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 USMLE and COMLEX Step III

USMLE Official USMLE Step 3 Experiences

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 Redpancreas ·  Mar 17, 2021

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Redpancreas
Full Member 10+ Year Member

Mar 17, 2021  #1

Score: 243
Study Period: 2 months
Step 2CK: 245
Step 1: 252.
UW Step 3 Average: 69% timed tutor, random. Repeated
Peds/OB+GYN/Endo.
UWSA 1 (4 weeks out): 206 (Fun fact: there's an option to
score recheck your practice exam. When I clicked it my
score went from 196 to 206). I hate practice exams and
think I split this one up into two days. I mainly used it for
more questions.
Demographics: US MD, 2 years of IM residency
experience
Study time: Two month time period, studied 9-5 most days
but took maybe 20-30 days off just goofing off or focusing
on other things in life.

Resources:
1.) UWorld Step 3 ($300)
2.) UWorld Step 2 CK (Peds/OBGYN mainly but I literally
went clicked through other sections the day before my
exam)
3.) OnlineMedEd videos for some review
4.) CCScases.com for CCS ($60)
5.) $25 Biostats package.
6.) MedQuest [new] by Conrad Fischer/Niket Sonpal
(Video lecture series based off 2020 Master the Boards).
Warning $$$ (300).

Study Period:
Out of all the Step exams, this one was the most
lonely/isolating one with no real dedicated resources other
than UWorld that I'd heard of. I studied January/Feb for
most the day. Most PGYs won't be able to do this, but my
advice is to not take the exam lightly. It seems like a lot of
people seem to fail it or drop scores and I felt the exam
was actually quite difficult despite all the sentiment from
attendings that it's a breeze or whatever. For those
interested in IM fellowship, your score probably doesn't
matter BUT score too low and you could get screened out
for a competitive fellowship so I wouldn't go in there with a
#2 pencil as the saying goes.

I started with UW questions and mixed in some OB/GYN +

Peds independent review and things were going slow. One
thing that sped me up was I met an IMG on the USMLE
Step 3 FB group and we basically started doing UW and
CCS together over Zoom and I went at a pace of
80UW+4CCS a day. She was super good with Peds/OB-
GYN and had just taken Step 2. We chose to use
CCScases.com instead of UW because it gave way more
feedback to learn from and gave us an exactly percentage
on each case based on a detailed analysis of how we
managed the patient and the order we did it in. After we
completed this, we kind of split up and went our own way
after re-doing some Uworld questions from my weak areas
(OB/GYN, Endo, Peds). I ended up not using Anki. TBH
near the end I kind of slacked and maybe 10-15 days off
the month, I did not really study. I spent most my time
redoing a bit of UWorld and watching the Peds, OB/GYN,
Endocrine, Hematology, Cardiology, and ID sections of
MedQuest (new 2020 resource).

Strategy:
There are 3 unique elements/curveballs to this exam aside
from what is in UW Step 3 some don't expect.

1.) Biostats Emphasis (Day 1):

I think what's most in your control on this exam is biostats
yet no one wants to spend time on it. I did UW random
tutor so I was exposed to biostats consistently throughout
and spent more time figuring out why I got these
questions wrong. There are a few recurring themes like it a
confidence interval cross 1, that's not the answer and to
never pick X causes Y as an answer. A week before the
exam, I purchased the biostats UW package which also
helped a bit to drill down less common concepts like
predictive values, NNH/T, and definitions and test taking
strategies for biostats. I felt this helped me on the real
thing. Definitely memorize the 2x2 table and learn how to
manipulate it. As someone pretty good at math, it felt
humiliating to memorize a 2x2 table and formulas I could
just derive/reason through but you are gonna get
questions testing sensitivity/specifity so you may as well
get super accustomed to doing these calculations fast
instead of wasting minutes trying to reason through stuff.

2.) Basic Science (Day 1)

A lot of IMGs were advising me to read First Aid and I
pulled out my old copy but didn't use it too much. I figured
I'd either know it or I didn't and spending all day reading
First Aid for Step 1 wasn't an active learning strategy and
too low yield to be worth my time. I didn't review any of
the First Aid Micro/etc. people said to. What helped me in
some cases were the MedQuest lectures where Conrad
Fischer hits on high yield basic topics simultaneously while
covering the higher level stuff like diagnosis &
management/etc.

3.) CCS cases (Day 2)

Start prep early. I preferred CCScases.com to UWorld
because the CCScases software gave me way more
feedback than UWorld and gave me insight as to how one
loses points. A lot of people seemed to get bogged down
by details like preventative care/vaccines/smoking
cessation when in reality that's like maybe 5% of the
points based on CCScases. The key thing to CCS I think is
your treatment. Per CCScases, it accounted for about half
your score. Missing a one key step like prescribing a
medication or calling surgery to do something costs you
30-40% of the points Don't worry about dosing as you
only need to know routes and for antibiotics, multiple
answers are accepted as long as you're covering the right
bug. Work-up was second most important. It's important
to not only order what's indicated to make a diagnosis but
order what's needed to figure out why things happened in
the first place or further complications. For example, with
AFib (not on my test) it's important to order TSH and BMP
even though it doesn't contribute to the diagnosis. As an
IM resident, this came naturally but to others it may be a
refresher. The diagnosis itself is not actually tested (I did
not have to type it in a box even when the case ended like
I think they used to have you do). I actually scored near full
points on a practice CCScases case where I didn't have
an exact diagnosis in my head but had a gist it was some
kind of ovarian mass and did the right things to manage it.
The best thing to do is to develop your own system for
orders and practice this. This is a bit like a video game in
that speed/accuracy come with time. Practice a lot of
cases. The real test had different order sets than
CCScases though and CCS cases were a little too obvious
about what the diagnosis was were my only two knocks
on them. Definitely download the official USMLE software
which has 6 cases to review to get a sense of what the
real order sets are like, but unfortunately the real cases are
a bit more challenging than those on that software too. On
the real deal the cases are a bit difficult because they kind
of "evolve" as one diagnosis turns out to be another
whereas CCScases the diagnoses were fairly straight
forward.

Experience:
I took it on a Wed/Friday. I don't think the time between
matters and it's probably more of a mental thing.

Day 1:
Honestly, I really felt good about this day which was eery
because everyone said this was the worst day. On my
exam, there were probably 7-10 biostats questions PER
block on Day 1 ONLY and covered a range of biostats
material. A decent amount of it was pretty basic 2x2 table
stuff so don't neglect that. There was some basic science
material on there. It may have hit on strengths but I felt it
was stuff residents should still know like MOAs of drugs,
etc. The way basic science was often tested was in the
form of a 2-3 order MCQ where they gave you a clinical
scenario. You had to get the diagnosis (1) and the
treatment (2) and the answer choices would be the
mechanism of action of the treatment. I honestly found
these to be easier because you can reason through them.
Some of the questions were super random but that's with
any Step exam. Some of those random ones were actually
random factoids I had a gestalt about based off something
I remembered way back in the M1/M2 classroom. All the
ethics questions were on day 1 for me as well and there
were some tough ones. I did run of time on a few blocks
with 1-2 questions left that I had to skim/guess on but
that's not atypical for me. I came out of day 1 with a 8/10
confidence level.

