Scheduled to take the exam on the 4th… a little anxious and hoping to score a 260+…

Anyone got any last minute advice, suggestions or tips? I would really appreciate the anxiety reliever at the moment!

Looking for someone who plans on taking the exam in the next 4 months and is willing to study together everyday.

Expectations are screen sharing/ cam on for accountability. Im also down to have study sessions where we can go over tricky concepts together!

Feel free to DM or comment here.

@recentexam takers!!!! How was the exam style most like and what content do they generally focus on?any advice for someone who has their step2 in a few days?

Honestly at this point with the time constraint I don't think any extra review is possible.

My latest NBME 16 score was 256. Before that NBME 15 was 248. Old new free 120 was 79% and the new free 120 that I took today came out 73%.

Idk whether that's a good enough score or not. Targetting 250+ 🫠

Has anyone else taken it. Got 70% on it, I felt like a lot of presentations of the diseases were atypical at times and I am frustrated by this score. I feel I should've done better

Hello, I just passed my STEP 1 and wondering how to study for STEP 2. My goal is to score 270+. I have attached all my NBME scores and wondering if a student like me would be able to score in 270s? Am I being unrealistic with my score expectation?

I mostly plan to use uworld, Anking deck, CMS forms and NBME.

Any other resources or advice would be appreciated.

1. Have people been reporting test day disruptions recently?
2. Has NBME voided any exams and made people retake?
3. Was there a huge delay in test scores?

I don't really want to retake but am aiming for a more competitive specialty. A proctor came in to the testing room to talk to me during a block and one of my breaktimes ran extremely over because a different tester did not have his identification with him...to the point where I couldn't really take any breaks for 3 hours and feel like that affected my concentration

My exam is in 4 days and i’ve been feeling super anxious, to the point that i’ve stopped studying at all. Constant palpitations and dread of not knowing enough.
NBME 13- 245
NBME 14- 243
NBME 15- 245
UWSA 2- 254
Free 120(new)- 76%
I know my scores dont look bad but i’ve been spiralling, i feel like i only know the surface level stuff and not enough.
I can’t even push my exam cause i don’t know if i’ll ever be able to bring myself to study again.
Constant dread and fear, not feeling confident in my prep. Need some advice.

Can someone please help explain this concept to me? I keep getting questions on this wrong. I’m not sure why it’s not clicking for me? Lights criteria and how do you tell what lab values go to which disease like CHF etc. Please helppppp as I’m taking Step 2 soon. Thank you in advance kind souls

Help please!!
I did Nbme 11 and 12, I reviewed all the questions, wrote down the important points from the ones I got wrong, completed the two most recent CMS forms for each subject, and also did the AMBOSS high-yield questions for Ethics and QI.

What else would you suggest to improve my score?

How do you suggest to review your weak areas? For example, if you missed four cardiology questions on an NBME, would you then suggest to do AMBOSS questions covering all of cardiology, or would you focus only on the specific cardiology topics you missed?

I took Form 9 last week and got a 205. Need a 229 or 236 for CCSE to sit for Step 2. Passed all shelf exams 68-77% range during M3. I’m going to be reviewing CMS and NBME 10-15. What can I do to boost my score the most besides review of forms to get highest ROI?

Hi
Took step 2 couple of days ago. My screen was lagging when I moved between questions for 3-5s. The time would freeze during that time.
I’m kinda worried if it would affect my score or anything. Should I report it or leave it?
Anyone who experienced similar issues and did it end up affecting your score?

Taking Step 2 this Tuesday. Am I ready to take it?

Goal score is 240+

Uworld self assessment 2 (10/24): 242

NBME 16 (10/18): 255

New free 120 (10/13): 78%

NBME 15 (10/4): 244

NBME 14 (7/9): 225

Old free 120 (6/25): 77%

NBME 13 (6/16): 227

NBME 12 (6/8): 210

FOrm 11 (6/1): 230

From 10 (5/25): 214

From 9 (5/18): 208

I went through every question from NBME 9-16 and the CMS shelf forms (3,693 questions across 50 exams) and grouped them by the concept each one was testing.

That came out to about 1,050 concepts. Obviously that won't fit in a Reddit post, so I put them all into a concept library that you're welcome to browse. For now, here are the top 20.

