USMLE Step 1 Preparation Tips

The Step 1 Board Exam is a cumulative test of the preclinical period of medical school. The test is eight hours long, which includes seven 60-minute sections of 46 questions each for a total of 322 questions and a 45-minute break to be used between sections. 

Vanderbilt medical students have consistently done very well on this exam. Do not feel the need to study for this exam during your preclinical period. Focusing on your coursework is all you need to do. The Vanderbilt Wellness Committee will guide you through this process with a handbook describing all you need to know, and by hosting the annual Boards Bash.


USMLE Step 2

You must sit for the Step 2 CK and CS exams by February 1st of your 4th year/final year of medical school in order to be eligible for graduation.  


This examination costs around $605 (2017). Dean Fleming will probably encourage you to take Step 2 CK early in the fourth year. The good things about taking it early are: you’re closest to the third-year clerkships, it could theoretically help you if you do well, and you can just get it out of the way and relax. The bad things are: it could theoretically hurt you if you do badly, and you may not have time to study much. Spend about 2 weeks reading First Aid and going through the NMS questions. You will register for a 3 month window in which you can take the test. If you are worried about your decision on when to take the exam speak with Dean Fleming for advice. Step 2 CK has 8 sections, 46 questions per section, and is definitely not as grueling as Step 1. It is zebra oriented, however, and be prepared to have lots of questions that you have no idea on. Be advised that some programs are now wanting to see your Step 2 scores prior to giving out interviews and many require prior to the Rank List deadline. You can look at the data on the Program Directors Survey from NRMP


This portion of Step 2 costs around $1280 (2017). It is offered in 5 different cities (Atlanta, Philadelphia, LA, Houston, and Chicago). You have to pay for transportation and lodging. Even if you take it late, schedule it early (months and months in advance). You have a one year window from the time you register to take the test. It lasts from about 8am-4pm, and there are 11-12 patient encounters. Lunch will be provided. Step 2 CS uses standardized patients to test medical students and graduates on their ability to gather information from patients, perform physical examinations, and communicate their findings to patients and colleagues.

If you have not seen Dr. Yakes' presentation about how to prepare for Step 2 CS please review the link below.

Download: Dr. Beth Ann Yakes' Step 2 CS PowerPoint Presentation

Remember you will have a lot going on from October through January of your 4th year. Adding in Step 2 CK and CS during this time has often resulted in overlap between testing dates and interviews. This is stressful.

You should take both of these exams seriously. While they are less grueling than Step 1 and our students are very well prepared for these examinations, failing to pass is a major issue. If you have any questions or concerns reach out to Dean Fleming.