Saminathan Anbalangan – USMLE Step 3 Experience

 

Hi, everyone. I got my results last week and secured 223. I’m an IMG from India and thought I could share my Step 3 prep experience so that people can benefit from a proper direction.

Sources I used:
For MCQ: UW (UsmleWorld) Step 3, my old UW step 2CK notes, First Aid Step 3, MTB (somewhat), Kaplan and FA step 1 pharmacology
For BioStats: UW questions from all steps, FA Step 1, Kaplan Step 1 Psychiatry book
For CCS: UW cases; CCScases.com (new software with feedback); USMLE practice software FRED

Link for the resources including archers: https://drive.google.com/open…

So my actual preparation started in October 2016 but was interrupted so many times for various reasons. I finally took the exam in Aug 2017 but my full-fledged studying was only for around 3 months. At the start, I did UW Qbank once and scored an average of 54%. I took NBME 4 and scored 400. The next day I took UWSA and got 194 and I was shit scared to take the exam. I postponed the exam, revised entire UW questions once again with special attention to wrong questions while taking notes and final the % was 78. I also read FA Step 3 once and revised my Step 2 CK notes because I took it more than a year ago. Then I redid my UWSA (since I didn’t read the explanations before) and scored 227 which boosted my confidence. Before my intense preparation, I looked through MTB and some of MKSAP (IM board exam Qs) and still UW seemed the best source to rely on for comprehensive reading. I personally felt FA was better than MTB as it had more organized facts. My thought about MKSAP is that it’s too much to study and its content level is very high for Step 3 exam. Ultimately it’s only UW for the 2nd day of step 3. I also read Biostats from all sources possible and Pharmac from Step 1 books like FA and Kaplan. This really helped me big time on Day 1 and to achieve higher end profile in MCQs.

Meanwhile, I was also preparing for CCS doing at least 1 case every day. I started with Archer CCS videos and it was IMMENSELY useful and can’t stress much it helped me. It gives you clear-cut directions that you can follow in general and for specific cases. After that, I practiced cases using UW software and the Readouts in the UW website. I was able to finish it twice. Close to my exam, I came across this new software called CCScases.com, which is a one-time 75$ pay, lifetime access software WITH FEEDBACK. It is very nice software to practice cases because you get feedback as to what you missed and what could have been done. It also gives a score! So, I purchased it and finished like half of the 100 cases it had. I’m glad I did it. I also used a mnemonics table (got it from a forum) for what all I’ve to do in all cases so that I don’t miss any of it. It helped me keep on track. Link for the mnemonics: https://drive.google.com/…/0Bw2yuwUW7nEfRjhRVDZEYzJlN…/view…

Exam experience:
Day 1: 6 blocks 38-40 Qs
It was FULL OF BIOSTATS! literally. Min 5 Qs at least. I had like 7 qs in almost all blocks. I recommend to all that you master biostats by repeatedly studying all concepts and formulas. Most Qs were simple calculations like NNT, ARR, PPV. Many concepts like the type of bias (identifying it and how to eliminate the bias), type of statistical studies, p values, type 1 and 2 errors and so forth were also tested. I had minimum 1 Drug ad in each block: interpreting the ad, interpreting p values and HR and coming to conclusions.etc. The rest of the exam was mixed from all subjects, mainly basic science. Pharmacology Qs were mechanism of action of drugs and the type of receptors they act on. Psychiatry Qs were about the pathophysiology of psychiatric diseases. Overall the entire day was about how you apply basic science concepts to patient care.

Break time for Day 1: 45 min was more than enough. I split it into 5min, 10min(went out for refreshing), 5min,20min(lunch break), 5min.

Day 2: 6 blocks 30Qs and 13 CCS cases
MCQ- Shorter and simpler questions. Exactly like UW step 3 Qbank. NO BIOSTATS. More than 50% Qs were about prognosis and risk factors which were doable. Rest was next / best step in management, dermat pictures n diagnosis, heart sound questions, ekg and radiology interpretations. Many were about most common disorders but asked in depth. Quite a number of questions from obgyn and ped also. I felt UW is enough for this day.

CCS – I had 7 20 min and 6 10 min cases. It was similar to UW and CCScases.com. I effed up one case but I guess everyone gets such cases. Rest were doable and pretty easy. Before each case, we have an extra minute to get ready. You can use that time to quickly refresh your mind / write down mnemonics. The exam software is SLOWWWW! It’s better to practice cases with FRED practice software from the USMLE website to get a hang of what it will be in the real exam. To avoid that lag I found a TRICK. After ordering multiple tests in cases like DKA, the system actually slows down and it takes time to get results. So once you place all orders in the Order screen, switch over to the H&P screen and then start advancing the simulated time to obtain the results. That way, you get results faster without the system lagging.

Break time for day 2: 45 min break wasn’t enough. I didn’t have enough break time between MCQs and first 4 CCS cases and I was exhausted when I reached there. Then I started finishing cases quickly and that extra time was added to break time to help me move forward. In the end, it was okay. So I strongly suggest you people split the 45min break time between the MCQ blocks and the 1st 3-4 CCS cases. Maybe 5,5,10,5,5 between 6 mcq blocks and then 10 min to start CCS and then 5min for next case.

My interpretation of the exam is that the level of easiness/toughness is based on the solid foundation in basic sciences and also the clinical experience you’ve had so far. Taking it soon after Step 2 CK really will help the exam. Trust me, that will be so beneficial. And for those who are applying to match, take the exam before applying as it can boost your chances of getting more interviews. It shows that you’re determined and you’re a great candidate. Moreover, it is so difficult to study during residency and you’re losing the residency experience also. Hence do take the step 3 ASAP after CK.

Suggestions:
-Do UW step 3 twice if possible and take notes
-Read FA or MTB Step 3 books if you have time
-Must Read Biostats from all sources possible (especially FA and Kaplan step 1 books and UW Step 2 Qbank)
-Must Read Pharmacology from at least FA Step 1 book or Kaplan Pharmac step 1 book
-Read through UW Step 2 CK notes (yours or someone else’s)
-Must Watch Archer videos and practice cases in UW at least once and if possible with CCScases.com also
-Don’t forget to read the 41 cases in text format on the UW website
-Practice CCS in the USMLE website practice software FRED at least twice
-Take Step 3 ASAP after your CK exam

Good luck everyone and thanks for those who contributed in the group ? Let me know if any of you have questions and I’m happy to help.

Link to My step 1 experience (252):
https://m.facebook.com/groups/666736830029592…

Link to My step 2 CK experience (251):
https://m.facebook.com/groups/213581002005720?view=permalink&id=1177130108984133

October 13, 2019
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