I begin by saying that there is no perfect practice set of questions for the USMLE Step 2 exam (not a single book that deserves 5 stars). This book highlighted several key points that actually came on my exam. However the format of the questions did not accurately represent the exam (but I have not found *any* set of questions that does). Good points: 1/3 of the questions have lots of lab values that you must sift through. In the actual exam you must be very comfortable with lab values. There are excellent quality images in the book. And the explantions are concise yet informative. Bad points: 2/3 of the questions are either "all are true EXCEPT" (which do not appear on the exam) or are quick recall (when the actual exam is more conceptual). All in all, I am glad I used this book and would recommend it as a study tool.