Day 2:
The Day 2 MCQs absolutely shattered my confidence.
My Step 1 score was way better than my Step 2 score so
maybe this is different for everyone because it seems like
a lot of people are saying these questions are like Step
2CK whereas Day 1 is a microcosm of Step 1. I spent a lot
of time with Uworld Step 3 and even CK but it still felt like I
was guessing on way too much. The answer choices I was
looking for just weren't there and I walked out of the first
set of 30 (my exam had 6 sets of 30) and was like holy ****
I don't think I was sure of a single answer (slight
exaggeration but still that's how it felt). I went 2 blocks at a
time from then on and honestly things got a little better but
it was still pretty bad overall and had to guess on the last
3-4Q on some blocks (another sign Day 2 was harder) and
honestly I just did not know what some questions were
trying to test or didn't see an answer I liked. Another thing
that messed with my head was there were these two-part
questions where answering one locks your answer and
most of the time the next question reveals the answer to
the previous question in the first sentence (ex. The
physician orders [insert answer choice from last question]).
I think I was like 7 for 9 on them between both days. There
were more pairs than that but others didn't necessarily
give away the answer. I couldn't help but take more time
on these knowing I would know if I got them wrong in a
few seconds so be ready for that mentally. Anyhow, this
whole day felt super tough. While I used some clinical
reasoning from residency I did not think the questions
made as much sense as UWorld Step 3. I just thought
questions were more vague...obviously I did well enough
so something went right though so don't be super
discouraged if this happens to you. When I left the center,
no one on Reddit or SDN seemed to share this
experience. Finally CCS came along. Note that you get a
45 min cumulative break time on day 2 for MCQs and a
separate 45 min break time for CCS. I personally used
very minimal break time which I think was a good idea
because I think my performance on an exam gets worse
the later it gets into the day and I finished at 2pm instead
of 4 pm which was optimal. The real CCS cases felt better
than the D2 MCQs I just ranted about but just not as slam-
dunk diagnosis types as CCScases.com. One case had
two separate diseases! I have residency experience and
that helped a ton. One case was a pretty realistic scenario
I see a lot in the ICU I didn't think CCS would test on. I
was perturbed when I had a case I knew exactly how to
manage end promptly after my first round of orders when
it said the patient was feeling better. There was also a
peds case that was a very rare dz i didn't realize until
midway through. I also stumbled on cant'-miss
diagnoses three times presenting atypically (which is
why it's so important to do a fundamental workup on
everyone and not anchor on a diagnosis at the
beginning). It’s also true that shot gunning takes time
because you are shown results for everything you order so
you have to know when to shot gun and when not to.
Overall, most cases ended early and most got better
through patient feedback. I didn't feel the need to take
many breaks between CCS. I ended the day 1.5 hrs early
(there is separate break timer for MCQ section and CCS). I
felt that was a good way to do it.

Results Experience:
Bonus section lol. There's a lot of confusion about this
which leads to anxiety. I've combed through tons of
reddit/sdn threads including SDNs very own "The Trick
Works!" thread and here is what seems to be the case:

1.) Your score report will show up on a Wednesday at

12:00AM EST on Interactive Website. No email will prompt
you to look. Log into linked website and click "Print Score
Report". It will download a PDF which will be your
numerical score, P/F, and some performance graphs you
may be interested in. The NBME/FSMB doesn't make this
an exact science, but from looking at everyone's
experience, the general principle is reporting goes 3
Wednesdays from the 2nd test date if that was a day after
Wednesday and 4 Wednesdays from the 2nd test date if
that was a day before Wednesday. The exception to this
is if you tested in January/February (see point #3).

2.) The Trick: The Sunday before your results come, the
"scheduling permit" link disappears from your USMLE
Step 3 row on the "Check Exam Status" link of the same
website: Interactive Website.
Previously people thought if the link disappeared, then you passed. This seems to be

wrong. The "scheduling permit" link still seems to disappear even when people failed

the exam recently per many recent reports which I imagine leads to situations of a false

sense of hope. What's not clear is whether the "scheduling permit" link not

disappearing means you've failed. There is like one person who has said it did not

disappear the week they got their score and they said they failed. The thing is in the

moment, you don't really know if the permit didn't disappear because you failed or if it's

just that you're not getting your results that week (more likely and not many people

followed up to give us that info).

3.) Per FSMB "necessary annual modifications to the test

item pool will result in a delay in reporting Step 3 scores
for examinees who test in early in the year. The target date
for reporting scores for most examinees testing in January
and February 20XX is Wednesday, March XX, 20XX (AKA:
Delayed reporting date). After this, the normal score
reporting schedule (see point #1) will resume.

Take Home Points:

1.Emphasize biostats. You don't have to buy another
biostats resource or watch biostats specific videos. Just
get comfortable doing basic biostats questions and
understand key definitions, etc. It's pretty similar to UW. I
also recommend the UW extension package for $25.
2. Emphasize CCS. Practice this regularly and don't wait
until this last minute. UW is great but I recommend
CCScases. I have heard good things about Archer/Crush
but haven't used those.
3. MedQuest USMLE Step 3 is an expensive, but valuable
resource IMO worth more than OnlineMedEd for Step 3
because it's more comprehensive which I needed for
OB/GYN & Peds.
4. The exam's just like the other steps except for
exceptions above and 95% pass, but I would not take it
too lightly. For those in IM, I would wait until after intern
year to take it. Do they use it for fellowship? Probably
not...but they may screen out low scores (a cards program
I saw said on their website they screen out anyone with
<220 on any Step). Remember, there's no rush to take
this. I remember trying to take this at the beginning of my
intern year duringa pretty poorly assigned vacation and it
felt like way too much new information and was unsure
what source to learn it (i.e. I just needed more residency
time), but now after revisiting it, things just made a whole
lot of sense. IMGs may not struggle the same way
because many have intern year built into their medical
school training. The test tests clinical reasoning you
usually gain as an intern. You'll run into questions where
your Step 1/2 brain will tell you to do X or Y but your
residency experience will tell you to do Z and Zs usually
the answer.
---
Despite me writing this novel, 95% of US MDs passed
Step 3 with an average score of 228 last year per my
2021 score report. Your mentors/attendings will tell you
they didn't study and aced the exam or that all you need
to do is pass. On here, there seem to be a lot of people
failing (probably as a selection bias). The reality's probably
closer to the actual data, but do note the exam has a
higher passing threshold than Step 1 and a lower average
so if you were in the 200-220s on your prior Steps, you
probably should invest some time just to be sure you
pass. I think 2 weeks of dedicated study in residency or 2
months of interval studying in residency is plenty. In my
position though, I was taking it 3.5 years after CK without
and plan on pursuing an IM fellowship so I didn't want to
take any chances because I know some places screen
scores.
Last edited: Apr 13, 2021

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Ryuzaki
Full Member 10+ Year Member

Mar 17, 2021  #2

Score: 205
Study Period: 4.5 weeks (causal uWorld mixed), 2 weeks
dedicated
Step 1: 231
Step 2 CK: 239
UW Step 3 Average: 70% timed tutor, subject oriented (for
the most part, only finished 1200 questions, skipped all
the ethics/social science and most of the psychiatry stuff )
UWSA-1 (5 days out): 183

Resources:
1. uWorld Step 3
2. CCScases.com for CCS (Did approximately 10-15
cases, found out about it too late but would highly
recommend this over uWorld), did uWorld CCS for the
most part (40 cases)
3. $25 Bio-stats package (bought it but never got around
to using it), instead did the uWorld Biostats about 80
questions followed by this YouTube video series
(approximately 4 total ~1 hour)

Study Period:
2-4 weeks, but given my ICU rotations it was split over 2
months

Strategy:
Honestly, was a cram session for me, I basically went
through about roughly 80% of uWorld, but given the time
crunch, I touched every topic to some extent (however,
didn't finish it, e.g. Infectious Disease had 168 questions, I
did about 120 of them and skipped the last set. However, I
did completely skip Social Sciences, Psychiatry, Poisons,
Miscellaneous and General Systems. I just didn't have
time to go through it. I read through master the boards
step 3 throughout the time while I was at work (when the
patients weren't crashing).

Experience:
Days: Friday/Monday for me.

Day 1:
As everyone said, lots of Step 1 and Biostats murdered
me on this one. If I could go back and do it again, I would
have taken Biostats significantly more seriously than I did.
I would have spent a solid 3-days on it, instead of 3 hours.
I felt like that dragged my score into the gutter, which it
probably did.

Day 2:
They did have 6 blocks of multiple choice questions,
completely different from Day I. Thankfully, no more
biostats and afterwards I ended up doing the CCS Cases,
somehow finished 3 hours early and basically left after
that. However, still felt completely crappy.

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.Asterion
Full Member 10+ Year Member

Mar 18, 2021  #3

Score: 250-255

Step 1: 265+
Step 2 CK: 265+
UW Step 3 Average: 68% timed tutor, random
UWSA-1: 217
UWSA-1: 237

NBME 4: 680
NBME 5: 700

Resources:
1. uWorld Step 3
2. Zanki step 2ck cards
3. CCScases.com for CCS [Did all of them, CCS is 25% of
the exam so make sure you study]

Study Period:
One month on a very chill elective.

