STEP-2 EXAM
This is mostly clinical exam so do not expect much of mechanism of diseases and drugs but concentrate on
diagnosis and management.
COMPUTER BASED STEP-2, CBT
This is the experience from one of IMGs, who took it very recently and explains the facts..."I gave CBT and i felt it does not make any difference.I was able to complete the questions just in time. some are short and some are as long as the whole screen."
MCQs books- the book which i found closest to the exam was NMS. Swanson (family practice) is good. Other for practise harrison mcq ,southland tutorials.
50 % of question were from int. medicine. the rest was mixture of ped ,trauma,ortho ,opth,obg,surgery. the no of match the coloumns were quite a lot.the joices for one best answer for many questions were from a to g.
medicine-respiratory-ca lung and its complications and treatment,pneumonia,copd,pulmonary TE.
CVS- pericarditis,tamponade,one of MI,aortic dissection,MV prolapse.
breast malignancy,fibroadenoma.
CNS-syncope,tia,multiple sclerosis,neuropathy,headache types and its managment,lumbar disc prolapse.
blood-B12 def,ALL,Cml,blood trasfusion and complication.
SLE,dermatomyositis,gout,osteoarthritis.
endo-parathyroid,DM was asked quite alot and its complication and managment.
git-duodenal ulcer , alcohol related complications were quite a lot,angiodsyplasia,ibd,ca colon. pancreatitis ,antiobiotic associated colitis.
fluid and electrolyte as standard was asked quite a lot.
pediatrics-abuse,pku,alcohol teratoginicity,congenital heart dis., peds. ortho.
psychiatry-schizophrenia,drugs and its side effects,child psychiatry.
trauma was asked say around 20 questions.
ob/gyn-ovarian dz,preterm delivery,amenorrhea.
toxicology ,heat related disorder,substance abuse.
HIV and depending on CD4 count the prophylaxis ,anaphylaxis.
Just solve as many mcq as possible that really helps.
It is my impression too that the exam is easier now because lesser no. of questions, more time, less tiring, and just one day. good luck for bigger scores fellas!!!
First aid for step-2 has been recently published by DR.VIKAS BHUSHAN , who wrote for step-1 also. its a good book..
New Book , very highly recommended, "Prescription for the Boards, author.. FEIBUSCH and BREADER, publisher LIPPIN-COTT".. Try this book it is helpful......
Medical/Clinical Ethics books for STEP-2 and step-3
1. Clinical ethics : a practical approach to ethical decisions in clinical medicine by Albert R. Jonsen, Mark Siegler, William J. Winslade. ......
2. Practical ethics for students, interns and residents: a short reference manual by Charles Junkerman, MD and David Schiedermayer, MD. ..
1. MEDICINE: Washington manual/ NMS/ Med-study series booklets/ for reference read "Essentials of CECIL".
2. OB/GYN: Hecker Moore/ NMS.
3. PSYCHIATRY: Appleton-Lange (MCQs)/ for ref. NMS.
4. PEDIATRICS: Appleton-Lange (MCQs)/ for ref. NMS.
5. EPIDEMIOLOGY/PUBLIC HEALTH: NMS (Don’t do all the details just surf through)
6. SURGERY: Just do TRAUMA/ BURNS/ ORTHOPEDICS.
7. DERMATOLOGY: An Illustrated Text. (author… Gawkrodger, publisher.. Churchill Livingstone), excellent
book.
Plz. read the recent review about this book "FAMILY PRACTICE Review, problem oriented approach by RICHARD W. SWANSON" it was a good book 3 yrs ago when the author was alive but since then it has not been updatedd and 33% of information in this book is out dated. So it's not now the no.1 choice for MCQs practice any more. So it's upto you if you want this book or not........MCQs books:
CRASH THE BOARDS by Brochert (publisher, hanley and belfus)
1. Southland tutorials for step-2..
2. Pre-test series (subjective). pretest neurology is excellent.
3. NMS for step-2 (by Goljan....very important).
4. Appleton and Lange for step-2 (Catlin).
Exam format:
Day-1 book-A (no pictures just MCQs), book-B (has many x-rays and ct-scans)
Day-2 book-C (no pics), book-D (has many dermatology/hematology/pathology pictures).
1. Main question types were most probable diagnosis and most important next step of treatment.
2. Primary care physicians problem questions (medical ethics, drug abuse, medico-legal aspects)
3. Main stress on medicine especially CVS and endocrinology.
4. Always try to learn in a manner that you should be able to tell the next step of management because in most of
the questions the initial steps of management were given already. Best thing to learn is first step of management,
second step and third step.
