The USMLE Step 3 is the US’s third and last licensing exam. A two-day examination that comprises all pre-clinical and clinical years, emphasizing clinical management and BIOSTATS. Day one consists of six blocks of 38/39 MCQs allotted sixty minutes, with a lot of BIOSTATS (drug ads and abstracts), a total of seven hours, and day two consists of seven blocks of 30 MCQs allotted 45 minutes and 13 Clinical Case Based Simulations allotted ten or twenty minutes, a total of nine hours.
Overall Timeline and Dates
Six to eight weeks studying on/off because MATCH week was in the middle of my studying.
I completed Day 1 on April 4, 2023, and Day 2 on April 6, 2023.
My timeline was off-cycle; I had a “gap” between January 2023 and June 2023. I chose to complete the USMLE Step 3 before starting my residency to lighten my load in intern year. If there is anything I learned throughout my medical school journey is that EVERYONE is on their own timeline, and my best advice is to do what is best for you under your own circumstances.
If you have to complete it during residency, your clinical management knowledge will be greater, which will be helpful. There are pros and cons to taking it before and during residency; I chose prior due to my gap.
Step 3
I aimed to do one block of 40 UWORLD questions in RANDOM, TUTOR mode (excluding social sciences and biostats) daily, and I would make ANKI cards for my incorrect. Some days if I had more time, I would do two blocks. I would also review the ANKI Cards I made ONLY.
Final Week Before Step 3
I wasn’t reviewing a different system daily as I did for Step 1 & 2 until I did my UWSIM 1 (approximately one week from Day 1). I didn’t do well on it, so I began doing my incorrect on UWORLD by the system to close some knowledge gaps I had. And utilizing my First Aid Step 2CK to review my weakest systems only (I lost my First Aid Step 1 in a flood; otherwise would have definitely revised that).
I did my UWSIM 2 (three days before Day 1) and improved tremendously. I began my final week of INCORRECT UWORLD RANDOM TIMED mode because it was approaching test day. I also attempted to do the Free 120 (day before Day 1) and completed the MCQs section. However, the CCS cases were lagging. Therefore, I only did one on the website, returned to CCSCASES.COM, and completed the highest yield ones the day before my DAY 2.
Biostats (so high yield)
I spent a few days doing just the BIOSTATS blocks in the final week because I didn’t include them in the RANDOM, TUTOR mode. Biostats is HEAVY on Step 3; I highly recommend spending the time to really learn it. Less than six months ago, I spent a lot of time on it for Step 2, so it was a review for me; however, if you have yet to learn it properly, I highly recommend you do it.
I reviewed some of the Randy Neil & Divine Intervention podcasts I had previously listened to.
The HIGHEST Yield Divine Intervention Podcasts
CCS CASES
I started CCS cases early on CCSCASES.COM but only completed approximately 65 cases. I did watch a YouTube video to understand how to use the CCS website, but then I got the hang of it. I used this (Step 3 CCS Guide) to learn the common orders. I wrote what I missed in a notebook and noticed the common theme of what I would miss.
My Personal CCS Cases Tips
- If the patient is a female in her reproductive years, order a pregnancy test. At the last 2 minutes, don’t forget the PAP Smear (depending on her last one)
- Most patients during the last 2 minutes require vaccinations (TDAP, pneumococcal, varicella, HPV)
- Don’t forget to order a Diabetic Diet or a Cardiac Diet.
Step 3 Thoughts
I took Step 3, Day 1, on a Tuesday, and there were six blocks of 38 or 39 MCQs. It had a lot of Biostats, and there was a drug ad or abstract on each block, but the rest were good questions. It felt more factual type of questions, which was rather I remembered, or I didn’t.
On Wednesday, between Day 1 and Day 2, I reviewed some of the Divine Intervention Podcasts and completed the highest yield CCS Cases on CCSCASES.com,
I took Step 3, Day 2, on a Thursday; there were six blocks of 30 MCQs + 13 CCS CASES. There were more questions I wasn’t sure of on Day 2. There were more vaccines, screening, risk factors, and prognosis questions that I was stuck between two answers. By the time I got to the CCS Cases, I was super tired but kept going, and they were fairly like CCSCASES.com.
Step 3 Results
I am commonly asked which practice exam was closest to my exam results, and UWSIM 2 was the closest to my Step 3 Score.
Things I Would Do Differently
Looking back, I would have reviewed some Step 1 Pharmacology mechanisms of action.
I also found this the night before my Step 3 Day 2, read through it, and it was helpful.
Conclusion
Saying goodbye to the USMLE was my greatest accomplishment for so many reasons. Step 1 was during the pandemic, and I had so many bumps in that road and a cancelation to even be able to sit for the examination. Step 2 was during clinical rotations and had its own challenges with scheduling. Step 3 was the exam on my own time and the one I studied the least for because I studied SO hard for Step 1 and Step 2.
If you had asked me a few years ago how upset I was knowing I would have a gap between my medical school and my residency, I was really upset. Now, I have utilized my gap to finish the USMLE Step 3, among other things. Everything Happens For A Reason.
Life is a marathon. Not a sprint. ENJOY THE JOURNEY. Every STEP of the way. (Pun intended)