Should I Complete Self-Assessment Examinations Prior To Taking USMLE® Step 2 CK or COMLEX® Step 2?

Should I Complete Self-Assessment Examinations Prior To Taking USMLE® Step 2 CK or COMLEX® Step 2?

Steve Leslie, MD; Associate Professor, Division of Urology, Creighton University

I write the best-selling board review book in urology, I was the founding editor in chief of eMedicine - Urology, and I am a regular contributor to the StatPearls database of questions and articles. Over the last forty years, I have had the privilege of mentoring thousands of medical students and residents. 

Sadly, I see many of them making the same mistakes. I wish that I could get to all of them early in their 3rd year, instead of when in their 4th-year elective they realize they want to become a urologist but don’t have the USMLE® Step 1 or USMLE® Step 2 CK scores to earn a training slot. The most common mistake I see is the failure to prepare for the USMLE® Step 2 CK early, attempting to cram months of study into a few weeks.

I recommend all students start studying for the USMLE® Step 2 CK on the first day of their clinical rotations. I recommend the entire third year of training includes at least 30 minutes a day of random practice questions on all topics found on USMLE® Step 2 Ck, and then 2 hours of practice questions daily focused on the clerkship rotation you are completing. In addition, I believe the Self-Assessments should be part of every student's armamentarium.

In my opinion, the NBME®️ or NBOME®️ Self-Assessments are a great way to evaluate your progress in preparing for the USMLE® Step 2 CK or COMLEX. I recommend my students take a baseline test before they start studying for the USMLE® or COMLEX® Steps.

Each student studying for USMLE® Step 1, USMLE® Step 2 CK, or USMLE® Step 3 will be eligible to take a practice exam at the Prometric test center once they have received their scheduling permit. The system only allows you to take one practice exam per registration.  The practice USMLE® Step exams provide an opportunity to become familiar with the USMLE® test format and the test center. They may not be the best predictor of USMLE® Step performance.

In addition to doing an official practice exam at the testing center, I recommend students take several NBME®️ or NBOME®️ Subject examinations, and the NBME®️ USMLE® or NBOME®️ COMLEX® practice exams. The NBME®️ and NBOME®️ Self-Assessment includes in-depth answer explanations. You can evaluate your potential mistakes, learn the rationale for the correct answer, reinforce your knowledge, and maximize your study time by focusing on your weaknesses.

I suggest to my students that they space out the NBMEs or NBOMEs every 2-4 weeks. Make sure you review each question you missed and be able to explain why the answer is correct. Taking a practice NBME®️ Self-assessment every few weeks allows you to replicate the real-time USMLE® exam and will help you become more confident and proficient in test-taking. 

NBME®️ and NBOME®️ Self-assessments are web-based. They have assessments available for USMLE® Step 1-3 or COMLEX® 1-3. Your self-assessment score will approximate your USMLE® or COMLEX® score.

The USMLE® or COMLEX® offers three self-assessments: Comprehensive Basic Science Self-Assessment, Comprehensive Clinical Science Self-Assessment, and Comprehensive Clinical Medicine Self-Assessment. For those that have the time, and money, consider also completing the NBME®️ Clinical Science Mastery Series in clinical neurology, emergency medicine, family medicine, internal medicine, obstetrics and gynecology, pediatrics, psychiatry, and surgery.

Each Comprehensive Self-Assessment and Clinical Science Mastery Series includes:

  • An assessment score, using the same scale as on USMLE® or COMLEX® 
  • Performance explanations similar to the USMLE® or COMLEX® Score Report
  • Diagnostic feedback on strengths and weaknesses relative to overall performance compared to others that completed the same assessment
  • The ability to review the correct answer
  • Longitudinal feedback when multiple assessments are completed

Current pricing for Comprehensive Self-Assessments is $60 each, and Clinical Mastery Series are $20 each.

In addition to completing practice exams through the USMLE, COMLEX, NBME, and NBOME, I recommend doing similar assessments through one of the many online databases. Try to locate a system that has the most questions with solid explanations and links to full-text articles. Most databases have 3,000 to 4,000 USMLE® Step 2 CK or COMLEX® Step 2 questions. This is probably not enough. The students that I mentor that score in the top 10 percentile on the USMLE® Step 2 CK typically do over 10,000 practice questions and then repeat the questions they miss. I recommend either purchasing several of the following databases such as Kaplan, UWorld, BoardVitals, Ambrose, and TrueLearn; or purchasing a single comprehensive database of 18,000 questions, with teaching points and articles from StatPearls.

Yes, it takes at least 12 months to get through all the questions needed to score well on USMLE® Step 2 CK or COMLEX® Step 2, but I find the students I mentor that start a consistent study plan at the beginning of their 3rd year of medical school and then study daily for a month before the USMLE® Step 2 CK or COMLEX® Step 2, achieve the highest scores. Don’t forget to take notes and review the points you miss. Repeat any question you miss at least three times so that you know you have it corrected in your memory.

Students I mentor are usually trying to match in general surgery or urology. It is a tough match. But those with a consistent long-term work ethic virtually always outperform those that procrastinate.

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