Experience:
Days: Thursday/Friday.

Day 1:
Day one felt super hard, way more guessing than
expected. You could be scoring very well and still feel this
way so don't feel bad!

Day 2:
Honestly felt easier than the first day, all clinically relevant
stuff that you've been doing during your intern year. CCS
felt fairly straight forward but I did spend a decent amount
of time preparing.
Last edited: Apr 2, 2021

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Redpancreas
Full Member 10+ Year Member

Mar 21, 2021  #4

More 2021 experiences:

Other Experience 1:

Oof. Took Step 3 this week. Day 1 on Tuesday and Day 2

on Thursday.

UW: averaged 57% correct and 20th percentile, got 74%

of the way done. Read through all interactive CCS cases,
practiced about 20 (after using CCScases).
UWSA1: 199
CCScases.com: used about 40ish% of their cases.

Day 1 was pretty rough. I was hoping that their would be

more calculations with biostats. LOTS of interpretation and
there was one where I wasn't sure the abstract matched
my questions it was so odd lol. But there were lots of
method of action questions, some
genetics/inheritance/mutations Step 1 type stuff on there.
Felt very much like I was narrowing down 50/50 and
guessing. Ethics...crazy scenarios.

Day 2 more of the same, though more clinically relevant

and reasonable. Lots of "next best step/test/medication",
side effects, prognosis/risks. CCS was more difficult than I
had imagined, don't be overly confident going in. Also, I
would shy away from a shotgun lab approach merely
because of how long it takes for you to get labs back/click
through them, especially the 10 min cases.

Never really felt confident after taking any of the steps, but
this one made me feel embarrassed I've gotten this far! I'm
just hoping the curve is as generous as people discuss.
UWSA1 was 199 so hopefully that will translate to the low
200s at least, though I'd be happy with a 198! --> OP he
posted later saying "Got a 22X on the real deal guys. You
will feel horrible after both days, CCS cases don't
necessarily end early, but things often turn out to be
okay!"

Other Experience 2:
Got a lot of reassurance from this thread. Thank you to
those who contributed to it.

Numbers:
PGY-1
Step1: 23x
Step2:22x
UWSA1:210 (1.5week before)
UWSA2:239 (4days before)
Actual step 3: 221

Study:
4months on and off throughout lighter rotations and
vacations(total ~2w of step2 study time for reference)
-Uworld 63% untimed tutor; repeat about 70% of wrong,
particularly the stats
-Crush step 3 CCS x1 and UWorld CCS only did the
simulations

Test day:
Day1:
~6% of random pathology slide/step1 q
-Marked 40-50% of the questions each blocks; barely
finished each block on time
-Lots of stats, was sure for 70% of them
-Drug ads sucks, too many words not enough time
marked all of them
-Walking out feeling horrible
Day2:
-Lots of prognosis questions. 2 MCQ blocks went well, the
rest marked up to 75% of the block
-CCS cases were straightforward all but one ended early
-Finished the test 1.5 hours early. Still feel horrible due to
the MCQ blocks being disasters

Most people pass. do take time to study for it if you're not

the best test taker (like me).

Other Experience 3:
Uworld: was sharing with my gf, so did UWorld about 1.5
times, average was 76 the second time round when I was
the only one doing it so probs not accurate.

UWSA 1: 213
UWSA 2: 225

Other Experience 4:

Just posting this for whoever is feeling distressed about

their upcoming exam and has very little time to study.

Step 1: 240s
Step 2: 240s
Step 3: Pass

Studied for 2-3 weeks, maybe 1-2 hours after work M-F
and maybe 4 hours on the weekend after work. Did about
80% of UWORLD only scoring about 50% correct, most
helpful section was biostats as I had forgotten everything
about it. Nothing on UWORLD was truly reflective of
what was on the exam aside from the biostats. Did
about 50% of the ccscases which I found to be very
helpful and very similar to the actual CCS component of
the exam.

Waited 2 weeks and got my score, this was the quickest

turnaround the NBME has ever provided and I am very
grateful for it.

My 5 cents on the exam is that it's tough, but the bar to

passing is probably not too high. There are more than 400
questions, you can probably miss 150 questions and still
pass the exam, given you do decent on the CCS
component.

Hope this helps somebody! If anyone has further

questions feel free to reach out.
NBME 5 124/176 (70.5%) - 430

Step 3: 219

Other Experience 5:
PGY2 in generalist field

Uworld untimed tutor mode first time pass: 66%

Score: 240

Did UWorld 1.5x, biostats module, and all the interactive

cases. Briefly skimmed the print only ones. Did the 6
official USMLE ones.

Other Experience 6:
Appreciated all the contributions to this thread and have
tried to make some as my timeline progressed.

Got my score a few weeks ago. Check earlier posts for

how the questions felt (spoilers terrible).

UWorld 1st pass 66% mostly on Tutor

UWSA1: 225
UWSA2: 231 i think

Real Deal Step 3: 238

The test felt brutal. I made some of the dumbest mistakes

possible on the cases but all is well and I never have to
think about this garbage again. Goodbye USMLE.

Experience 7:

Hello everyone!

First time typing my experience here so please be patient

with me. A little about myself - an IMG, graduated med
school in 2018 and took all my boards along the way (Step
1, 2 CK, 2 CS and 3). I just passed step 3 June 2021.
While studying for step 3, SDN helped me SO SO SO
much! I came here often to read others' experiences so I
figured I can give back to future students who will be
taking step 3
Currently: working as an Interdisciplinary Group
Coordinator at a hospice agency as I worked on studying
and taking my boards.
Next: Residency applications and prep

My experience on step 3:

Study materials: UWorld Qbank, bio stats review and the

CCS interactive cases (did not really help), master the
boards, and ccscases.com
Uworld was unitimed and tutor mode for about 20 blocks
(I did time myself on each question and my goal was to
answer in 60 secs or less). Then did only subject-based
incorrect based on the uworld statistics. I did about 75%
of UWorld overall.

Day 1: Brutal. I was calling out to God with every other

question. I was marking at least 20 questions in each
block. Like everyone says, bio stats is heavily emphasized
since I had a couple of questions in each block. However,
the questions are basic stats: sensitivity, specificity,
likelihood ratio. Master the boards helped me in this but I
also repeatedly made my own notes until I understood the
concepts. I also had a lot of article based questions - 1 in
most blocks and 2 in a couple of blocks - I marked these
and came back to them at the end so I do not waste time
and run out of time to obtain easy points on other mcqs. I
did not read the articles, instead, jumped to the questions
to look for the answers and it worked for me personally.
Three step pharmacy questions asking mechanism of
action of drugs - read the prompt, ID the disease, ID the
medication required for treatment, ID the mechanism of
action. I had about 1-2 per block but the medications were
commonly used in practice in the US today - beta agonist,
antibacterial agents, antihypertensive medications. I did
finish each block several minutes early so I was able to
review a couple of my marked questions. However, based
on my practice experience in uworld, changing my
answers has never been in my favor so I refrained from
acting on that impulse

Six days in between the two days: Practiced

ccscases.com cases - went through about half of them,
esp the 10 minute cases to practice optimal time
management

Day 2: Easier but I was going through an asthma

exacerbation at the time so I feel like my focus was not all
there. Regardless, I feel the question stems were a little bit
more straightforward and to the point. I had a couple of
drug interaction/allergy questions that were a little tricky.

CCS cases go fast! One thing I would suggest is READ

THE HPI AND PE VERY CAREFULLY! I had one case
where I could not make the patient feel better and her
symptoms were not stabilizing. I decided to go back and
read the PE in detail again and realized there was one
small four letter line on the right end of the page that gave
away the diagnosis and treatment. Luckily I still had a
minute before the 2 min screen to add the treatment. I did
not take too many breaks because once I did a couple of
cases, I got a little more comfortable with the pace and
timing. I mostly received feedback stating "the patient
hopes this treatment will help" and I managed not to kill
any patients on the software. I did, however, make one
patient worse and was unable to figure what I could do to
make them feel better. Only about 3 cases ended early for
me and the rest I was able to get treatments and
counseling in prior to the case timing out.