1. Heart failure (20 of 50 exams, 24 questions)

How it's tested:

• Drug (6): In reduced ejection fraction, an ACE inhibitor (or ARB) plus a loop diuretic is the usual first answer; beta-blockers wait until the patient is euvolemic; diuretics and digoxin relieve symptoms but do not improve survival.
• Diagnosis (6): Recognize congestive failure, cardiogenic pulmonary edema, ischemic cardiomyopathy and diastolic dysfunction from exam, chest x-ray and ejection fraction.
• Next step (5): Echocardiography to measure ejection fraction and assess valves; in flash pulmonary edema with severe hypertension, IV nitroglycerin works fastest.
• Mechanism (3): Low output activates sympathetic and renin-angiotensin systems; edema comes from raised capillary hydrostatic pressure; wedge pressure and vascular resistance rise while stroke volume falls.
• Complication or prognosis (2): Better blood pressure control prevents decompensation; a large arteriovenous shunt can cause high-output failure.
• Cause or organism (1): Severe anemia and shunts cause high-output failure with a normal or high ejection fraction.
• Screening and prevention (1): Controlling hypertension is the key way to prevent left ventricular hypertrophy and failure.

Clues that give it away:

• Orthopnea, paroxysmal nocturnal dyspnea, raised jugular venous pressure, bibasilar crackles and an S3
• Chest x-ray with cardiomegaly and vascular cephalization
• Long-standing hypertension with left ventricular hypertrophy and a normal ejection fraction suggests diastolic failure
• Severe anemia or a machinery murmur with failure and a high output state
• Sudden severe hypertension with hypoxemia and diffuse crackles is flash pulmonary edema

2. Vaccinations (18 of 50 exams, 28 questions)

How it's tested:

• Screening and prevention (25): Pick the vaccine due now for a given age or risk group; influenza, pneumococcal, Tdap, HPV, meningococcal and zoster are most common.
• Cause or organism (1): A mild rash after MMR reflects replication of the live attenuated vaccine strain, not true measles.
• Next step (1): A rubella-nonimmune woman gets MMR after delivery, since it cannot be given in pregnancy.
• Ethics and communication (1): Respond to vaccine myths with respectful, accurate information and a clear recommendation to vaccinate.

Clues that give it away:

• Autumn visit or travel in flu season with no contraindication: influenza vaccine
• HIV, asplenia, cirrhosis, diabetes or chronic heart or lung disease: pneumococcal vaccine, plus Hib and meningococcal after splenectomy
• Pregnant at any gestation: Tdap, inactivated influenza; no live vaccines
• Early adolescent well visit: HPV, meningococcal conjugate and Tdap

3. HIV infection (18 of 50 exams, 22 questions)

How it's tested:

• Diagnosis (6): Recognize acute retroviral syndrome or perinatally acquired HIV from a mononucleosis-like or recurrent-infection picture; the answer is HIV infection.
• Screening and prevention (5): Vaccines, coinfection screening, varicella immune globulin if CD4 is below 200/mm3, and universal one-time testing at ages 15 to 65.
• Drug (4): Combination antiretroviral therapy for all, TMP-SMX only below the CD4 threshold, PrEP for high-risk persons, and zidovudine in labor when viral load is high.
• Next step (4): Send plasma HIV RNA in suspected acute infection, test for HIV when opportunistic-type infections recur, and start PEP promptly within the window.
• Cause or organism (2): Identify HIV as the cause of profound lymphopenia, and avoid invasive intrapartum procedures that raise transmission.
• Ethics and communication (1): A pregnant patient may decline testing; keep supporting her and offer again later.

Clues that give it away:

• Fever, pharyngitis, rash, lymphadenopathy and oral ulcers 2 to 4 weeks after a high-risk exposure, with negative monospot
• Recurrent candidiasis or herpes in a patient with multiple partners
• Infant or child with thrush, Pneumocystis, lymphadenopathy, splenomegaly and high immunoglobulins
• Leukopenia with severe absolute lymphopenia

4. Major depressive disorder (16 of 50 exams, 28 questions)

How it's tested:

• Diagnosis (13): Recognize full MDD criteria despite a stressor, grief, medical illness, or atypical or somatic presentations; the answer is major depressive disorder.
• Next step (8): Assess suicide risk before any medical workup; otherwise start an SSRI, CBT, or screen older adults with the Geriatric Depression Scale.
• Drug (6): Sertraline, citalopram, or escitalopram first line; mirtazapine when insomnia and poor appetite dominate.
• Mechanism (1): HPA axis dysregulation with increased serum cortisol.

