Questions about Step II

While I was studying for Step I, I was wishing that I hadn’t been afraid of the exam and had studied/reviewed some first year material in First Aid last summer. Using First Aid during second year was really helpful.
With that in mind, I want to start thinking about Step II now. What is/are good book(s) to use in third year to help keep me focused on the important test material? I know that third year is about a lot more than getting ready for Step II, but I now that 13 months from know I will literally be sitting in the same room again for the next exam.
Should I keep any of my materials that I used for Step I? In particular, I was wondering if I would use resources such as Microcards, Pharmcards, BRS Physiology, or BRS Pathology again, either for the wards or Step II?

Hi Tara,
You can toss the USMLE Step I stuff or better yet, pass is to some rising second year student who will need the stuff. Your best prep for USMLE Step II are your shelf exams especially Internal Medicine.
Depending on how your schedule is arranged, the closer you take this exam to finishing your Internal Medicine clerkship the easier for you. I did Internal Medicine last so it was very easy for me to review a little Peds and OB-Gyn and take the exam.
The best advise that I can give you for USMLE Step II is to get a good nights sleep for this exam. It has 400 questions and you really get exausted just reading the material. The question are very straightforward and are not convoluted at all. The scenarios are just very long. Often I just had to go back and figure out what they wanted me to glean for the jumble of lab results. Needless to say, Endocrinology, Pulmonology, cardiology, rheumatology, infectious diseses and gastroenterology are all well represented.
I found the General surgery much easier than the Surgery Shelf exam! THe surgery was stuff like trauma, acute abdomen (peptic ulcer), cholecystitis, choledocholithiasis and pancreatitis.
The OB-Gyn was failure to progress during labor. I only had one OB-Gyn case. The psychiatry was very easy to figure out. If you keep one book from USMLE, keep the Behavioral Science book. Peds was all about immunizations and developmental milestones. There was one case about child abuse.
Go though your clinical clerkships over the next year and study for your shelf exams. When you are done with third year, spend a couple of weeks reviewing Internal Medicine and take that test. I recommend taking Step II as soon as you can because the further you get away from third year, the more you forget.
I did Radiology as my first elective during fourth year. Everyday, we were done by 10AM so I could spend the rest of the day reviewing medicine and neurology (not much on the exam but this stuff ran out of my head the fastest). No matter what you decide to do in medicine, radiology will make you a good intern. I took Step II in September. I was very disappointed with Q-Bank for Step II. We got three months free at Howard and I stopped using it after one week. It just wasn’t doing much for me. Turns out that I made a good decision.
All of the top ten places that I interviewed, Hopkins, Mayo, Mass General and UVa (remember, I interviewed for Anesthesia) asked me if I had taken Step II. It was good to be able to answer that question in the affirmative.
I was also able to score 20 points higher on Step II than on Step I with far less prep. Again, I thought Step II was more grueling than Step I but I really did phenomenally well on Step II. I couldn’t believe my score when I saw it because I came out of the test center exhaused. I was too tired to over-read the questions so I think that was the key to my good score. I also was very tight in Internal Medicine especially the rheumatology and hematology/oncology stuff. I was fresh from the trenches and I had done my third-year medicine at Inova Fairfax (one of the outstanding places to rotate for Internal Medicine).
Anyway, I know that this reply is convoluted but don’t get excited over Step II. It is so much less menacing than Step I and I am willing to bet that you ace it with no trouble.
P.S. My experience with shelf exams: Arranged from most difficult to easiest. Most difficult: Family Practice, Internal Medicine, Pediatrics Moderately difficult: General Surgery Not difficult and downright easy: OB-Gyn, Psychiatry. Most of my classmates thought General Surgery was very difficult. In terms of failure, most people failed the Internal Medicine, Surgery and Family Practice exams. No-one failed Psychiatry.

Hi there,
Good books for shelf exams and clinical rotations:
Internal Medicine: MKSAP for Medical Students - these exams will kick your butt but you really learn good stuff. Baby Cecil’s or Cecil’s Essentials of Internal Medicine.
Family Practice: Swanson’s
Pediatrics: Baby Nelson’s (Essentials of Pediatrics)
OB-Gyn: BRS Obstetrics and Gynecology and BluePrints for OB-Gyn.
General Surgery: Lawrence: General Surgery Lawrence: Surgical Specialties and Mont Reid.
Psychiatry: On-Call Psychiatry
My order of clerkships: Pediatrics(Howard University Hospital and Childrens Hospital National Medical Center), Family Practice (Providence Hospital and Georgetown Family Practice Center in Ft. Washington), Surgery(Howard University Hospital), OB-Gyn (Howard University Hospital and Prince Georges General Hospital), Medicine (Howard University Hospital, Inova Fairfax Hospital, Bread for the City Free Clinic). Neurology/Neurosurgery(Howard University Hospital and Inova Fairfax Hospital).
I spent the first two weeks of my month in Radiology studing for Step II and took it first week in September. (Our third year runs through the second week of August).
I didn’t know that wanted to do Surgery until I did the rotation. I was initially leaning towards Pediatrics and stayed on course for Peds until I did Surgery in the middle of the winter. It turned out to be a great schedule me.
Lots of people say not to do your rotations in what you want to do first but order of third year does not make much difference and I did not have a choice. At Howard, we are assigned to groups randomly.
Just some thoughts if you have a choice about third year.


Thanks for the replies. I actually heard your voice in my head today during Step I, reminding me to stay calm and read all of the answers.

I have Peds, OB and IM as my last three rotations of thrid year, and from what you say this is a good thing. My scholarship requires that I take Step II no later than September 15th. I assume this is so that they have our scores when the board meets in late Nov/early Dec.

I will definitely look into those books for my rotations. Is First Aid for Step II the bible like it is for Step I? Just curious.

Thanks again for all of the advice.



Is First Aid for Step II the bible like it is for Step I? Just curious.


Hi Tara,

I was not too impressed with First Aid for Step II. This book might have changed drastically since I took Step II so it might be much better at this point. Since the First Aid folks are so responsive to public opinion, I would almost bet that this book has greatly improved since 2001.

I did love First Aid for the Wards. There is lots of great information in this book so add it to my list above. It is very informative in terms of telling you the important student duties and information to study and learn. Another great book called “How to Be a Truly Excellent Junior Medical Student”. This last book costs about $7 and is great for navigating you through third year. The last book is a pocket book that will keep on point during third year. Enjoy!


I read USMLE II Secrets twice (very easy read) and did the Q-bank with Kaplan and aced the boards. If you know the concepts and how they ask the questions (Kaplan) you will do wonderful. I wish I would have done that for the first one (didn’t do as well).