Know when to keep your patient in the ER, transfer them

to the floor or send them home! ccscases.com is a really
good source as the software gives you feedback on where
you went wrong and where you were right. I eventually
started to see a pattern in my weakness after doing so
many cases. I feel the actual exam is not testing whether
you know EVERYTHING. It tests if you can MANAGE a
patient, stabilize them and provide the necessary
treatment for their disease process. Not if you can cure
them. It is looking for in-the-moment-what-would-you-do
type of care for the patient. Sort of a step up from step 2
CS. MANAGEMENT/STABILIZATION more than CURE.
Can you at least start the basic lab work, tests, imaging
and treatment and at least BEGIN to move in the right
direction to helping your patients?

Some topics from my day 1/day 2 even though most of it

seems like a blur - diabetes (Type 1 AND Type 2) - KNOW
THEM IN AND OUT, HTN, nephrotic syndrome, acute
thyroiditis, autoimmune diseases such as
SLE/RA/Ankylosing spondylitis/Lyme disease, rabies
vaccination protocol, COPD, asthma exacerbation,
neonatal jaundice, preeclampsia/eclampsia,
gallstone/kidney stone protocols, epiglottis, croup - not
sure how much this will help because the topics on these
exams are so unpredictable and can come from anywhere
and everywhere but uworld is a one of the best sources
I've used on ALL of my step exams
Last edited: Aug 21, 2021

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PantherPride
Full Member 10+ Year Member

Mar 24, 2021  #5

Step 3 impressions

Step 1: 255-260
Step 2 CK: 245-250
Step 3: 250-255
Total study time: 2-3 weeks

Resources:
UWorld for Step 3- all questions 40 q blocks timed, first
pass 71%
UWorld ccs cases- did a handful of cases each day for a
week leading up to the test, ended up doing like 70% of
interactive and brushed through peds and OBGYN cases
in the non-interactive list.
UWorld biostats
First aid for step 1 -briefly brushed through the pharm
micro and random path portions of systems chapters as a
refresher for pathophys, mechanisms, etc
NBME officials ccs cases
Skipped UWSA 1/2

I bought half a year UWorld subscription and did an almost

negligible amount of blocks in intern year during free time
on wards (in theory I planned chip away at it all year..). I
had a super chill elective and had about 2 1/2 weeks
dedicated study just prior to my test during which I did
two blocks of UWorld (40qs each timed, testing
conditions) a day. Previously I used anki to study for the
boards but i didn’t really want to dedicate the time making
cards and doing reviews during intern year. Instead I had a
tiny hand sized notebook where I’d divide the pages in half
and write anki style questions on one half with answers on
the other. I’d write down any incorrects or useful tidbits of
knowledge from UWorld into it. This notebook proved to
be extremely valuable as in my last few days of study I
reviewed it thoroughly and had multiple questions pop up
on the test from it. For ccs, previous posts and videos
online cover what you need to know, just practice a good
amount in UWorld to get comfortable, I felt no need to buy
any additional cases for practice outside of UWorld.
UWorld ccs cases felt on par and sometimes slightly more
difficult compared with cases on the actual exam.

For biostats I have a research background which I think

helped the most out of anything. There isn’t really a way to
practice interpreting studies or drug ads outside of
uworlds resources and biostats package. That being said
uWorld’s questions feel similar to what you see on the real
test and the biostats module is an absolute must to have
down cold. These resources were good for 90% of the
biostats on my exam.

I think one thing that was absolutely useful was brushing

through first aid for 2-3 days prior to the test. I didn’t want
to redo all of sketchy pharm and micro. Just remember
broad strokes mechanisms for drugs and pathophys (e.g,
increased ACh, GABA, decreased X receptor activity)
because, as others have alluded to, random things from
step 1 will pop up on the first day. I didn’t dive deep and
read/memorize things from first aid, but laying eyes on
certain buzzwords and basic science principles was more
than enough to help me with the exam. A lot of people
report day 1 being insane but having a basic science
refresher made it very manageable. Day 2 was harder for
me because though the clinical questions were more
familiar/in line with uworld they were still very vague or
nitpicky at times.

I’m prelim medicine intern at an academic hospital that

has really solid didactics and wards teaching. Because of
that I feel like I overstudied and probably would have
passed comfortably doing less than half what I did above.
Stuff learned on wards, ED, and specialty electives
(rheum, DM, ID) gave me a good clinical foundation for the
test. The thing I’m most happy about was really only
studying hard for a couple of weeks and not wasting any
more time on this pointless test. If you have a strong
medicine background I could see you completing half of
uworld MCQs with ccs practice and passing comfortably.

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Redpancreas
Full Member 10+ Year Member

Mar 24, 2021  #6

PantherPride said: 

Step 3 impressions

Step 1: 255-260
Step 2 CK: 245-250
Step 3: 250-255
Total study time: 2-3 weeks

Resources: Click to expand...

UWorld for Step 3- all questions 40 q blocks timed, first pass
Definitely better results with far less time than me. Solid
work! I also was one of the few that felt day 2 was harder
and noticed both us have Step 1 percentiles much higher
than Step 2 CK. It may just be a thing that Day 1
resembles Step 1 more vs. Day 2 resembles Step 2 CK
more. That's seemed more and more apparent the more
impressions I see on here. I didn't know how to describe
what was wrong with the Day 2 questions but yeah...I
think just vague is the right word. Like there was no
answer that popped out and I had to kind of just guess
based off a 60% hunch one way vs a 40% hunch another
way. Anyway, you're basically done with medicine now!
Congrats!

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Nephronlearner
N Full Member 10+ Year Member

Mar 24, 2021  #7

I took the exam in early March and got the score today. My
experience differed somewhat from what has been
described so far so hopefully a slightly different
perspective is useful to someone.
Final score: 247 (for reference: Step 1 250+, CK 260+).
UWSA2: 241
Resources: UW, CCSCases

Day 1:
Spent the day prior to the exam telling myself not to panic
over micro and pharm questions because most people will
find them tough anyway and biostats is definitely a
strength of mine. Well, to my surprise I got maybe... 2 of
those all day?! And maybe 2-3 biostats questions per
block. Definitely nowhere near what I had expected. They
did throw in a couple of gross anatomy questions for good
measure which was... well... gross. The rest of the
questions were clinical.

Day 2:
Felt literally like the continuation of day 1, just without any
biostats. Definitely not what I expected.

Thoughts:
A TON of questions on risk factors and complications.
Mostly obscure or something that you just don't think
about - ever. Like imagine you have 5 kids and one of
them is always the trouble maker. They ask you which one
of them is most likely to chew your residency contract.
You see the question and you are thrilled you know the
answer. But then you look at the answer choices and they
left that one out and make you pick between the other 4 -
but you thought they were all fine kids. So you pick Fred
because he kinda sounds like he could be a troublemaker.
And then the next question starts with: "after Jim chewed
on your contract, which of the following would be the most
appropriate way to approach him?" It wasn't Fred after all.
That's kinda how I felt throughout the test. I was marking
probably 50% of the questions in many blocks. There
were blocks where I was sure of maybe 30-40% of
questions. Some were a bit better. The main message:
don't stress it if you feel you didn't know anything.

CCS: pretty straight forward. I can't believe I am saying

this but UW's proposed case solutions are just... too good
and CCSCases may be closer to what they expect and
how dramatic they can be. Had big plans to make a ton of
orders for a bunch of them. Then the case ended the
second I gave them the appropriate treatment. Definitely
missed a few important orders here and there. Had a
couple of negative updates in total but every patient
eventually got better. Rarely put anything on the 2-min
screen, counselled during the case. The temptation to just
end the case was too strong when the 2 min screen
showed up. Most cases lasted literally 5 min.

Left the exam center wondering what had just happened.

Knew I would fall somewhere between 170 and 270 so
definitely thought odds were in my favor to break the
passing mark. Ended up close to my UWSA... so I guess...
trust your practice scores?

Best of luck everyone! Kudos to everyone getting super

high scores on this one! Well done to everyone for
passing! I can't imagine the score on this thing really
reflects one's clinical abilities in any meaningful way.