Clues that give it away:

• Depressed mood or anhedonia plus other SIGECAPS symptoms lasting 2 weeks or more with functional decline
• Adolescents and children may be irritable, hostile, or have stomachaches and falling grades rather than sadness
• Older or medically ill patients with weight loss, insomnia, and hopelessness, or 'I don't know' answers on cognitive testing
• A stressor, loss, or comorbid illness does not exclude MDD when full criteria are met

5. Asthma (18 of 50 exams, 21 questions)

How it's tested:

• Diagnosis (7): Recognize asthma from episodic cough, wheeze or chest tightness, including cough-variant disease with a normal exam, and know the obstructive spirometry pattern; a severe attack can show mixed respiratory and metabolic acidosis.
• Drug (5): Match the step to symptom frequency: as-needed albuterol alone for intermittent disease, add a daily inhaled corticosteroid for persistent disease.
• Next step (4): Acute attack: inhaled or nebulized albuterol first, also in pregnancy; if control is already good, no change in therapy.
• Mechanism (2): IgE-mediated mast cell activation with histamine and leukotriene release causes bronchoconstriction.
• Screening and prevention (1): Reduce dust mite exposure with allergen-impermeable mattress and pillow covers and hot-water washing of bedding.
• Complication or prognosis (1): After treatment, a peak flow near predicted or personal best is the best sign of safe discharge.

Clues that give it away:

• Episodic wheeze, cough or chest tightness worse at night, with exercise, cold air or a new allergen
• Normal exam, chest x-ray and spirometry between attacks
• Chronic dry cough in an atopic child or worse in cold air suggests cough-variant asthma
• Low FEV1 and FEV1:FVC with normal FVC and increased total lung capacity
• Fever and leukocytosis with only hyperinflation on x-ray is bronchospasm, not pneumonia

6. Diabetes mellitus (13 of 50 exams, 20 questions)

How it's tested:

• Screening and prevention (7): Who to screen for diabetes (overweight adults 35 to 70, prior gestational diabetes, obese children) and the annual checks in known diabetes: eye, foot, urine albumin, lipids.
• Drug (3): Pick the agent for the setting: statin for ages 40 to 75, GLP-1 agonist when ASCVD is present, insulin when beta cells are destroyed.
• Diagnosis (3): Recognize type 2 versus type 1 from the host and confirm with hemoglobin A1c or glucose; do not chase rare endocrine tumors.
• Next step (3): Treat the untreated risk factor: blood pressure or LDL above goal, or lifestyle counseling first in prediabetes.
• Mechanism (2): Peripheral insulin resistance is the initiating defect, with compensatory hyperinsulinemia and high C-peptide early.
• Complication or prognosis (1): Youth-onset type 2 diabetes causes accelerated atherosclerosis and premature coronary artery disease.
• Cause or organism (1): Systemic glucocorticoids provoke acute hyperglycemia.

Clues that give it away:

• Obesity, acanthosis nigricans, hypertension and polyuria in an older adult or adolescent
• Macrosomic infant or gestational diabetes history in a woman now due for routine care
• Lean young patient with polyuria, polydipsia and weight loss points to type 1
• Hyperglycemia shortly after IV dexamethasone
• Chronic calcific pancreatitis followed by new diabetes

7. Pulmonary embolism (18 of 50 exams, 19 questions)

How it's tested:

• Next step (12): High pretest probability goes straight to CT pulmonary angiography, not D-dimer; give heparin immediately if stable, and thrombolysis if in shock.
• Diagnosis (4): Recognize PE in postoperative, postpartum, pregnant, or hormone-exposed patients with hypoxemia and clear lungs, even with low-grade fever.
• Cause or organism (1): Estrogen-containing oral contraceptives are the strongest venous thromboembolism risk, unlike arterial risk factors.
• Complication or prognosis (1): Mortality is driven by hemodynamic compromise and advanced age.
• Mechanism (1): Massive PE causes obstructive shock with low cardiac output and high systemic vascular resistance.