5. Developmental pediatrics, geriatrics, old age amnesia/ fractures and normal old age changes.
6. Psychiatry, mainly schizophrenia and depression.
7. Very difficult x-rays and dermatology pictures so plz. do prepare these items specially.
8. Almost all questions of Ob/gyn were clinical vignette, problem based.
9. Surgery, only abdomen and trauma and neuro surgery. trauma management very important.
10. Treament of medical emergencies (toxicology, asthma, myocard. infarction, drug toxicities, environmental
injuries, anaphylaxis, diabetic ketoacidosis)
11. Acid-base balance read very carefully. The ionic differences, anion gap.
12. Many questions on AIDS treatment (based on CD4 cell count)and prognosis.
13. Many questions on clinical practice and preferred tests which should be done when a patient of specific age
arrives for routine physical check up.......
Topics on August 1998 step-2 exam
Dear Friends,
I did not take the exam but this is the feedback from my friends, who took
the exam. Most of the people found book-C very difficult and others found book-D very difficult. Well it is just a
matter of preparation. I would suggest you to prepare as good as you can because I do not expect any easy exam
from ECFMG.
1. Every possible drug and disease of psychiatry, Child abuse, Academic skill disorders, ADHD, Touretts d/o, Tics.
2. All STDs, abortion, cervical diseases, ABO incompatibility.
3. Drug abuse and withdrawal, intoxication.
4. CNS: headaches, syncopes, Eaton Lambert, Vision problems, amyotrophic lateral sclerosis, GB syndrome.
5. Respiratory: Pneumonias, occupational lung diseases
6. CVS: chest pain, HTN, arrythmias, aortic diseases.
7. Endo: Diabetes, Thyroid.
8. Blood: leukemia, anemia.
9. GIT: ulcers, diarrhea, ileus,
10. Others: Immunizations, nephritis, acid base disturbances, strpt./staph. infections, hip fractures/dislocation,
osteoporosis, myelitis.
Matching set questions were very long and difficult. Many questions on Urology (prostate) problems. Medical ethics questions were usual in number....
Generally the people are saying that it was a tough exam than March 1998 and the questions on treatment were
horrible. Most of questions were asking about the 3rd or even 4th step of treatment and the first two steps of
treatment were given in the questions.
Step-2 exam-March 1999 as told by examinees
A lot of internal medicine questions,trauma,calcium metabolism,a lot of x rays and some professional ophtalmology diagnostics. There were many questions from geriartric medicine.
advice from recent examinee..
1. cecil essentials plus NMS (med).
2. haker n moore plus BRS. (OB/GYN)
3. NMS peds (first 10 chapters only)
4. there were many questions from geriartric medicine. get a chapter of ger. med. photocopied from current medicine and from katzung pharmacology 6th ed.
5. psychiatry from goldman lnge series (section III only)
6. review of cram summaries of jawetz micro and pharma for bugs and drugs............
Note, all the booklets (ABCD)had 150 questions each. There were 2 EKG's in the booklet B, one of them was a post-MI EKG and the question was what do you use to treat the ventricular arrhythmia's in this case. x-rays in the booklet B were all chest x-rays and that was tough. it was about 5-8, one pediatric X-ray, with enlarged heart.
The majority of the questions were from internal medicine and gynecology - management questions-like intrapartum complications etc. of course other areas were also covered (psych, etc). Most of them were GI- like relating to the liver and pancreas/gallbladder/alcoholics etc. GI operations and complications etc. Acid base and electrolyte are also important. For example the changes with Conn's, Addisons etc.
ambigious question: question had the symptoms/signs you would find with vitamin A deficiency and we had do answer which vit overdose would produce those symptoms. That was quite strange. I didnt know what to answer. could it be a printing error?
Endocrine was also covered quite a bit. And Preventive/Behavioral. I dont remember any question on biostatistics-no 2x2 table
these were the reviews from the recent examinees friends, I hope it helps.........
Division of step-2 exam subject-wise:
1. Medicine is the key subject, 60-70% (CVS, CNS, Endo., infections, dermatology, geriatrics, Alzheimer's,
primary healthcare/family practice)
2. Pediatrics, normal development, meningitis, pneumonia, child abuse, child psychiatry.
3. Ob./gyn and psychiatry almost equal, breast cancer, CA-cervix, infections in Ob/gyn.
In Psych., do depression, schizophrenia, personality disorders.
4. Surgery and epidemiology almost equal, trauma management, hernia, orthopedic, in epidemiology, do 2x2 table
of sensitivity/specificity and exposure, medical ethics (law related), recent American stats...........
General points for step-2
1. Plz. try to learn specific points about the diseases and treatment. steps of management. Do not concentrate
much on the molecular basis of diseases because in step-2 less emphasis is given on mechanism of diseases.
2. Do not leave any disease, which is common in USA.
3. You should know everything about AIDS (HIV).
4. Plan to do 200-300 MCQs every day especially when only a month is left in your exam, so that you should make
it a habit.
5. Do remember trigger (buzz) words and even if you find a buzz word in the question do not blindly mark the
answer, plz. read the whole question and try to read the last line first so that when you are reading the 10 line
question you could go into right direction.