I wrote this post for Elite Medical Prep and you can find it on their blog.
The UWorld question bank is your best resource for achieving your dream Step 2CK score. I know, not exactly a hot take.
It tops the list of every blog post, YouTube video, or personal recommendation from medical students of yore telling you how to score well on Step 2CK for one simple reason…it works.
Why is it so beloved and trusted? Because it is extremely user friendly and takes all the work out of employing active learning strategies with a crazy busy schedule.
It excels as a preparatory tool because the question writers have mastered the language and feel of the USMLE style question. And after several thousand UWorld questions, I bet you won’t encounter many surprises come test day. Think of how good that will feel!
But chances are you already know it is a stellar resource. What you came here to learn is how to use this powerful tool to realize your full potential. Let's walk through the strategy for using UWorld as a primary study resource for Step 2CK starting from the beginning of your clinical years. We’ll cover how you might decide to spread out questions over the long term as well as how to approach shorter dedicated periods of study.
Before we get too far into it, I need to outline some of the features of the question bank.
Mobile app and web browser access. The fully functional mobile app that allows you to create and take practice blocks anywhere. You can also sign in from a web browser from any hospital workstation when you have some down time on rotations. One minute you’re falling asleep while retracting in the OR, and then all of a sudden, you’re crushing questions in the doctor’s lounge.
Flashcards with built in spaced repetition. Easily clip text and images into flash cards as you review topics and find your weak areas. It utilizes spaced repetition similar to that of applications like Anki. If you like making your own flash cards or just want to make sure you remember a few really tricky topics, you can do it right within the question bank.
Notebook. Lots of functionality here. You can build out a robust collection of notes on topics you find really challenging or particularly high yield. You have a place to store all those classic UWorld tables and advanced organizers for future use. In fact, you can link your notes that you take for Step 2CK to your Step 3 account. This is a pretty big deal. There is significant overlap in content between Step 2CK and Step 3, so Intern You will benefit from any notes you make as well. ***Of note, you can only link notes between active subscriptions. This means that as it stands currently, you would have to activate your Step 3 Qbank subscription before your Step 2CK subscription expires in order to have access. So, plan accordingly.
Shelf Mode. Switch between Step 2CK and Shelf Mode with a single click. Shelf Mode shuffles questions around to specific shelf exam topics that include more of the “nitty gritty” detailed questions you can expect to see on NBME shelf exams but that might be lower yield for Step 2CK. There will be some overlap between certain shelf exams (ie, certain trauma questions might appear in both surgery and emergency medicine shelf sections). Within Shelf Mode, you can further filter by system for targeted review as you rotate through different services (cards, nephrology, infectious disease, etc).
Performance breakdown. You will be able to see how well you’re doing in different disciplines, how long you spend on each question, as well as how you compare to other test takers. Individual questions also give feedback to let you know their relative difficulty.
LOTS of questions. There are new questions constantly being added to the question bank, so the numbers fluctuate a little, but in general there are 3700-4100 questions for you to learn from.
In a perfect “UWorld”
Forgive the pun.
Ideally you will be reading this prior to starting your clinical rotations, because I’m about to save you a lot of stress and headaches. If you’re discovering this a bit further down the road, you’ll still benefit going forward. As you already know, or will soon discover, gone are the days of luxurious afternoons spent reading, watching videos, and lazily eating flaming hot Cheetos with one hand while cranking through Anki cards with the other. The clinical phase of medical school makes you whittle down your studying time substantially, so you have to focus on what works. And what works are active study methods. Enter UWorld (and maybe Anki).
We know active study methods lead to improved exam performance and retention of information. Utilizing active recall (flash cards + question banks) will get you further than just reading alone. A commonly quoted article from Science showed taking a practice test improved learning more than rereading material four times over. Personally, I don’t need to see any data to believe that could be true. All this is to say, you can and should use UWorld as your main day to day resource during clinical rotations to prepare for Step 2CK.
- Plan to get through >80% of the questions for a given shelf exam (shouldn’t be more than 20 questions per day)
- Put on “Shelf mode” and make a couple of tutor mode practice blocks (between 5-20 questions)
- Work through tutor mode questions during down time in clinic or on the wards
- Finish extra questions and review missed and marked questions briefly in the evenings; create flashcards from these questions (in UWorld or with Anki)
- Complete larger timed blocks (40-80 questions) on the weekends to work on pacing (shoot for average of 90 seconds per question)
- Keep an eye on your performance in each discipline. Start saving tables, graphics, and even entire answer explanations in your UWorld notebook for future dedicated review and reference
This is the basic recipe for using UWorld during clerkships. I’ve written further about balancing clerkships and Step 2CK studying in separate post if you want to read more about that. If you aren’t able to get through every question during your rotation, don’t sweat it. Some rotations will be really busy, but the more you’re able to get through, the better.