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Redpancreas
Full Member 10+ Year Member

Mar 24, 2021  #8

Nephronlearner said: 

Like imagine you have 5 kids and one of them is always the
trouble maker. They ask you which one of them is most
likely to chew your residency contract. You see the
question and you are thrilled you know the answer. But
then you look at the answer choices and they left that one
out and make you pick between the other 4 - but you
thought they were all fine kids. So you pick Fred because
he kinda sounds like he could
Click be a troublemaker. And then
to expand...
the next question starts with: "after Jim chewed on your
This allegory's the funniest thing I've read today. So true
about Day 2 mainly for me. Different perspectives are
good! It makes me nervous when I come out of a test
expecting one thing people told me, but I experienced
another. Hopefully more people feel good about this test
moving forward after reading stuff like this. Congrats on
being done! Glad to see more high scores! Coming into
this exam I didn't see too many and felt most people were
posting borderline passing scores which made me
anticipate the same thing for myself.
Last edited: Mar 26, 2021

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Dr. USMLE
USMLE tutor Lifetime Donor  Verified Member
10+ Year Member  Physician  Faculty
 Verified Expert Gold Donor

Mar 31, 2021  #9

cj_cregg said: 

I got a 239! Super happy with that especially given my less than
stellar performance on step 1/2. Will be updating my original
post shortly with more info.

Congratulations! No more USMLE!

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mudpiles
Full Member 5+ Year Member

Apr 8, 2021  #10

cj_cregg said: 

I got a 239! Super happy with that especially given my less than
stellar performance on step 1/2. Will be updating my original
post shortly with more info.

CONGRATS! Do you mind sharing your

algorithm/flowsheet that you wrote out before the cases?
Can I message you? thanks!

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sylvanasw1ndrunner
New Member

Apr 10, 2021  #11

I took mine in late March and got scores back this week. It
felt like a hard test and I left feeling like I failed.
USWA1: 235
Step 3 real deal: 250

I just used uworld (taking notes) and CCS cases. Studied

for 2-3 months. Step 1 was 250+ and step 2 was 270+.

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me16
Full Member 7+ Year Member

Apr 14, 2021  #12

sylvanasw1ndrunner said: 

I took mine in late March and got scores back this week. It felt
like a hard test and I left feeling like I failed.
USWA1: 235
Step 3 real deal: 250

I just used uworld (taking notes) and CCS cases. Studied for 2-
3 months. Step 1 was 250+ and step 2 was 270+.

How late in March ?

took it late March as well but still don’t have scores back
yet :/

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sylvanasw1ndrunner
New Member

Apr 15, 2021  #13

me16 said: 

How late in March ?

took it late March as well but still don’t have scores back yet :/

I took mine 3/15 and 3/20. I bet yours will be next

Wednesday!

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mudpiles
Full Member 5+ Year Member

Apr 25, 2021  #14

cj_cregg said: 

Yes, feel free to message me!

Here's the algorithm to the best of my memory at this point lol.

It is probably a little more detailed than I remembered off the
top of my head on test day but the general idea is there. For me
it was very much worth taking a few minutes to write out during
a break before I left my station just to keep me organized and
methodical about things.

You are SO awesome. Thank you!

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carty_in
C New Member

Apr 26, 2021  #15

So my permit link has disappeared on nbme however the

Status is APPROVED on FSMB website with grey link at
the bottom and no link to reapply. Day 1 was 13 April and
day 2 was 16 April. From everything that i have read i think
i should expect my result this Wednesday ? Am i right ?
Seems too early imo....

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Inversion_recovery
I New Member 2+ Year Member

Apr 26, 2021  #16

carty_in said: 

So my permit link has disappeared on nbme however the

Status is APPROVED on FSMB website with grey link at the
bottom and no link to reapply. Day 1 was 13 April and day 2
was 16 April. From everything that i have read i think i should
expect my result this Wednesday ? Am i right ? Seems too
early imo....

Yup, result should be out Wednesday 0000hrs.

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carty_in
C New Member

Apr 26, 2021  #17

ohh ****.... that makes me scared... have somehow stuck

in my mind that ppl who get results early screw up
although the statistics might not support that.....

Inversion_recovery said: 

Yup, result should be out Wednesday 0000hrs.

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7Epinephrine
Full Member 2+ Year Member

May 26, 2021  #18

Hello,
I am an unmatched US IMG and am preparing for Step 3
to boost my chances of matching this upcoming cycle.
Exam booked for July-August-September. I am currently
doing UW and am averaging 50% (40% done with qbank)
and I have not read MTB Step 3 or any other books and
am just focused on questions and making my own notes
(this worked for my CK prep).
However, in addition to CCS Cases, did anyone
supplement their studies with DIT Step 3, ABIM prep,
Kaplan or anything else? And did you find it helpful? I'm
thinking about it because the uworld qbank is less than
1700 q's and I'm wondering if I need any other resources
to pass this exam with a decent-high score.

Thank you in advance.

Best of luck to all!

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Redpancreas
Full Member 10+ Year Member

May 28, 2021  #19

7Epinephrine said: 

Hello,
I am an unmatched US IMG and am preparing for Step 3 to
boost my chances of matching this upcoming cycle. Exam
booked for July-August-September. I am currently doing UW
and am averaging 50% (40% done with qbank) and I have not
read MTB Step 3 or any other books and am just focused on
questions and making my own notes (this worked for my CK
prep). Click to expand...
However, in addition to CCS Cases, did anyone supplement
I don't like anything you have listed outside maybe the
Kaplan QBank near the end if you need more questions.
Don’t buy ABIM or DIT. DIT isn’t that good. ABIM isn’t
even the same test, even if medicine overlaps. I also don't
really like MTB. The whole thing in there about the most
accurate test is hardly ever asked on Step 3 but Fischer
keeps emphasizing it.

General Strategy in a Nutshell:

1.) Do UWorld as you did for everything else.
2.) Go through a video series fully. The only two I can
recommend are OME and MedQuest (similar to DIT in $,
but much more recent). I personally don't think OME is
really for Step 3 even if it's labeled as such. It is better at
framing things in a basic way, but MedQuest is more
comprehensive but has a lot of ranting by Fischer which is
a little funny at times. No source is amazing.
3.) Drill CCS and Biostats regularly and not just the week
before test day. Biostats is like every 5th question on day
1 and doing well on it when you sucked at it previously
can really improve your score. Step 3 CCS is a blackbox,
but it's apparently 20% of your score so if you bomb it it
doesn't matter how good you are at MCQs.

Don’t take the exam unless you’re certain you’ll score well.
Yes...taking Step 3 is pretty much the only thing you can
do if you're reapplying to add to your app...but if you fail it
especially with decent Step 1 and 2CK, you've caused
created a major problem for yourself.

Everyone's experiences are different for Step 3 so it's hard

to give generic advice. Step 3 is not like Step 1 in that it's
not as "studiable for" IMO. Some questions draw on your
intern/residency experience and you know it or you don't.
Others draw on factoids you somehow still remember from
medical school or Step prep. Also performance generally
correlates with previous Step scores as you can see some
people who didn't even do IM/FM are scoring 250s with
minimal prep while some IMGs or AMGs who struggled
with prior Steps are failing it despite being in a primary
care residency that tests Step 3 knowledge daily.
Last edited: Jan 28, 2022

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7Epinephrine
Full Member 2+ Year Member

May 29, 2021  #20

Redpancreas said: 

I don't like anything you have listed outside maybe the Kaplan
QBank near the end if you need more questions. Don’t buy
ABIM or DIT. DIT isn’t that good. ABIM isn’t even the same test,
even if medicine overlaps. I also don't really like MTB. The
whole thing in there about the most accurate test is hardly ever
asked on Step 3 but Fischer keeps emphasizing it.

General Strategy in a Nutshell:

Click to expand...
1.) Do UWorld as you did for everything else.

Thank you so much, this was very helpful! I’ve never used
medquest but I’ll give it a shot. I used OME in my CK prep
and though some swear by it , it didn’t work out that great
for me. I’m having some anxiety with this test, as I’ve had
with steps but I can do this, it’s just a matter of preparing
well and going in for the test clear minded. Thank you
again for your response!

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sss2g2
S Full Member 7+ Year Member

Jun 7, 2021  #21

Anyone expecting results this wednesday?

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BazingaHero
B Full Member 2+ Year Member

Jun 15, 2021  #22

Redpancreas said: 

UWorld Step 2 CK (Peds/OBGYN mainly but I literally went

clicked through other sections the day before my exam)

I am terrible at Peds and Obgyn. I have finished UW and

Kaplan question bank but feel it did not cover these two
well enough. Reading MTB Step 3 (detailed but) alone is
not satisfying enough since questions are important.

