You’re Likely Using USMLE World for Step 2 CK Wrong, and It’s Costing You a Lot of Points

At this point, it’s pretty darn unanimous that USMLE World is the best question bank out there, and for good reason. It has realistic questions, it’s updated constantly, and it has detailed answers that cover a large breadth of information. For this reason, people often correlate higher UWorld %s with higher USMLE scores and do the question bank multiple times. They have even gone so far as to make a correlation list online about what score you can expect depending on your UWorld %.

While I can see why this logic is so alluring, it is that same allure that makes it so dangerous.

USMLE World is not only a fantastic question bank; it is also a fairly exhaustive and complex USMLE textbook, and if you do not respect both aspects of it, you will be leaving precious points on the table. The amount of information it includes is astonishing and often goes far beyond what most people would expect.

To understand how to use USMLE World to maximum effect, we must understand the fundamentals of why a textbook and question bank is useful in the first place.

Textbooks are useful for exams because they give you both the breadth and depth of knowledge to tackle any situation a question writer could throw at you. No matter how much a question is manipulated, it cannot deviate from the source material it is based off of. For that reason, someone with a full understanding of that material should be able to think their way out of any question.

USMLE World tends to have the information in a similar amount of breadth and depth needed for USMLE and repeats information in direct correlation with the likelihood of it being seen on exam day (with some exceptions of course). If a topic comes up six times in a section, then it is extremely likely to be seen on exam day, while ones coming up only once or twice are less likely.

However, the downside of UWorld being a question bank rather than a textbook is that the information is often segmented into multiple questions (work-up in one and treatment in another), preventing you from getting the complete picture needed to answer increasingly complex USMLE questions.

For memory and learning reasons, which I will go into in future articles, USMLE World should ALWAYS be done by section — Cardio, GI, etc.

Basically, if you see two questions with different parts of the same topic, but they are too far apart, then you are unlikely to remember to correlate them.

Second, you have to read and understand the ENTIRE answer, as you will find incorrect answers are often summaries of high-yield answers to other questions.

So while there may only be six questions on pneumonia, there may be fifteen with correlated wrong answers that are actually high-yield summaries of the information in the six original pneumonia questions, which will go even further in reinforcing that high-yield topic.

With all of that said, it is important to keep in mind that while USMLE World is an exhaustive USMLE textbook (and admittedly it goes overboard at times), it is also complex, meaning it has a fairly high level of assumed knowledge.

If you go into it with a lack of fundamentals, you will find that you miss the nuances needed for higher scores because you are spending significant time piecing together the big picture.

USMLE World is not a great resource for the basics, because its information is both fragmented through questions and also explained in a way that will be lost on those lacking in fundamentals. You could go through the Qbank multiple times getting the big picture first, but this is extremely inefficient and often difficult to do.

Step 2CK asks question in an algorithmic way. Unlike many Step 1 questions, your thinking cannot be linear; rather, your thinking should be dynamic, since answers change depending on the patient presented.

After going through nearly every CK resource there is, one stood above the rest for both simplicity and the way it taught its lessons using algorithms. For that reason, I recommend you review Online Med Ed before you do the corresponding section of USMLE World. Depending on how solid your fundamentals are, this may be a quick review or may take more time.

While not all lectures are as high yield as others, if you lack the fundamentals taught there then you will have a lot of trouble on Step 2 CK. If you do not have the time to do the entire thing, which is understandable, then you should focus on the ones with algorithms written in them or the sections that correlate to repeated USMLE World questions / high yield shelf topics.

Now back to our original position that USMLE World is an excellent Qbank, which it is, but it is important to ask ourselves why having a realistic Qbank is so important. The obvious reason is to maximize our chances of recognizing the way in which examiners like to ask USMLE questions.

Okay, but how best do we do that? Many would argue that you do that by simulating the test itself, doing it on random and timed, and then reviewing it later, but they are missing a key point about learning.

Imagine if you were learning a language and there were two learning options. One would have you go out for eight hours speaking the language, unaware of your mistakes, and record you. Then you would come back, look at the mistakes with the corrections, and try to remember not to make them next time.

The other would give you live feedback every time you made a mistake and explain how to do it properly on the spot, so when it came up again that day, you would remember not to make it or get the same feedback until you got it correct. Which one do you think would lead to more efficient learning of that language?

If you complete a large group of questions without knowing if they were right or wrong, then you are missing out on a key opportunity to get immediate feedback into your thought process when answering a question. If you go through too many questions at once on timed mode, you miss out on knowing if your thinking was correct, both because you do not know immediately if you got the question right or wrong, and because you’ve now gone through so many questions that when you come back to review them you may have forgotten WHY you picked or did not pick an answer in the first place.

For reasons I will go into in more detail in later articles, all questions should be done on tutor mode, giving yourself one minute per question and then reviewing after every 10 – 15 questions. Through this method, you are given immediate feedback on whether or not your thought process was correct or incorrect on a particular question (because you see the answer immediately), you know exactly what you were thinking when you review it (since you answered it 10- 15 minutes ago), and it allows you to learn information and then solidify it with later questions because the high yield questions repeat so frequently.

For now, some of this advice may seem radical, but as I delve into the learning process you’ll understand more fully. Right now, just trust me that this is how you maximize USMLE World.

This is how I was able to score over 260 on nearly every CK NBME and on the real thing, and this is how you will maximize USMLE World and, more importantly, your USMLE score.