This is the fourth article in a series which describes the USMLE Journey of three friends from Al-Quds University, Palestine. They are – Amjad Elmashala, Kinana Abu-Rayyan, and Mohammad Adawi. Below are the links to all the articles in this series –

  1. Amjad Elmashala (Step 1 Score 269)
  2. Kinana Abu-Rayyan (Step 1 Score – 257)
  3. Step 1 Success Story – Dr. Mohammad Adawi (Step 1 Score – 259)
  4. Step 2 CK 265 Plus – The Exam Experience of Three Friends (Combined Step 2 CK Experience)


Part 4

Step 2 CK 265 Plus – The Exam Experience of Three Friends


Hi all, we – Amjad Elmashala, Kinana Abu-Rayyan, Mohammad Adawi – are fresh graduates of Al-Quds University- Palestine / class of 2016. We took our exam nearly in the same period and got our results on the same day, so we have decided to share one experience since we did pretty much the same with a few differences. We all started preparing for the USMLE by preparing for the Step 1 exam in the beginning of our internship year.



USMLE scores

Amjad: 272 (step 1: 269, CS passed)

Kinana: 271 (step 1: 257, CS passed)

Mohammad: 267 (step 1: 259, CS not done yet)




Amjad Kinana Mohammad
NBME 4Not done273Offline (10 mistakes)
NBME 6Offline (11 mistakes)262Offline (8 mistakes)
NBME 7247244252
UWSA 1272281281
UWSA 2261270262



Preparation duration

It took us 3.5 – 5 months to prepare for the step 2 CK exam.


Studying hours per day

We initially studied for an average of 4-6 hours per day. Towards the end of our preparation period, we dedicated an average of 8-14 hours per day. All of us were doing our internships during the preparation and we did not take time off except when we traveled to the Prometric center in Amman to sit for the exam.


Image - Quote



UWorld for step 2: It was our ultimate resource. Our goal was to master UWorld as we were all sure that it will be our only friend during the exam! We all did it topic wise once offline over 1.5-2 months during which we took extensive notes, then registered for the online version for one month and did it randomly. Our cumulative performance was in the 99th percentile and we got 95-97% correct questions. Each of us revised the notes 2-3 times.


Books (Kaplan & MTB): We did not rely much on books for many reasons. All three of us were in the top 10% of our class as we studied very well during our clinical rotations. As for MTB, one of us skimmed through it rapidly while the other two did not touch it. As for Kaplan, we studied its books during college years (especially IM and OB/GYN). Amjad went through Kaplan OB/GYN once. We did not feel the need to spend much time on books since we were running out of time. However, our previous readings of Kaplan books during college definitely helped.


UWorld for step 3: We worked on our weak points with UWorld step 3. Amjad did not solve any step 3 questions, Kinana solved psychiatry and biostatistics and Mohammad solved psychiatry, behavioral science, biostatistics and OB/GYN. Our rationale here was to solve more questions for a given subject to be more confident during the exam.


CMS: Each of us tried to solve as many CMS questions as they can, knowing that CMS questions are written by the same people who write the real exam. Fields covered differ between the three of us since not all of us had enough time to continue the whole thing. All of us solved OB/GYN and psychiatry.


100 cases by Conrad Fischer: Not all of us did it because we all had gone through it while preparing for the step 1. It’s helpful especially for those with no prior step 1 experience.


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First Aid for step 1: The Psychiatry & Biostatistics chapters are very well presented in FA, and our step 1 notes were crucial to us, so we all decided to revisit our beloved FA. For those who are taking the step 2 CK prior to the step 1, we do highly recommend solving UWorld for the step 1 and reading FA for these two topics.


UpToDate: We used it whenever we felt the need to understand more about a certain topic. Amjad did not use UpToDate. The contribution of UpToDate, however, to our preparation was minimal.



Mohammad Adawi’s experienceImage-Profile Picture

As for step 2 CK, I started my preparation in the beginning of March 2017. I have read many experiences and found that all of them prioritize UWorld pretty much over everything else. Nearly all experiences mentioned that books are not that important for STEP 2 CK compared to step 1 for which FA was the Bible 😛

So, I have started my journey with step 2 CK first by skimming Kaplan and MTB, just to be safe, and then began solving UWorld offline, subject wise, with note taking which was time-consuming but for sure worthy –. This process took me about 2 months to completely and thoroughly go through it. After that I read the notes and took my first assessment, I did NBME 6 offline and got eight wrong questions.

After that, I subscribed for UWorld online. I started solving UWorld questions again, but this time it was in a random and timed mode. I solved 100-120 questions per day and took some additional notes. During this period, I took NBME 4 offline, which was harder than NBME-6. I, then, resumed solving UWorld questions and it took me 1 month to finish it. My overall performance was 97%.

After that, I had less than a month. I have decided to reread my notes, solve the remaining assessments, and maybe CMS questions whenever I had the time. So, I took NBME-7 online, and it really felt terrible since I found it very vague with many distractions, ended up with 252. I was frustrated because I made many silly mistakes and had no time to study anything new. However, I was a bit reassured since my friends did it too and had the same experience and bad performance – maybe it was viral 😅

I kept reading my notes and solving CMS questions. I solved all of them and finished reading my notes at the same time UWSA-1 was OK in terms of questions length, with some short questions and some long questions. It is not that hard and does not look like the real exam. I think it overpredicts your performance. UWSA 2 was much harder with very long questions and resembled the real exam much more than UWSA-1 – we all agreed upon this issue.