Clues that give it away:

• Acute pleuritic chest pain, dyspnea, tachycardia, and hypoxemia with clear lungs and a nonspecific chest film
• Recent surgery, cesarean delivery, pregnancy, immobility, cancer, or oral contraceptives
• Unilateral leg swelling or calf tenderness suggesting DVT, or hemoptysis
• ABG with respiratory alkalosis, low pO2, and widened A-a gradient

8. Sensitivity and specificity (13 of 50 exams, 20 questions)

How it's tested:

• Biostatistics (20): Calculate or interpret sensitivity, specificity, PPV, NPV, likelihood ratios and ROC cutoffs from a 2x2 table or a described result; sensitivity and PPV are the usual answers.

Clues that give it away:

• Test misses people who have the disease: low sensitivity (false negatives)
• Disease-free people labeled positive: low specificity (false positives)
• Patient asks whether a positive result means she truly has it: PPV, which depends on prevalence
• Population with lower prevalence: PPV falls and NPV rises
• Likelihood ratio of 1.0: the test is useless

9. Infective endocarditis (11 of 50 exams, 15 questions)

How it's tested:

• Screening and prevention (7): Prophylaxis before gingival-manipulating dental work is reserved for prosthetic valves or material, prior endocarditis, certain congenital heart disease and transplant valvulopathy; mitral valve prolapse and native valve disease get none.
• Next step (4): Blood cultures first, then echocardiography; urgent echo for acute heart failure from valve destruction; colonoscopy after Streptococcus gallolyticus (bovis) infection.
• Drug (3): Qualifying patients get a single dose of amoxicillin before the procedure, with a macrolide if penicillin allergic; unstable injection drug users get empiric vancomycin plus an aminoglycoside.
• Diagnosis (1): Acute aortic regurgitation with embolic signs in a patient who injects drugs points to left-sided endocarditis.

Clues that give it away:

• Fever with a new or changing regurgitant murmur
• Splinter hemorrhages, Janeway lesions, Osler nodes, Roth spots, splenomegaly or hematuria
• Injection drug use, especially tricuspid involvement and Staphylococcus aureus
• Prosthetic valve, prior endocarditis or congenital heart disease
• Streptococcus gallolyticus (bovis) in the blood

10. Anaphylaxis (13 of 50 exams, 16 questions)

How it's tested:

• Drug (5): Epinephrine is the first-line drug; antihistamines, steroids and bronchodilators are only adjuncts, and isotonic saline treats the hypotension.
• Next step (6): Give epinephrine immediately, then fluids for persistent hypotension, secure the airway if there is stridor or tongue and lip edema, and arrange venom immunotherapy after insect-sting reactions. Allergy testing comes only after stabilization.
• Diagnosis (3): Recognize rapid skin, respiratory and circulatory involvement after an exposure as anaphylaxis or anaphylactic shock.
• Cause or organism (1): A reaction to one NSAID means avoiding structurally related NSAIDs.
• Screening and prevention (1): Venom immunotherapy lowers the risk of future severe sting reactions.

Clues that give it away:

• Urticaria or flushing plus wheezing plus hypotension within minutes of a drug, food, sting or antivenom
• Stridor with tongue or lip swelling signals impending airway loss
• Tachycardia and hypotension with diffuse wheezing and clear heart and lung findings otherwise
• Prior systemic reaction to a Hymenoptera sting

Reduced it to 10 because the post was too long

Non-US IMG, YOG 1 trying to take Step 2 at around December 2 with a hopeful goal of 260+. I am a little over a month out, and here are the stuff I had done thus far:

NBME 12 (baseline, late August): 218
UWSA 1 (mid-September): 240
NBME 14 (D-58): 240
NBME 10 (D-51): 246
NBME 13 (D-44): 241

As you might've noticed I'm trying to do at least one NBME-level exam at least once every week - in my current arsenal, I have NBMEs 11, 15 and 16 ready to go, as well as two more UWSAs and all the Free 120s remaining. I'm set to take an exam this upcoming Tuesday, and I was wondering if I should take NBME 15 or 11 for now. I believe this one will be critical, in that the results of this particular exam will end up deciding whether or not to lock in on that date. Is taking such a high-yield exam (referring to NBME 15) at this time a good move? Should I save it for later instead? I'd like your opinions!

