This detailed week-to-week study guide is focused towards students who have completed their
third-year clerkships and taken NBME-style shelf exams throughout the year. For these
students, hopefully you have gotten through a majority of the UWorld question bank already. I
would recommend resetting your bank to start fresh when your dedicated Step 2 studying starts.
For students whose schools do not follow this third-year model, are international medical
graduates, or are non-traditional, this schedule will likely need to be adapted to allow for more
content review and learning. This may involve spreading out practice questions and going at a
slower rate, while also incorporating online video resources or more focused practice.
If you want personalized help on your Step 2 studying, check out our Step 2 coaching page .
Necessary Study Materials
UWorld question bank
o The gold-standard set of practice questions that has been proven for years. This
bank is updated annually and contains a comprehensive set of questions
covering the full set of content on the exam. Its explanations are very thorough
and make for an excellent source of learning.
The error log app
o Reviewing exams is essential to improvement. Having a systematic method for
review will go a long way in identifying gaps in your knowledge and recurrent
logical fallacies that may be forcing you to fall victim to tricky, nuanced questions.
CCSSA NBME practice exams 9-14
o NBME practice exams are the gold-standard for evaluating where you are at.
These are written by the test-writers themselves. Some forms are widely thought
to be more accurate than others, but overall, all six forms are highly
representative and useful.
UWorld self-assessments 1-3
o While these assessments are not as representative as the CCSSAs, and
question stems may appear longer or more detailed, these three forms are still
useful. They are a great way to evaluate your test strategy and level of content
knowledge.
Amboss reference library
o The Step 2 exam is content heavy. Test taking strategies are important, but you
will not find success unless you know the content. Once you identify the broader
categories of content where you are weak, the Amboss library is a great resource
to learn this content and quiz yourself in a focused manner. Furthermore,
searching terms and concepts on Amboss is far more efficient than Googling.
Amboss will provide you focused information specific to the NBME. If you are
confused about a particular topic, search it on the Amboss library and read
through its respective article. This will save time and ensure you are getting the
most relevant, high-yield information. One excellent tip is to turn on the
highlighting feature, which will further bring your attention to the most important
parts of the article.
Anki
o If you have kept up with Anki throughout third year, it is worthwhile to continue.
This avoids the curve of forgetting and helps you stay on top of material you are
struggling to retain. Further, it is a great place to add in new content gaps that
you identify or keep track of things you have learned from practice exams and
UWorld sets.
Amboss question bank (optional)
o Students are recognizing that Amboss has better kept up with the latest changes
to Step 2, and its platform is more user-friendly and interactive. If you have
already completed the full UWorld bank, perhaps this will be more useful than a
reset of UWorld so you can see new questions. Certain topics like evidence-
based medicine, biostatistics, and ethics are well covered by Amboss as well.
NBME shelf practice exams (optional)
o The NBME shelf practice exams are written by the test-writer and hence are
highly representative of the real deal. Further, many shelf questions are actually
drawn from old Step 2 forms- which is how the “shelf” got its name! If you have
time, it can be helpful to do these forms for targeted, subject-specific practice
using NBME-style questions.
Week 1
Purchase and take the NBME CCSSA 9 form
o Review test results while filling out the error log
o Identify key weaknesses: Are there certain subjects that you particularly
struggled on? Which clerkship shelf exams did you take early in third-year and
have likely forgotten by now? Are there certain subspecialties within internal
medicine that you did not see during your rotations and find to be especially
difficult?
These weaknesses will be key to work on during your “focused” 40
UWorld questions each day
o Real test taking- no unscheduled breaks, no notes, quiet environment.
o Simulate test day as much as possible
Daily UWorld (120 questions)
o 2 sets of 40 (random)
o 1 set of 40 (focused)
o Doing 120 questions daily (other than practice exam completion & review days)
for 6 weeks should allow you to easily finish the question bank, with some wiggle
room
Anki (30-60 minutes)
o Anki is useful if you have kept up with it throughout third year. If you have not,
now is not the time to start.
o I would limit time spent on Anki each day. At this point, you have already learned
the material once during clerkships, and your goal now should be to recall that
material, and more importantly, apply it to confusing and complex NBME
questions. Therefore, Anki has a limited purpose in ensuring that you are not
forgetting key concepts. However, once you have gotten several weeks into Step
2 dedicated, and hence have seen most of the material again, there is likely
limited benefit to devoting large amounts of time to Anki reviews.
Weeks 2 – 5
Daily UWorld (120 questions)
o 2 sets of 40 (random)
o 1 set of 40 (focused)
o Incorrects and flagged questions: you should begin maintaining a list of “big
picture categories” that each of these questions fits into. Then, you can identify
your weak points. For example, are you getting a large number of cardiology
questions wrong? If so, there may be value in reviewing that content (discussed
below).
o I would suggest making Anki cards for content that you have forgotten, but it is
important to limit the number of new cards you are making. Anki can be very
helpful, but can also become a hindrance if you are making hundreds of cards or
writing large paragraphs of information on cards. Limit yourself to 5-10 cards per
UWorld set, and keep it limited to high-yield, memorization-heavy material that
you are likely to see again.
o As you get further along in dedicated, you can begin reading UWorld
explanations more quickly. Chances are, you are getting better and recalling
more information. Over time, you can stop reading every answer choice
explanation and skip to the summary/key takeaways at the bottom. Efficiency is
important too!
