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Throughout my academic career, I’ve made it a habit of performing some large gesture to signify the completion of every major academic milestone. When I completed the ACT, I celebrated by burning the review book in a bonfire at my parent’s house. After learning that I did well enough on the MCAT, I purged the Kaplan books from my life in the fire pit at my college house. While I’m not a pyromaniac, you can guess what happened to my First Aid for Step 1 when I finally closed that chapter of my life.

While not everyone is as dramatic as me, I could probably pay off 1% of my student loans if I had a dollar for every time I heard someone say, “I can’t wait to never have to open that book (First Aid) again.” Unfortunately, I’m here today to be the bearer of bad news. If you’re preparing for Step 2 CK, it’s time to dust off your copy and maximize your score!  

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Why Do I Recommend Revisiting First Aid When Studying for Step 2 CK?

Like I tell the students that I tutor, I’m not playing a cruel joke on you and I’m not trying to torture you. It’s just a fact that this material will still be relevant. Over the past 3 years, students have been telling us that an increasing amount of content from Step 2 CK is coming from material that was initially learned for Step 1. This content typically includes:

  • Vitamin deficiencies + toxicities
  • Genetics – disease inheritance patterns, working through genetic tables, and genetic diseases
  • Immunology – namely, immunodeficiencies, transplant rejection, and autoantibodies.
  • Biochemical diseases such as inborn errors of metabolism, lysosomal storage disorders, and glycogen storage disorders
  • Pharmacology – though most pharmacology on CK consists of knowing the first line treatment for various diseases, there are some questions related to mechanisms of action and side effects

Unfortunately, this information is not heavily represented in UWorld and none of the comprehensive resources (Step Up to Step 2, Master the Boards, First Aid for Step 2) fully cover this content either. As such, many students are coming to CK unprepared for this content and are missing an opportunity to score some easy points had they only spent a little bit of time preparing.

Calm Down!

Before you freak out, I have two pieces of good news. The first is that, on CK, this information is typically some of the easier content. Unlike Step 1, where you were expected to know every biochemical pathway in some of these diseases, CK is mainly about having the basic knowledge necessary to pick out a certain disease. The second piece of good news is that you also won’t need to read the entire book, just some relevant pages that will refresh your memory.

What to Do With First Aid for Step 2 CK

Just like for Step 1, when studying for Step 2 CK I recommend never putting off material like biostatistics until the end of your study period. Considering that you're unlikely to see a significant amount of this in your question bank, I’d recommend reading through the material at least 2 times, with one of those passes occurring no more than 7 days from your test. Additionally, don’t panic and fall into the trap of thinking that you need to know everything in fine detail. Like I said before, you’re just trying to get the basic information down.

If using the 2017 edition of First Aid, here are the sections that I would recommend reading:

  1. Biochemistry – ADA deficiency and Lesch-Nyhan syndrome (page 34), diseases associated with collagen and elastin synthesis (pages 47,48), genetics (pages 55-61), vitamin deficiencies and excesses (pages 62-67), inborn errors of metabolism (pages 76,77, 79, 80, and 81), glycogen storage diseases (page 83), lysosomal storage diseases (page 84), and familial dyslipidemias (page 90)
  2. Immunology – blood transfusion reactions (page 110), autoantibodies list (page 111), immunodeficiencies (pages 112, 113), transplant rejection (page 115), immunosuppressants, recombinant cytokines, and therapeutic antibodies (pages 116-118)
  3. Microbiology – common diseases of HIV positive adults (page 173) and microbiology systems (pages 174-182)
  4. Pharmacology – autonomic drugs; mainly focusing on their clinical applications (pages 232-234, 236, and 237) and drug toxicities, side effects, and treatments (pages 239-243)

While there might be more relevant information in there for specific students, this is the information that I have each of my students focus on to ensure that they are maximizing their performance on refresher questions. With a little bit of extra work, you can make a big difference on your Step 2 CK score.

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Dr. Christopher Carrubba

Dr. Christopher Carrubba

USMLE Tutor & Senior Contributing Editor
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