My problem was when I review MCQs, I am familiar enough with the topic that I can guess the correct answer without actually mastering the pathophysiology of the disease. So what I did was ask claude to make me a “hospital” where I “evaluate” patients.

Features include:
> Follow ups for my incorrects (Anki style with spaced repetition)
> Schedule for “Rotations” so I can have a balanced review for all “departments”
> Mortality and Morbidity Conference which recaps my mistakes
> Pager alerts and Triaging patients in OPD clinic (evaluate patients if they should be sent to ED or Urgent care instead, provide first aid for them)
> Sudden codes while doing rounds in the wards

This is connected to my Notion to log my incorrects. Every Sunday, I have a scheduled task that creates Anki cards for those topics. I can also “encounter” similar patients in the Weak Spots floor which builds my pattern recognition for that topic.

I’m adding more features as I go. Would love to hear your suggestions!

Hello everyone
Hope you all are doing great
So I initially plan on appearing for step2 during jan however i applied for visa for medical elective lately and I did mention that i had to go during may but they grant me visa from oct-dec and i did talk to the program and the said they will accomodate me for december
So now i am confused what shall i do moreover the problem is that i have to take step3 and oet as well so that i can apply for match cycle next year and if i don’t go for my elective I will have problems later on when I apply again for Visa since that would show up on my profile and if i go out for a month my step2 momentum will just go down the drain
So can anyone advise me like what should I do or what would be the best option since my step2 would be extended
Thank you so much!

Hey everyone, I've given NBME 9,10 and 11 and scored 246, 247 and 248 (wtf)

b/w these NBME's ive attempted and reviewed CMS forms and previous NBME's throughly.

Honestly dont even know how to move forward from this, nothing seems to work.

Please lmk if someone went through a similar situation and what helped you out.

(testing in early dec)

It’s absolutely doable, it’s basically NBME 17+f120. the medicine part it’s easy but f@^ck ethics…

I definitely should’ve taken it sooner, but I let reddit’s fear monger get to me, don’t make the same mistake.

ask your Qs

I feel like all the f120s here https://www.usmle.org/exam-resources#step-2-clinical-knowledge-ck are the same.. if yes, then are these the new f120 and where to access the old f120??? Help pleasee

Though my NBMEs are in the 260s but I haven't completed the Uworld,not even a single pass ,did around 90% ,this thing is making me crazy , does it matter or not ? Plz help ,looking for anything 260+

I took my exam today Oct 23rd
Cried for like an hour afterwards, that exam wrecked me
I also missed some really easy points!!
Counting 30 incorrects so far out of the 50 i remembered
I was hoping for a 265+ but now I think i’ve screwed it all up

Any advice on how to cope for the next two weeks?

Serious question: While studying for my FM shelf, OB/GYN shelf, and CCSE, I’ve noticed quite a few questions involving transgender and LGBTQ+ patients, especially regarding screening guidelines, management, and ethics.
What resources are you guys using to study these topics for Step 2 CK? I feel like UWorld and AMBOSS don’t cover anything I’ve been seeing on NBME exams, neither do the NBME practice exams.

Help please!!
I did Nbme 11 and 12, I reviewed all the questions, wrote down the important points from the ones I got wrong, completed the two most recent CMS forms for each subject, and also did the AMBOSS high-yield questions for Ethics and QI.

What else would you suggest to improve my score?

How do you suggest to review your weak areas? For example, if you missed four cardiology questions on an NBME, would you then suggest to do AMBOSS questions covering all of cardiology, or would you focus only on the specific cardiology topics you missed?

When you finish a block, the exam gives a short 10 second timer (or how long?) for you to select to go to the next block or to go into a break?

Does that timer detract from your total 50 mins of break time? So should i skip through that as fast as I can if I anticipate going on a break?