Worth doing UW Step 2 IM for additional questions before

repeating incorrect/marked UW Step 3? Or use UW Step 2
IM for weak topics?

Perhaps, use UW Step 2 pediatrics/obgyn questions?

Any specific strategy to tackle abstract biostatistics

questions? I hate those

I do whole heartedly agree with going overboard with

biostatistics because that's one subject thats guaranteed
to show up and can help overall.

Thanks

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RADSTEPMD
Full Member

Jun 19, 2021  #23

Big congrats to all who are DONE!

- RadstepMD

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Redpancreas
Full Member 10+ Year Member

Jun 23, 2021  #24

BazingaHero said: 

I am terrible at Peds and Obgyn. I have finished UW and

Kaplan question bank but feel it did not cover these two well
enough. Reading MTB Step 3 (detailed but) alone is not
satisfying enough since questions are important.

Worth doing UW Step 2 IM for additional questions before

repeating incorrect/marked
ClickUW Step 3? Or use UW Step 2 IM
to expand...
for weak topics?
I am IM and share the predicament re: Peds and OB/GYN.
So much material I hadn't seen since M3. I think the more
questions the better.

I did the Ped/ObGYN Step 2 UW bank. If you have time

and paid for the Step 2 bank already I think it's fine to do
the IM questions there too, but I wouldn't buy it just for
that.

For Biostatistics, you need to just really drop your pace of

study and figure out why you're getting the question
wrong and get a pen and paper out and do some math or
watch some video until you understand the concept. It's
not like the rest of medicine where you memorize some
facts about diseases. Here you need to get good at
problem solving and developing a sense of statistics takes
time. I did UW Biostats, watched tons of videos to get
different perspectives (OnlineMedEd, MedQuest, YouTube,
etc.)

For most, all this above isn't needed but if you have time
and nothing better to do, it's what worked for me.

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dartmed
D Full Member 10+ Year Member

Jun 24, 2021  #25

I take this in a week and debating about post-poning

All I need to do is pass, though

NBME 5: 420 (1-week before test)->correlated to 217-

220?
UWorld: 66% on timed, tutor mode. Took notes on almost
all section. Reviewed noted x 3
CCS: have like 30ish cases left, but doing fairly well on
them
Did the Biostats section
Finished Biostats and tried to drill it as much as possible

Step I: low
Step 2 > 240

Should I post-pone or just take it?

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doc-Oc
D Full Member 7+ Year Member

Jun 25, 2021  #26

dartmed said: 

I take this in a week and debating about post-poning

All I need to do is pass, though

NBME 5: 420 (1-week before test)->correlated to 217-220?

UWorld: 66% on timed, tutor mode. Took notes on almost all
section. Reviewed noted x 3
CCS: have like 30ish cases left, but doing fairly well on them
Did the Biostats sectionClick to expand...
Finished Biostats and tried to drill it as much as possible
DId you take any UWSA?

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 dartmed
D Full Member 10+ Year Member

Jun 25, 2021  #27

doc-Oc said: 

DId you take any UWSA?

I took the last practice test the one from USMLE (the free
137) and got 81%

I didn't do UWSA. I haven't done them in the years past

for the other Steps as they consistently under-predicted
and I don't need that for my confidence right now. Ha

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dartmed
D Full Member 10+ Year Member

Jun 29, 2021  #28

Here's my experience for those that would like my 2 cents:

Step 1: low
Step 2CK: >240
Step 3: TBD
NBME 5: 420 (~217)
Free practice questions: 79%
Predicted score based on algorithms: 225-230

Day 1 experience: it was hard. There were multiple

questions that I absolutely had no idea what they were
looking for. Some blocks, I probably flagged like half the
questions. UWorld didn't have the topics covered as some
of the questions were completely left-field. There was a
significant amount of Biostats, rougly 4-5 questions per
block. There were a lot of MOA questions, which was
somewhat unreasonable to ask, i.e. you can get the
diagnosis and know the treatment but they will test you on
the MOA. I guessed and moved on because there was a
fairly good chance most people taking the test probably
also were as clueless on them. If I were to re-do the
studying, I would actually crank out my Step 1 book and
learn the MOA of all the drugs as well as the Pharm

Day 2: much, much better. There were definitely some

questions that I was between two options, but this was a
reasonable test of knowledge questions and I think I got
most of them right. CCS was fairly reasonable. All of my
cases ended early, which I hope is a good sign.

Here's to hoping that I passed this and it's past me.

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icemonstero
New Member

Jun 30, 2021  #29

Score is out! I passed

UWORLD SA1:237
UWORLD SA2:235

Real Score: 249

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BazingaHero
B Full Member 2+ Year Member

Jul 4, 2021  #30

Redpancreas said: 

I am IM and share the predicament re: Peds and OB/GYN. So

much material I hadn't seen since M3. I think the more
questions the better.

I did the Ped/ObGYN Step 2 UW bank. If you have time and

paid for the Step 2 bank already I think it's fine to do the IM
questions there too, but I wouldn't buy it just for that.
Click to expand...
For Biostatistics, you need to just really drop your pace of

Thank you.

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doc-Oc
D Full Member 7+ Year Member

Jul 11, 2021  #31

Permit just disappeared :S.

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dartmed
D Full Member 10+ Year Member

Jul 14, 2021  #32

Score it out! I passed! 222!

Goodbye USMLE!
I am not a great test-taker so I put my time and effort-in
and took it seriously.
For those that are about to take it—here’s what I did:
Uworld x 1 (didn’t finish like 250 questions), CCS cases
(did about 70 of them) and half of the Biostats module. If I
probably finished UWorld and spent more time reviewing
Step I material, I could have probably cracked 230 but all I
needed was a Pass. Onto Boards next year!

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Done with the mle zee
D New Member

Jul 14, 2021  #33

Hi. I never write online but given my experience and the

help this thread rendered, I will do so.
YOG: 2008
Step 1: 205/85 (2010) April
step 2 CK: 202/83 (2010) August
Step 2 CS: first attempt September (2010)
all first attempt. Currently an infectious disease fellow
but haven`t done IM residency in the U.S. I am applying
for the residency match this year 2021/2022.
Step 3: came out today (14th July): 210 first pass. Exam
June 23rd and 29th (biostats were below average and ccs
was above average)
Study timed: Dedicated study half of April, May, June. Full
work schedule
Materials: uworld: could only finish 50% of the Q bank
(mixture of timed and untimed), uworld . I HAVE NEVER
FINSHED uworld Q bank. Could only do about 834
questions
CCScases, ccscases.com, (practised 85 cases), all of
uworld interactive cases

uworld biostats: I only read mean, median, mode,

sensitivity, specificity and npv,ppv in biostats.
first aid step three. read every chapter except peds, OB
(read gyne), psych, biostat, oncology, neurologty. Didn`t
read through the cases at the end
I only did UWSA form 1 and only did three blocks: 35%,
58% and 46%
I did better on the NBME free download blocks. 66%,
67%, 70%. I forgot to practice the ccs portion!

Day 1 as an absolute disaster. It felt like I was reading

another language. It was really bad. I I had a minimum of 5
biostats per block. I left those for last and when I nearly
ran out of time so just picked random answers.
The biostats were drug ads which were two-three pages.
NO CALCULATIONS!!!!!. Forger PPV,NPV,snesitivity and
specificity, they ain`t gonna ask.
They didn`t ask for causative drug in the other questions
but the receptors at which the drug worked. So you had to
guess the offending agent then determine MOA. I marked
a significant portion of the block. Nearly ran out of time on
4 blocks. The ethics questions were just bizarre...a
previous post gave a hilarious example which I agree with.

I was unaware of the biostats youtube videos and couldn`t

understand the Uworld biostats (I struggle with abstract
****) so I felt I will just fail it and do well in the other areas. I
did fail it.

Day 2 was significantly better. Significantly. These were

actual clinical medicine questions. And they were
reasonable enough that I could check the answers after
the exam. I couldn`t do that after day 1 because I couldn`t
remember the questions. No ****ing biostats. I barely saw
hematology questions.

