December 9, 2015, marked the day that I was officially done with all of the USMLE Step exams. After more than four years of anxiously prepping for the 4 Steps, I am happy to finally wrap up that part of my medical training. It’s nice to be able to focus all of my attention on learning clinical medicine as it pertains to the field of anesthesiology.
Recap of the USMLE Step 3 Exam
I decided to take the two-day exam back to back in November. Although test takers have the option of scheduling the two days in a nonconsecutive manner (e.g. schedule Day 1 for a Monday and take Day 2 on Wednesday), I do not recommend extending the testing period. It unnecessarily prolongs your anxiety and can be difficult to schedule on a busy rotation.
In case you were wondering, you cannot take Day 2 (Advanced Clinical Medicine) before Day 1 (Foundations of Independent Practice).
Compared to the other two Step exams, I thought that Step 3 was the most difficult. I didn’t have the same level of confidence that I passed this exam compared to the others. Despite my self-doubt, I ended up scoring above average (which was 222 for my testing group).
I believe that this is due to the fact that most residents do not spend much time studying for the USMLE Step 3 exam, which leads to a much more generous curve. Either way, here are a few tips for doing well on the exam:
Practice for the CCS cases
With each Step exam, the USMLE throws another curve ball. Step 2 had the CS component and Step 3 has the CCS (Computer-based Case Simulations).
Initially, I procrastinated on practicing the CCS cases—I just focused on UWorld questions. With one week left until my test date, I finally opened up my first CCS case and worked through it. To my surprise, the cases were (dare I say it?) fun to work through.
The most difficult part of the CCS portion is getting comfortable with the Primum software, remembering the order of actions (e.g. if a patient needs to be moved from the office to the ED, that should be done before ordering tests or a physical exam), and putting in orders that are normally done in the ED or part of an admissions order set (e.g. IV access).
Once you get used to these things, most of the cases are relatively straightforward diagnoses.
Be prepared for evidence-based medicine questions
Drug ads or abstracts from randomized-controlled trials appear with a much higher frequency on Step 3. They are generally accompanied by questions concerning interpretation of the study results or calculating biostatistical values, such as the positive predictive value or odds ratio.
Do not skimp out on this material while you’re preparing for the USMLE Step 3!
Be realistic with your study plan
When I developed my study plan, I had the lofty goal of completing an in-depth review of our Master the Boards Step 3 book. At that point, I already completed about 20% of the Kaplan Step 3 Qbank.
As I struggled to balance doing UWorld questions with patient care, I realized that there was no way I would be able to finish an entire review book prior to my exam.
So during the two weeks leading up to my exam, I focused my energy on completing all the UWorld questions and referencing review books only when a concept was not clear. The weekend before my exam, I took an NBME practice test (Comprehensive Clinical Medicine Self-Assessment or CCMSA) to ensure I could pass the exam.
Looking back, I wished I had been more realistic with my study plan so I could have paced myself more efficiently. It’s not easy to try to study as a resident, but through trial and error, you’ll find what works best for you.
To ensure the USMLE Step 3 doesn’t catch you off guard, learn how to prep efficiently with Kaplan—the world leader in test prep!
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