After being done with UWSAs, and getting decent scores, I thought that there is nothing much to do left. I solved FRED online and got 8 mistakes, 92%. And I solved behavioral, psychiatry, biostatistics and OB/GYN from step 3. I did them just because I had time, not because they are important, and honestly, I did not find them useful – too advanced for Step 2 CK.


Exam Day – I tried to sleep well before the exam since this was my mistake in Step 1. I went to bed at 9.30 but was not able to sleep until 12.00 a.m. and kept awake throughout the night. As I entered the exam room and started solving the questions, I felt they were very similar to UWorld style but they were much harder and with fewer clues. I took a break every 2 blocks initially and then after each block of the last three. I have stayed focused till the sixth block but after that – you know mental frying and fatigue kicked in. I managed to finish on time. I had extra 5-8 minutes on every block. After finishing the exam, I felt very happy since I did my best.

If I am going to give you an advice, it would be doing something for the behavioral. The questions were tricky.

I know I did not perform well on them as my performance was borderline.



Kinana’s experienceImage-Profile Picture

I started preparation in April after finishing my CS exam. I started by reading UWorld offline. I was slow in the beginning but then I became faster. I timed myself to get done with UWorld offline in 2 months. I didn’t take regular days off. I just had a break whenever I felt tired or had something to do. My plan was to do MTB with UWorld but when I did one of the chapters, I found that its content is much less than UWorld with insignificant additions. So, I decided to forget about it at that time. During that time, taking notes was time-consuming but, of course, worthy.

When I finished UWorld first time, I rapidly went through my notes over around 10 days, after which I subscribed for UWorld online for one month. I had to do a minimum of 80 questions a day randomly which was overwhelming to me but I managed to finish on time. During my second run, I had NBME 6 (6 weeks before exam) and NBME 4 (3 weeks before exam). Then, I went through my notes for the second time over 6 days and took NBME 7 (10 days before exam), I was disappointed by the results. My problem was that I ran out of time in 2 blocks and had to leave some questions unsolved. Two days later, I did FRED which was kind of easy with a few confusing questions. I also did CMS offline for psychiatry and OB/GYN. I wanted to do the whole thing but I was running out of time. Five days prior to the exam, I did both UWSA 1 & UWSA 2 together. My scores assured me that I was ready for the exam. In the last week before the exam, I did UWorld step 3 for Psychiatry and biostatistics. I also went rapidly through 100 cases by Conrad for ethics. I revised easily forgotten subjects like development charts, drugs of abuse and dementia subtypes.

On the night before the exam, I slept well and was not anxious since I went through such experience in step 1.

The exam day was very long and mentally exhausting. I took short breaks after each block. I had 3-5 minutes after each block, which was not enough to revise tagged questions. In most blocks, I did not revise anything. I was able to answer a maximum of 30 questions per block from my studying. For the remaining 10 questions, I had to think of logically and analyze before giving my best guess. My advice to you is to be as much relaxed during the exam as you can and get used to the USMLE pattern of questions. My impression after the exam was that I did not do very well and the exam was harder than I expected. For me, UWSA 2 was the most predictive of the real score.



Amjad’s experienceImage-Profile Picture

I resumed my journey with USMLE in the beginning of April when after I got back from my step 2 CS exam and took a two-week break. I did not feel the need to go back to books since I have studied Kaplan for IM and OB/GYN, first aid for surgery and the illustrated textbook of Pediatrics during my 6th year of medical school.

I began solving UWorld questions offline and took notes extensively as I went through. My performance was very good on most topics. This process took me a month and a half. Then I dedicated two days to refresh my memory with Kaplan OB/GYN. After that, I printed my notes and went through them once (two weeks) and took my first self-assessment (NBME 6).

I registered for the UWorld online for one month and was able to go through all of the questions randomly in 20 days (120 questions per day). My overall performance was 95%. I took NBME 7 online and got 247 … at this point, I was devastated! I had one month to go, so I revised my notes one more time over a period of 10 days, took the UWSA 1 & 2 on the same day, solved psychiatry, OB/GYN and half of IM CMS questions and took FRED self-assessment online. I went back to my FA and read Biostatistics, Psychiatry, and Microbiology (fungi and parasites only). I was planning on doing the step 3 questions for psychiatry, but as I read the first five questions, I knew that the exam will not ask questions like these.

My exam was on July 19th, so I took one week off of my internship and traveled to Jordan three days before the exam. I did not study as I wanted to not be mentally exhausted on the day of the exam. I slept well on the night of the exam and woke up a couple of times … but who wouldn’t, right? The questions on the exam were similar in difficulty level to UWSA 2 and definitely harder than UWorld and UWSA 1. On the first two block, I had +20 minutes extra to revise. As I was going through the exam, my performance was getting slower – with only 5 minutes remaining in the last block. I felt comfortable after the exam but knew that I did not perform well in behavioral and psychiatry (which I studied most) as this was reflected in my score report.


A frequently asked question


Do you think taking step 1 prior to step 2 CK is better, even after graduation?

Absolutely! We all agree that preparing for the step 1 before the step 2 CK has saved us a lot of time and, of course, has boosted our scores. It was very helpful especially for psychiatry, statistics and infectious (fungal and parasites). We do strongly advise doing step 1 before.






Mohammad Osama Adawi

Kinana Abu-rayyan

Amjad Elmashala




This article first appeared on Facebook. Published here with the permission from the authors.

Image designing by Arnab Mukherjee.



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