All my 20min CCScases finished early which was really

disconcerting. What helped was my UK clinical
experience. All my patients got better. Though I can`t
remember 2 cases. I did make some mistakes and forget
stuff like neuro checks, I/O chart, daily weights
I did this a week after day 1. I did all my ccs practice from
ccscases.com during this period.

I felt so bad about day 1 I spent most of my time online

reading step 3 experience cos I was in absolute shock. I
had already gotten permission to take time off to repeat
the exam and had just begun studying again. I lost sleep
and had minor PTSD, I kept calling my friends to stress
about it, I had nightmares. I got score reports of others to
try and calculate my avereage. I even emailed usmle /fsmb
to ask if they could keep my step 3 score off my transcript
for my application. To make matters worse two IM
residents in my hospital failed

I advise CCScases. You are assessed and that will help

know what to focus on best like exam, diagnostic tests
and treatment.
Also, my ccs cases weren`t straightforward. Of the 11 I
remember 6 had more than one problem I needed to
solve. By the way, most were up to date on vaccination
schedule! All my orders were placed for that the time. I
didn`t do Q24 or whatever cos I didn`t know to do that.
Practice with NBME ccs software cos it is a bit different
from CCS cases.

Watch the biostat videos so you can feel better about your
day one.

Good luck! I am ****ing done. **** step three, it was ****ing

meaningless

Like me, if you feel your exam was horrible, you`re

probable right but you may still pass!

1
Last edited: Jul 14, 2021

1 user

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Dopamine023
D New Member 7+ Year Member

Jul 19, 2021  #34

I wanted to write this for anyone struggling to find the time

for this exam during your intern year. I’ll be honest and say
that I am not a good exam taker.

UW assessment 1 week prior: 198

Real exam: 220

I just wanted to emphasize that it is possible. I didn’t have

much time to study due to my last 4 months of being in
busy inpatient/ICU. I studied for about 1 week on/off
mostly UW MCQ. I was only able to complete Cardio, GI,
Resp, ObGyn, Bio stat.

I had two days off before the 2nd day of the exam.

For CCS, I highly recommend getting CCS cases, it gives
you feedback which is great. I got through about 65 of the
cases.
I did about 5-6 UW CCS cases.

I hope you guys find this somewhat helpful.

Last edited: Jul 19, 2021

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BazingaHero
B Full Member 2+ Year Member

Jul 26, 2021  #35

Any idea if there are experimental questions that aren't

scored? If so, how many (guess)?

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qwertyuiop78
Q Full Member 2+ Year Member

Jul 27, 2021  #36

My experience: took the exam my last month of my PGY1

year in FM, so pretty good review of all systems during the
whole year. I only did like 120 questions of uworld total,
did a UWSA 1 about 5 days out and scored 182. In the
exam I got 206.
During those 5 days I did the bio stats section in uworld
and a few CCS cases, including the ones from NBME. I
also did the free questions by NBME.

1 user

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7Epinephrine
Full Member 2+ Year Member

Aug 7, 2021  #37

Last month of prep.

Finished CCS cases (qbank and book), made notes of the
cases not listed in the book and reset UW and doing it
over again.
I'm doing 1 block of FIP and 2 blocks of ACM per day so I
don't run out of FIP cases before Day 1.
No video lectures, mostly UW, and making my own notes.
No practice tests yet, waiting to finish my 2nd round of q's
and don't want to freak myself out, it seems the UWSA are
underpredicting, and they don't incorporate CCS so I'll
take them a week before Day 1. Just fyi for those going
through the same thing.
Stay strong, finish strong.

1 user

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AzBasRad
Full Member 5+ Year Member

Sep 1, 2021  #38

Score: 244
Study Period: 2 months (mid-June till mid August)
Steps I + II: Both ~255
UW Step 3 Average: 72% untimed, tutor, topic based non-
random blocks
About me: Brand new TY intern

All the Resources I used:

(1) UWorld Step 3 (essential)

Studied for 2 months from mid June until mid August. First
month of residency was inpatient wards(July), but I still
managed to do 20-40 questions everyday. I did more
question on weekends. I did all of my questions on
untimed, tutor mode with non-random, topic based
blocks. Finished UWorld in about 1.5 months and made
my own flashcards, which helped the most. Did not do a
second pass or incorrect.

(2) First Aid for Step 1 - microbiology + antimicrobials

(essential), immunology (optional).
Lots of mode of action of antimicrobials (and other drugs
too) especially what they inhibited, microbe characteristics
(DNA/RNA virus, gram stain, etc). For some reason, my
exam had a lot of basic science immunology questions, so
a cursory review of FA immunology section would have
made the exam less painful.

(3) CCSCases (essential)

Definitely the gold standard for CCS prep. Did 80
CCSCases in the last 2 weeks. In retrospect, I strongly
recommend doing them all and spreading them
throughout my dedicated. Focus on knowing the cases
and the presentation, what common labs/consults to order
for cardiac, pulmonary, GI, GU, OB, pediatric patients etc.
Pregnancy test, mammography for women. Vaccination for
all patients. Other screening/ preventative health stuff per
pt age.

(4)Crush CCSCases book (Not necessary)

Read on SDN that this book is a must. Read through all of
it w/i 1 week, and did not feel that I needed it. CCSCases
should be enough

(5) UWorld Biostats module (not necessary).

I bought it but did not use it. My own flashcards from
UWorld were sufficient. However, perusing through it now,
its certainly not a bad investment if you are seeking extra
help on biostats.

(6) Others I did not use but could be helpful:

If I had more time/energy, I would have gone through
Sketchy micro + pharm. I had mode of action of other
drugs as well, not just antimicrobials.

(7) Practice tests: None! No NBME or UWorld Sims. I had

>250 in Steps I + II, so I knew I would pass.

Exam days:
Day 1 (Saturday)
Questions felt more like Step 1, lots of mechanism of
action for antimicrobials + other drugs, immunology
questions, ethics/biostats/drug adds (4-6 questions per
block), path sides (3-4 total). Left all of drug add questions
toward the end. Finished all blocks with 1-5 min to spare
and flagged 5-7 per block max. Only questions I flagged
were those where I was 50-50 between 2 choices. If I was
between 3 or more choices, I made an educated guess
and moved on. Felt pretty good after first day.

Day 2 (48 hours later, Monday)

Felt more awful. I felt my exam was OB heavy (which is
confirmed by the results report). Lots of questions on
preventative medicine, primary care, “which of the
following is the worst risk factor among all of the patient’s
co-morbidities”. No biostats, no drug adds, no basic
science.

CCSCases: All of my cases finished early. 2 cases were

exactly the same as those from CCSCases. If you do all of
the CCSCases and review them prior to your exam day,
you should be good here. Finished my exam 1.5 hours
early.

1 users

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7Epinephrine
Full Member 2+ Year Member

Sep 2, 2021  #39

7Epinephrine said: 

Last month of prep.

Finished CCS cases (qbank and book), made notes of the
cases not listed in the book and reset UW and doing it over
again.
I'm doing 1 block of FIP and 2 blocks of ACM per day so I
don't run out of FIP cases before Day 1.
No video lectures, mostly UW, and making my own notes. No
practice tests yet, waiting to to
Click finish my 2nd round of q's and
expand...
don't want to freak myself out, it seems the UWSA are
Okay wow. Took UWSA 2 (2 Days ago) - 199, and just
finished UWSA 1 - 188. WTF?
Im going to have to postpone, my exam was originally
scheduled for this Saturday but my confidence is crushed.
Postpone at least a few weeks and review CK and Step 1
material. WOW. All I have to say.
This does jeopardize my plans for applying to residency, I
won't get my score back in time, I can always reauthorize
my USMLE transcript on ERAS but programs may have
sent out invitations for interviews... this really sucks. This
exam is NOT a joke.

My first pass of UW - 50%

2nd pass - 66%

I still have a lot of work ahead of me, I've noticed a trend

that the UWSA are underpredicting but still it is a
confidence crusher... I've been heavily focused on UW and
my step 3 notes that I haven't looked over any Step 1 or
CK material.... wow. Hope everyone is doing a lot better
than me.

