/or how you performed on Step 1.  Do not postpone taking it!  You don't want to worry about this exam while applying for residency in early fourth year.

For the MCCEE, as I stated in my previous blog post, you should take this soon after Step 2 CK.  The only additional studying I recommend involves doing practice questions on Canada QBank.  At least try to cover the ethics/population health-type questions.

- Phil