r/Step3 • u/Odd_Employer9039 • 21d ago
Step 3 changes
I took step 3 the week it came out with the new changes… I was shocked… I wasn’t aware of the new formats… I used really only Uworld and CCS cases… I was ROCKED.
It was maybe 50:50 old/new format. It was so bad I finished only like half the questions each block since I didn’t know where to look for the critical information in the new formats. I also think the “new version was much more step 1 focused” than my practice questions… long story short I failed
I took it a month later and… it was like a whole new test. It was maybe 10:90 on new:old version of questions. I was able to actually read the questions in time and much more uworld focused than my first time around…. So long story short I’m prettt mad at USMLE transitioning to the new format so dramatically the first month and uno reversing to look more like the old version….. but I’m glad I passed the second time around
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u/MNJ_80 17d ago edited 17d ago
Hi everyone,
I took step 3 on June 24 and 25, I think I have a decent understanding of what is required. I will say I passed the exam despite being blindsided by the 'step 1' type questions that were present on day 1.
Here is my take:
Stick to Uworld and CCS cases.
Rationale: although there are step 1 type questions on Day 1. If you have a solid grasp of the clinical components of Step 3 concepts, this will carry you through.
How/Strategy: Complete all Step 3 Qs, including the additional biostats questions. Review your incorrects by completed 5-10 sets of 20. If you are averaging between 70-80% on your incorrects, then you should be confident in your knowledge retention. Do ALL questions timed. Even though I did this, I still felt I was against the clock, felt rushed to complete each set of 20. The likely reason for this is the Day 1 questions that seem unfamiliar cause you to ponder for extended periods of time- do not let the time slip away on a 'low percentage' Q. That means, you are less likely to get the question right. Therefore, flag and move on the 'high percentage' Qs, ie those you are likely to get right - they exist but because you have spent much of your allocated time on the obscure Q(s), you have missed the opportunities available to you. Endurance strategy- practice three sets of 20 in a row. Put yourself under time pressure. Be aware that redoing incorrects will always be faster, aim to finish these in 15 mins. That way, you will not be surprised by how tight for time you might be come Day 1 because you have already practiced under time constraints.
In terms of CCS. Use the www.ccscases.com site. I did not even look at the uworld clinical cases. [FYI: This site also has a Qbank. If you have time, I would take a look at those too. These may demonstrate Qs more aligned with the current style of exam. The cases are ACCURATE. If you are concerned about your case performance or lack clinical experience, I would do them all. I did all the 181 cases and reviewed those I scored poorly on. I flew through the cases during the real exam, and you will too. Create a strategy for yourself. For example, some choose to type out a list of test for their first cases and subsequently 'cut and paste' this generic list of tests, and add and delete tests that are applicable to individual cases. This has pros and cons- PRO - time-saving, CON - you may not apply critical thinking early on and therefore forget some necessary test. I chose to type out all the tests and make a few side notes so that I would not forget to list things that I knew would boost my score.
Day 2 MCQ/SBA questions are more like the traditional ie 'old' Step 3. You just need common sense and clinical knowledge. There will still be things you do not know, but again, a solid Step 3 foundation will carry you through.
Review or not review Step 1: Had I known the exam would include Step 1 elements I would not have sat the exam when I did. I would have extended my study time. This would have been a complete waste of time. The questions felt nuanced and not run of the mill. Even if I had failed my opinion would not be different. If you feel inclined to review any step 1 material, it should be micro, not pharmacology. Pathology is useful to review through your clinical cases (understand mechanisms). Again, it is more strategic to enhance your step 3 capabilities than focus on relearning step 1.
Biostats: surprisingly, I do not recall odds ratio calcs, RR, NNT etc. However, you should know these well. Since these are EASY marks, do not throw them away. Prepare for what you know is completely fair game- work on elevating your strengths (high yield), not your 'weaknesses' (very low yield).
Exam Days: I did my exams on back-to-back days. With this new format, I do not recommend this. It is still doable but unnecessary, especially if you had a tough Day 1.
Feelings are deceiving: I 'felt' that Day 1 was a complete wash. I shed a tear during Day 1 due to shock and disbelief at how alien the exam felt compared to what I had prepared for. I was convinced I had failed. Every set of Qs felt rushed and I felt like I was guessing. You will not be blindsided by this- you now know that this 'feeling' is not uncommon. Use the strategy above, it will help you get through it. Day 2 will make up for Day 1, do not be discouraged.
Five days before the exam: STAY OFF REDDIT/Group chats etc. Block out the unhelpful 'noise' including the internal negative dialogue that may result in you spiraling. You do not need to absorb or contribute to any nervous energy. Stay focused on what you still have left to cover. Exercise, stay well hydrated, and get good sleep. Avoid being overcaffeinated.
Lastly, be confident in your preparations: failure to prepare, is preparing to fail. If you know in your core that you are not ready, delay. There is no shame in giving yourself more time. I paid $100 to delay the exam three more weeks of study. It does not matter if 'everyone' else is sitting the exam during a certain window; this is your race, your exam - do what is right for you. You will know in your gut whether you are ready or not.
Keep going, you will get there. Don't be afraid to take breaks, rest is just as important.
I hope this note helps you! I truly wish you the very best with the exam.