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kablemach2o
K Full Member 5+ Year Member

Sep 22, 2021  #40

Score: 241 (9/22/21 release)

Study Period: 6 weeks (evenings and weekends)
Step 1: 251
Step 2: 244
UW Step 3 Average: 65% untimed, tutor, set blocks,
completed 50% of the Qbank
About me: Brand new PGY1 ophtho intern

UWSA1: 225 (7 days before)

USWA2: 235 (4 days before)

1 user

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jordan789
J Full Member 7+ Year Member

Sep 23, 2021  #41

Step 3: 260
Step 2: 269
Step 1: 265
Current dermatology resident, took it PGY3.
Studied 45 mins a day for 3 months, increased to a couple
hours a day the last couple weeks before test. I went
through UWorld once (75% correct at the end, started off
more like 60-65% right and then started going up), did
both UWorld practice exams (projected 250s for both I
think), did the UWorld cases (both the interactive and the
review format they have), and reviewed my 2016 FA step 1
book for biostats.

The exam was long and grueling obviously. I took day 1

and 2 a few days apart which was nice, definitely glad I
did...catch back up on sleep if you're someone like me
who never falls asleep before big tests. The cases felt very
easy but the multiple choice questions were tough. They
were long and I was crunched for time every section (one
of the sections I had to guess the last 3 questions quickly).
Day 1 just felt like a combo of Step 1 and 2 all over again.
Day 2 questions were very specific clinical questions that I
felt like I was just guessing on all of them. I actually
thought I was going to do worse on the exam than I did. I
knew I'd pass but I thought I'd be average or below. For
me, I heard all the books (First aid and master step 3) are
pretty useless so I just focused on UWorld and I was
happy with the result. Good luck everyone. It's stressful
like always but you got it.
Last edited: Sep 23, 2021

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redsox93
Full Member 7+ Year Member

Oct 26, 2021  #42

Doesn’t look like anyone uses this lol but I’m taking it next
Monday just looking for advice.
UW average 70%
Uw1 203
Uw2 222
Free 138 77%
Not feeling great but honestly just want to pass. Should I
just hammer CCS this last week? Is it worth looking over
some step 1 stuff like micro and pharm?

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ciestar
All grown up! 10+ Year Member

Oct 26, 2021  #43

Took it last week and feel terrible about it.

1 user

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ciestar
All grown up! 10+ Year Member

Oct 26, 2021  #44

redsox93 said: 

Doesn’t look like anyone uses this lol but I’m taking it next
Monday just looking for advice.
UW average 70%
Uw1 203
Uw2 222
Free 138 77%
Not feeling great but honestly just want to pass. Should I just
hammer CCS this last week?
Click toIsexpand...
it worth looking over some step
1 stuff like micro and pharm?
Do some cases, stats review

1 user

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ciestar
All grown up! 10+ Year Member

Nov 3, 2021  #45

Welp, I passed.
Got a 210 on UWSA1, 234 on the real deal

2 users

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SinghMD
Full Member

Nov 9, 2021  #46

D1stant said: 

Passed USMLE step 3 exam on the 5th attempt:

Back Ground:
IMG, Graduated in 2012.
(2014) Step 1 : 199 (1st attempt)
(2014) Step CS: Passed (1st attempt)
(2015) Step 2: 209 (1st attempt)
Click to expand...
(2016) Attempt 1: Was before I got into residency. UW once or
Thank you for sharing this detailed information, I my self
failed once after PGY3 just thinking it was a breeze and
experience gets you through, Its certainly not the case.
Makes sense though, why not just do NBME questions
and learn from them especially when they give you
explanations. Uworld didn't help me at all, what probably
did is my experiences.

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donovank730
D Full Member 10+ Year Member

Dec 6, 2021  #47

step 1: 261
step 2: 276
step 3: ???

took last week

day 1: biostats, random pathoma style path/histo

questions, a couple immunodeficiencies, just very random
and hard. Biostats is mostly conceptual with a decent
amount of things I have never ever even heard of, like
weird biases.

day 2: more like the isoteric NBME factoid type questions.

Every other questions is " pick out of 5 risk factors and
choose the biggest one." Everything is either know it or
don't. Or they ask a pharm question and test a rare side
effect you can only identify if you under stand the MOA

CCS is the part giving me concern. I finished within like 2

hours of the possible 3.5 hours, but several of my cases
WOULD NOT END. No matter what I did. Identified the
infection, got the microbial sensitivities, treated the pain
and gave fluids, literally nothing left to do, yet the case
would not end. Kinda threw me off and makes me
concerned because I didn't study CCS a ton and just got
the general feel for how to do it from ccscases, only did
like 30. Now I am worried my work flow was off and I
missed a major component. I had 4 cases that just
wouldn't end no matter what I threw at them although
every case said XXX is feeling improved so they all atleast
started to improve.

Not really worried I wont pass, just shamelessly want a

high score and feel like I crushed this exam other than
CCS and since I have enjoyed doing well on NBME exams
and want to finish my USMLE series strong.

2 users

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7Epinephrine
Full Member 2+ Year Member

Dec 8, 2021  #48

7Epinephrine said: 

Okay wow. Took UWSA 2 (2 Days ago) - 199, and just finished
UWSA 1 - 188. WTF?
Im going to have to postpone, my exam was originally
scheduled for this Saturday but my confidence is crushed.
Postpone at least a few weeks and review CK and Step 1
material. WOW. All I have to say.
This does jeopardize my plans for applying to residency, I won't
get my score back in time,
ClickI can always reauthorize my USMLE
to expand...
transcript on ERAS but programs may have sent out invitations

God is GREAT!
PASSED! 1st attempt. Have not begun residency
(applying).
I just want to note that the other formus (step 1 and step 2
CK) are a lot more active, I did not feel that much online
support for this exam, but please believe in yourself and
work hard and you can pass.

UWSA 2 – 199 (8/29)

UWSA 1 - 188 (9/1)
UWSA 1 – 201 (9/20)
NBME 5 – 180 (9/23)
UWSA 2 – 220 (10/31)
NBME 5 – 253 (11/2)
Free 120 – 66% (11/5)
Old 120- 83% (11/7)

Real score: Between 200-205

I began studying hardcore in May, I did Uworld twice (50%

average first pass and 66% 2nd time around). I also did
AMBOSS supplemental step 3 qbank for a week closer to
my exam date - got through a 1/3rd of it and I did CCS
cases twice - in dedicated study and in between day 1
and day 2 of exam, 1 week apart. I did not read any books
or watch any videos, strictly questions and answers, this
worked for my CK prep. There are only 3 practice exams
so I had to gauge myself solely on those exams.
The exam is very challenging, I felt defeated after Day 1. I
am not a good exam taker and have never been one, but if
I can clear this exam, so can you. Thank you to everyone
in this forum who helped me. I appreciate your guidance.
NO MORE USMLE! Done and done.
Last edited: Dec 10, 2021

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JJacobsDO152
J Full Member 2+ Year Member

Jan 9, 2022  #49

NBME 5 score 140. Hoping to take the exam by start of

summer to have it for residency applications. Any
recommendations? This is kind of a baseline score.

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7Epinephrine
Full Member 2+ Year Member

Jan 13, 2022  #50

JJacobsDO152 said: 

NBME 5 score 140. Hoping to take the exam by start of

summer to have it for residency applications. Any
recommendations? This is kind of a baseline score.

You have plenty of time between now and when the match
opens to get it done, that’s a plus. 140 on nbme 5 is low
but don’t let that diminish your resolve, I’d suggest
hammering out uworld questions, you should do it twice.
Don’t focus on your % correct the first time around, get
through the questions, read the explanations, make your
own notes and review. I’d suggest after completing uworld
the first time to carve out 3 weeks for CCS cases, get
through all of the CCS cases on the ccs cases qbank and
familiarize yourself with the cases, orders and software.
Then go through your second pass of uworld, half way in
take a UWSA, gauge yourself, identify weaknesses, finish
the second half of the qbank and then take the second
UWSA. If you haven’t reviewed nbme 5 also take it again
and the free 120. I did not use any video lectures but I’ve
heard Conrad Fischer’s med quest is good. After all this
you should be ready, set 1 week in between day 1 and 2
so you can get through CCS cases again. And also,
emphasize biostats over and over so you know the
formulas cold. This should be sufficient enough to pass.
Good luck!

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