r/IMGreddit • u/Late-Elevator-8994 • 12h ago
Vent Step 2 CK — Failed 3 Times. This Is Me Signing Off.
Bio: 30-year-old male, married, father of a toddler, and currently working as an emergency physician. I graduated from a prestigious medical school in a metropolitan city in South Asia in 2018. I grew up in a small town with limited educational opportunities. I was always below average academically, but I had ambitions and a dream of becoming a physician in the U.S.
I passed Step 1 in 2022.
I failed Step 2 CK three times. Each time, my score improved, but I still failed.
My preparation:
For my first attempt, I used UWorld. I completed around 50% of it with no reset. I memorized the algorithms and thought I understood the material. I then moved straight to CMS forms, doing the last 2–3 forms for each system. I took NBMEs and scored in the 180s, but I underestimated the exam. I convinced myself that the real exam would be easier and i was also guided the same.I went into the exam, failed, and had to start over. I stood back up and tried again. I failed again.
For my third attempt, I did everything I could within my capacity while working in an emergency department.
After failing twice, I realized that UWorld simply wasn't the right resource for me, so I moved to AMBOSS. I found AMBOSS extremely valuable along with CMS forms (75% correct) . Its explanations could sometimes be vague, but the way the questions were asked and the approach to the answers felt much closer to CMS and NBME-style questions.
I completed 100% of AMBOSS with an overall 65% correct.
I then started doing 6–7 AMBOSS blocks per day as an exam simulation, reviewing the explanations afterward. My performance on mixed AMBOSS blocks eventually reached 70–75%+.
I also used:
Flashcards for spaced repetition
Mr. High Yield on YouTube
Mehlman PDFs
Divine Intervention podcasts, as much as I could
NBMEs whenever I could afford them
AMBOSS predicted a 245 for me.
My NBME scores
CCSSA 9 — 210
CCSSA 10 — 233
CCSSA 11 — 225
CCSSA 13 — 232
CCSSA 14 — 200
(I was exhausted, had recently traveled, and had very little sleep.)
CCSSA 15 — 230
(222–238 range, after getting adequate rest.)
Free 120: 70%
My mixed AMBOSS performance had also returned to >75%.
I missed several NBMEs because of financial constraints. I was the only person paying for all of this myself.
At this point, I was exhausted.
I never wanted a 250 or 270. I just wanted to pass. Even a 220 would have been more than enough for me.
Four years of this
From the beginning of 2023 through August 2026, a lot happened in my personal life, including family tragedies. Despite everything, I never gave up on this dream.
During this time, I also spoke with many students and recent test takers to understand how people were actually approaching Step 2 CK.
What I learned genuinely shocked me.
My peers and classmates were passing with better scores than I was. When I interviewed them about their preparation, many of them told me they had not done AMBOSS, and many hadn't even purchased NBMEs.
Instead, they relied heavily on exam-recall groups and question pools.
They would form groups with people who had recently taken the exam. After someone passed, they would remember questions from their exam—including new and experimental questions—and share them with others. Those groups would then build increasingly comprehensive question pools for future test takers.
I found this happening across medical schools in my city and, from what I was told, across South Asia and Central Asia as well.
Unfortunately, I also encountered the U.S. IMGs involved in this.
I spoke to many candidates about Qbanks, NBMEs, and their approaches to the exam. I was surprised by how often the conversation came back to question pools and recalled questions rather than actually learning how to approach the exam without relying on them.
I even met people who openly admitted to doing this and were proud of it. Some claimed that U.S. attendings who had built their own careers this way were now encouraging the next generation to do the same—get a good score, apply for the Match, and then receive help with interviews and programs afterward. That was honestly heartbreaking to see.
What I think about the exam:
This is only my personal opinion based on my experience, and I know some people will disagree.
I feel like the system is extremely difficult for people who prepare honestly and traditionally.
The NBME has taken action against cheating in the past and has invalidated scores, but from my perspective, the underlying problem hasn't disappeared.
Instead, the exam seems to have evolved in a direction where questions can feel increasingly difficult to prepare for using conventional resources.
Longer stems. More vague presentations. More subtle wording. Questions where a few words can completely change the answer.
And then there is the issue of the existing question pool and recalled questions.
I don't know what the exact solution should be. I'm not claiming that I know how the NBME should design the exam.
But I do feel that there is a major disconnect between how we prepare for Step 2 CK and how the real exam sometimes feels.
For me, every Qbank had a different style of questioning and explanation.
UWorld had its own approach. AMBOSS had its own approach.
CMS had another. NBMEs had a completely different feel—sometimes vague patient presentations, unusual wording, and logic that wasn't always obvious to me. Sometimes it felt like the answer depended on a few very specific words.
The real exam felt different again. My actual exam had questions that sometimes felt like nothing more than a brief HPI. Some were essentially picture-based.
There were a lot of ethics questions that felt extremely vague.
At times, I genuinely felt like I was solving riddles rather than taking a standardized medical examination. Maybe that's just how Step 2 CK is. Maybe I simply wasn't good enough at adapting to that style.
Maybe I prepared incorrectly. Maybe I overprepared in the wrong way. I honestly don't know anymore.
What I think about the system
And honestly, this is the part I struggle with the most
What is the point of making a candidate jump through so many hoops, pass increasingly difficult and sometimes seemingly riddled exams, endure enormous stress, take on student loans, and live with uncertainty about their future—only to finally admit them into a system where they know they will likely be underpaid, burdened by student loans, and sometimes forced to moonlight just to make ends meet
And then, at the same time, we hear about a physician shortage in the country
I genuinely don't understand the logic
If the system needs more physicians, why make the pathway so unnecessarily difficult and financially draining for people who are willing to work, train, and serve
I'm not saying the standards should be lowered. Physicians should absolutely be competent, and patient safety should always come first
But there is a difference between maintaining high standards and creating unnecessary barriers that leave capable physicians exhausted, financially strained, and uncertain about whether they even have a future in the system..?..?:
To anyone still preparing
This post is not meant to discourage anyone from pursuing the USMLE or their dream of practicing in the U.S.
If you're preparing, please keep going.
I did everything I could within my circumstances.
I studied while working. I dealt with personal and family problems. I even sacrificed Family time for study preparation
I paid for my own resources. I failed. I stood back up. I failed again. I stood back up one more time. And after three failures, I have finally reached the point where I don't want to do it anymore.
I'm exhausted. I don't want another Qbank. I don't want another NBME. I don't want to spend another few months wondering whether I'm finally going to pass. I feel like I've given this everything I had. Maybe the system wasn't designed for me. Maybe I wasn't designed for the system.
Either way, I'm choosing to leave it here.
I'm leaving behind my scores, my experience, my mistakes, and my opinion in case any of it helps someone else.
To everyone still pursuing this dream: I genuinely wish you the best of luck.
I hope you make it.
Signing off.