Chipping away at questions daily keeps you sharp and helps you steadily build your fund of knowledge. Working on larger blocks on the weekends helps you train your approach to questions and makes sure you maintain the stamina required to do well on the shelf. As well as increase your capacity to hold your bladder for several hours in a row.
On the topic of making flashcards...spaced repetition is sort of like the holy grail of knowledge retention. And the biggest return on your investment occurs if you start early. It's certainly effective but making flash cards can be really painful. Especially if you try to make a flashcard for every single question (or even multiples per question). You only need to make flashcards for things you missed or found really difficult. And if that still feels like too much effort, do what I did and go find a premade Anki deck that was heavily sourced from UWorld questions. Instead of making your own cards, you can just search Anki for a card that corresponds to the question you missed. It may not have all of them, but it will significantly cut down on the number of cards you have to make on your own. Then you just keep reviewing them during down time on rotations.
Short term/Dedicated periods
Early in dedicated or just before dedicated starts:
These recommendations assume you have been staying diligent with your studies throughout your core clerkships. If you made it less than half-way through, then you may or may not want to reset the question bank at this point. Perhaps you’re just starting the question bank now. Reach out to us if you have questions about your specific situation.
- Clean up remaining questions from your first pass
- Work through your incorrect questions (don’t perseverate on these, you just want to quickly get through and see them again)
- Take UWorld Form 1 to establish a baseline of where you’re starting from
- Reset the question bank to begin your dedicated period
In the heart of dedicated:
The main focus of dedicated study periods is to cover lots of ground and pick up every single extra point you can. Its not a time to get lost in the weeds and waste an entire day reviewing niche topics.
Here’s a personal example of what I’m talking about here. I was really strong in the OB/GYN and Peds topics because I had those rotations near the end of my MS3 year. I got super good scores and it was fun to review because I was crushing practice questions and loved to review the nitty gritty stuff. But it would’ve taken me probably 10+ hours of studying to get 1-2 more questions right on the exam. I was already going to get the bulk of Peds and OB questions correct. Neuro was totally different story. 10 hours of Neuro review would get me 10’s of more questions on the exam because it was a weaker subject for me as a whole. Even though it was painful to study.
We want all the low hanging fruit and round out our understanding as a whole. So we need to make sure our use of UWorld reflects this mindset.
- Step up the number of questions per day (80-120 per day)
- Take practice blocks of undifferentiated topics
- It’s okay to supplement a few extra blocks in weak areas, but you want the authentic diversity of questions
- Let the percentage assigned to each question guide review
- If you miss a question that <35% of people get correct, then review it, learn what you can from the explanation, then move on. Spending tons of time on these types of topics are unlikely to yield a significant change in your score.
- If you miss a question that 35-69% of people get correct, this represents a good topic to review in a little extra depth. These would be higher yield topics for you.
- If you miss a question that >70% of people get correct, then you should definitely devote time to studying this area. You will get the most bang for your buck by covering this material.
- Keep an eye on your performance scores in each specialty as well as the disciplines
- Always do timed blocks
- Identify why you missed each question
- Pacing and problems with your approach are common reasons to miss questions, not just knowledge gaps
- Practice like you play. Start your study days around the same time you will be taking the exam.
- Build out your practice exams with extra UWorld blocks so you build up your stamina to be able to complete a 9 hour exam. And do it well.
- Keep doing your flash cards during dedicated, but don’t spend tons of time making new ones
- The real benefit of spaced repetition is over the long term, you wont benefit that much from newer cards because (hopefully) you will still remember them
- Get a mouse and practice highlighting within the question stem like you will on the real thing
Another common question is “how many times should I get through the question bank?” Honestly, if you make it through one full pass during your core rotations with a slow and methodical approach, you’ve already done a great job. If you’ve been utilizing the spaced repetition flashcards, then that’s even better. Any further questions beyond one full pass will be fantastic, but a complete second (or even third) pass of UWorld isn’t totally necessary. It is possible to get great scores with 1-1.5 passes.
Not everyone jives with flashcards or making extensive notes. The important thing is to consistently test your knowledge throughout the clinical years. UWorld makes it so easy to keep building your fund of knowledge by taking the guesswork out of studying and consistently putting high yield information in front of you. Not just for Step 2CK, but for clerkships as well.