First Aid For The USMLE Step 2 CK

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First Aid For The USMLE Step 2 CK, medyczny

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INTRODUCTION
The United States Medical Licensing Examination (USMLE) Step 2 allows
you to pull together your clinical experience on the wards with the numerous
“factoids” and classical disease presentations that you have memorized over
the years. Whereas Step 1 stresses basic disease mechanisms and principles,
Step 2 places more emphasis on clinical diagnosis and management, disease
pathogenesis, and preventive medicine.
The Step 2 exam is now composed of two parts:
■
The Step 2 Clinical Knowledge examination (Step 2 CK)
The Step 2 Clinical Skills examination (Step 2 CS)
■
The USMLE Step 2 CK is the second of three examinations that you must
pass in order to become a licensed physician in the United States. The com-
puterized Step 2 CK is a one-day (nine-hour) multiple-choice exam.
Students are also required to take the Step 2 CS, which is a one-day live
exam in which students examine 12 standardized patients. The goal of the
Step 2 CS is to ensure that students from more than 1600 medical schools
worldwide, with varying curricula and educational standards, can collect and
interpret a history, perform a physical exam, and communicate with patients
at a comparable level. For more information on this examination, please refer
to
First Aid for the USMLE Step 2 CS.
Information about the Step 2 CS for-
mat and about eligibility, registration, and scoring can be found at
www.nbme.org.
The information found in this section as well as in the remainder of the
book will address only the Step 2 CK.
USMLE STEP 2 CK—COMPUTER-BASED TESTING BASICS
How Will the CBT Be Structured?
The goal of the Step 2 CK is to
apply your knowledge of
medical facts to clinical
scenarios you may encounter
as a resident.
The Step 2 CK is a computer-based test (CBT) administered by Prometric,
Inc. It is a one-day exam with 368 questions divided into eight 60-minute
blocks of 46 questions each. A new form of testing software called
FRED
is
now being used by the USMLE. FRED is different from the Step 1 exam you
took in that you can now
highlight
and
strike out
test choices as well as make
brief notes
to yourself. During the time allotted for each block, the examinee
can answer test questions in any order as well as review responses and change
answers just as in the Step 1 exam—but examinees cannot go back and
change answers from previous blocks. Once an examinee finishes a block, he
or she must click on a screen icon to continue to the next block. Time not
used during a testing block will be added to your overall break time, but it
cannot be used to complete other testing blocks. Expect to spend up to nine
hours at the test center.
Testing Conditions: What Will the CBT Be Like?
Even if you’re familiar with CBT and the Prometric test centers, FRED is a
new testing format that you should access from the USMLE CD-ROM or
Web site (www.usmle.org) and try out prior to the exam.
If you familiarize yourself with the FRED testing interface ahead of time,
you can skip the 15-minute tutorial offered on exam day and add those min-
utes to your allotted break time of 45 minutes.
2
For security reasons, examinees are not allowed to bring personal elec-
tronic equipment into the testing area—which means that digital watches,
watches with computer communication and/or memory capability, cellular
telephones, and electronic paging devices are all prohibited. Food and bever-
ages are prohibited as well. Examinees are given laminated writing surfaces
for note taking, but these must be returned after the examination. The testing
centers are monitored by audio and video surveillance equipment.
You should become familiar with a typical question screen (see Figure
1-1). A window to the left displays all the questions in the block and shows you
the unanswered questions (marked with an “i”). Some questions will contain
figures or color illustrations adjacent to the question. Although the contrast
and brightness of the screen can be adjusted, there are no other ways to ma-
nipulate the picture (e.g., zooming, panning). Larger images are accessed
with an
“exhibit”
button. The examinee can also call up a window displaying
normal
lab values.
You may
mark
questions to review at a later time by click-
ing the check mark at the top of the screen. The
annotation
feature functions
like the provided erasable dry boards and allows you to jot down notes during
Annotate
Highlight and
strike-
through
Time
status
Mark
question
Lab
values
Exit
Highlighting
Marked
question
Annotated
question
Strike-through
Incomplete
question
FIGURE 1-1.
Typical FRED Question Screen
3
Keyboard shortcuts:
A–E—Letter choices.
Enter or Spacebar—Move to
next question.
Esc—Exit pop-up Lab and
Exhibit windows.
Alt-T—Countdown timers
for current session and
overall test.
the exam. Play with the
highlighting/strike-out
and annotation feature with
the vignettes and multiple answers.
You should also do a few practice blocks to get a feel for which tools actu-
ally help you process questions more efficiently and accurately. If you find
that you are not using the marking, annotation, or highlighting tools, then
keyboard shortcuts
can save you time over using a mouse.
What Does the CBT Format Mean for Me?
The CBT format is the same format as that of the USMLE Step 1. If you are
uncomfortable with this testing format, spend some time playing with a Win-
dows-based system and pointing and clicking icons or buttons with a mouse.
The USMLE also offers an opportunity to take a simulated test, or practice
session, at a Prometric center. The session is divided into three one-hour
blocks of 50 test items each. The USMLE Step 2 CK sample test items (150
questions) that are available on the CD-ROM or on the USMLE Web site
(www.usmle.org) are the same as those used at CBT practice sessions.
No
new items will be presented.
The cost is about $42 for U.S. and Canadian
students but is higher for international students. The student receives a
printed percent-correct score after completing the session. No explanations of
questions are provided. You may register for a practice session online at
www.usmle.org.
How Do I Register to Take the Exam?
Information on Step 2 CK format, content, and registration requirements can
be found on the USMLE Web site. To register for the exam in the United
States and Canada, apply online at the National Board of Medical Examiners
(NBME) Web site (www.nbme.org). A printable version of the application is
also available on this site.
The preliminary registration process for the USMLE Step 2 CK is as fol-
lows:
■
Complete a registration form and send examination fees to the NBME
(online).
Select a three-month block in which you wish to be tested (e.g.,
June/July/August).
■
Attach a passport-type photo to your completed application form.
■
Complete a Certification of Identification and Authorization Form. This
must be signed by an official at your medical school (e.g., the registrar’s of-
fice) to verify your identity. This is a new form and is valid for five years, al-
lowing you to use only your USMLE identification number for future
transactions.
■
Send your certified application form to the NMBE for processing. (Appli-
cations may be submitted more than six months before the test date, but
examinees will not receive their scheduling permits until six months prior
to the eligibility period.)
■
The NBME will process your application within four to six weeks and will
send you a fluorescent orange slip of paper that will serve as your schedul-
ing permit.
■
Once you have received your orange scheduling permit, decide when and
where you would like to take the exam. For a list of Prometric locations
nearest you, visit www.prometric.com.
■
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