Week 4: Amboss Health Policy, Biostatistics, and Ethics questions
o There are around 200 questions on Amboss for this category. These topics are
also covered in UWorld, but increased exposure to these topics is often helpful,
as these questions can often seem pesky and subjective for students. This set
should be quick to get through in a few days and can replace some UWorld sets
for those days.
Anki (30-60 minutes)
o I would reduce time spent on Anki as you get further and further along in your
dedicated period.
Practice exams
o There are 9 practice exams remaining (NBME 10-14, UWSA 1-3, Amboss SA)
o Taking 2 exams per week should allow you to finish on time
I would space these out (every 3 days) to avoid burnout, as doing a 150-
200 question practice exam gets tiring very quickly.
However, at least once during your study period, I encourage you to do
two exams back-to-back on the same day. Remember, the real test is up
to 318 questions. This is very tiring, and it is important to practice doing
that many questions to evaluate your own stamina. You can try doing one
NBME plus one Amboss (350 questions) or an NBME followed by 118
UWorld (318 questions) to replicate the real test day. Don’t stress about
doing this every single time you are taking a practice exam, because you
will quickly burnout.
o Each exam can be followed by one review day. How do you effectively review a
practice exam? You should have two goals: identifying content gaps, and
identifying gaps in your logic and reasoning. Start a spreadsheet to use as an
error log. Similar to what you were doing for UWorld reviews,
o Content gaps can be quickly addressed with Amboss. I would strongly suggest
that you avoid Google for any questions. Amboss is an excellent resource that
will provide you focused information specific to the NBME. If you are confused
about a particular topic, search it on the Amboss library and read through its
respective article. This will save time and ensure you are getting the most
relevant, high-yield information. One excellent tip is to turn on the highlighting
feature, which will further bring your attention to the most important parts of the
article.
o Logical gaps can only be addressed through thoughtful, honest reflection. Ask
yourself what you were thinking when you got a question wrong. Were you
anchoring on a specific word (symptom, exam finding, demographic) in the
question stem? Did you pick an incorrect answer choice because it was
something you had never heard of? Did you get overwhelmed by the length of
the question stem or the large number of answer choices?
o An excellent way to test yourself when reviewing exam questions is to read the
explanations for the incorrect answer choices. This will train your mind to
understand what the NBME was thinking when they wrote each of the answer
choices. When you are taking the exam, this is a profoundly valuable strategy.
When you are eliminating answer choices, ask what each choice is meant to
represent- especially on second- or third-order questions. Simple first-order
questions may have the actual diagnoses as answer choices- for example,
“tuberous sclerosis.” Harder, second- and third-order questions may require you
to go a step further- for example, asking you what else is associated with the
diagnosis- like “subependymal nodules.” To best answer these questions,
systematically look at each answer choice and ask yourself what it represents
when you’re stuck. If you can’t arrive at the diagnosis after simply reading the
question, work backwards. If you read “subependymal nodules” and recognize
that means “tuberous sclerosis,” something might click in your brain and help you
realize that was the diagnosis all along.
If you have additional weeks
Continue to work on UWorld if you have not finished
Amboss question bank: The Amboss question bank may not be the gold-standard, but it
is excellent. It’s questions are often more detailed and cover some new information
versus UWorld. However, some students feel that the question stems better represent
the real NBME. Additionally, its website is more user-friendly and interactive. I especially
like the feature where they highlight the key words of the question stem when reviewing
questions. This helps train your brain to identify the important parts of a wordy, complex
question stem when you are answering questions.
Amboss articles and focused practice: The Amboss library offers articles and specific
questions for each topic. For example, if you are especially struggling with sickle cell
disease, you can search that topic on the library. In addition to a thorough and focused
educational article, Amboss will provide you around 15-20 questions focused only on
sickle cell disease.
NBME Practice Shelf Exams: You have likely taken several practice shelf exams to
prepare for shelf exams throughout your third year. Remember this content is largely the
same as Step 2, and often the shelf questions are recycled from old Step 2 forms! In
fact, that’s how “shelf” historically got its name! If you have extra time, it can be
worthwhile to go back and do practice shelf forms that you may not have done
previously, or those that you really struggled with earlier in third year. This is a great way
to practice with the NBME test writing format, especially with its confusing and vague
question stems.
Final week
Daily UWorld (120 questions)
o 2 sets of 40 (random)
o 1 set of 40 (focused)
o Incorrects and flagged questions: you should begin maintaining a list of “big
picture categories” that each of these questions fits into. Then, you can identify
your weak points. For example, are you getting a large number of cardiology
questions wrong? If so, there may be value in reviewing that content (discussed
below).
Anki (30-60 minutes)
Your final practice exam
Day before the exam
Go to bed and wake up early– sleep two nights before an exam is as important or more
important than sleep immediately before
Don’t do anything more than a few minutes of Anki review or one set of UWorld. The
information is in your brain by now- stressing out to fit more in there will not help.
Relax, exercise, do whatever you do to stay calm. You’re almost done!
About the writer
Yash S. is a medical student with a longstanding interest in medical education. He has
tutored numerous students on standardized exams across the spectrum from SAT/ACT to
MCAT and USMLE. He scored 99th percentile on his own Step 2 exam.