You’ve heard it before - timing is everything! As medical students, it's common to go to great lengths to organize our lives. Whether you call it micro-managing or being in total control, it feels good when your schedule lines up your way. A lot of important life decisions happen because of scheduling. Maybe the random orthopedic slot you were assigned to made you fall in love with the work. On the other hand, maybe the oncology elective was filled up by the time your lottery number came up and you never discovered the joy of the subject. Despite our best plans to align schedules perfectly to guarantee a certain future, we can’t control everything.
First thing’s first - Play it cool. Don’t worry. There is no bad rotation to have; even having time off is all right. You aren’t screwed. You aren’t in danger. Even if things are less than peachy (i.e., you’ve got a very tough rotation scheduled near Step 2), you can still find great success. How come? Because…
The most important thing that you can do to prepare for Step 2 CK is lots of practice questions.
Find a way to do lots of practice questions regardless of your schedule. Just as having “the right” rotation near Step 2 won’t obviate the need to study hard, having “the wrong” rotation won’t mean that you need to study harder. A tough rotation that gives you less free time simply means that you need to start working through your question bank sooner. The level of dedication is the same no matter how your schedule falls on the calendar. Let your difficult rotation foster some solid work ethic to propel you through studying to test success.
Use your clerkship situation to your advantage.
A case can be made for any rotation or situation being the “right” one to have near the test. We’ve already sung the praises of core clerkships like internal medicine and emergency medicine being comprehensive subjects with a wide array of conditions you should expect to see on Step 2. Your general surgery clerkship, as well as any surgical subspecialty, will have you exposed to surgical management of various conditions, and the more medicine-driven post-operative management of them as well. No facet of medicine is an island; the entire science is driven by inter-subject relationships. While more highly specialized electives like radiation oncology or dermatology might not come packed with as much workable general knowledge, you will be dealing with at least some of the pathologies and treatments you can expect to see on CK.
If all else fails, consider rescheduling your elective (or even Step 2 CK).
Are you concerned that your rotation will burn you out or wear on your psyche enough to negatively impact your score? If so, the elective may not be the right move, especially if it’s not a course that is necessary to complete. Sure, your 4th consecutive 80 hour per week ortho elective will demonstrate your dedication to the field, but you have a lifetime of ortho experiences ahead; eschewing the elective won’t make your residency more difficult.
Although we certainly don’t advocate rescheduling Step 2 CK just because it looks like it might not gel well with your schedule, there are some circumstances that make rescheduling the right move. For instance, if you are given a rotation that you are sure will run you into the ground, burn you out, and leave you with no free time to study, you could make a good case for a new test date. Be careful, and only use this maneuver if you are sure that your score will suffer. Some residency programs may want to see a Step 2 CK score before ranking you.
A parting thought— your entire medical career will be full of balancing important and necessary tasks. Boards exams, in-training exams, research, and committees don’t go away when residency and work start. It is up to you to learn the art of giving yourself, your brain power, and your energy to these tests, even when you feel like there’s not much left to give. Do what you can to cut the extraneous fluff out of life, and the things that don’t bring you joy, and give whatever’s left to the task at hand.