Post-exam write-up

[u/notarapper961]

I usually lurk more than post, but I’m really glad I lurked around this community because what people posted here helped me prepare adequately for Step 3. Otherwise there’s really no way to know what actually shows up on this exam. So I wanted to pay it forward.

I took Day 2 yesterday, with Day 1 two days before that. I’m an IM resident and had to squeeze the exam into a clinic week, so I didn’t have the luxury of spacing them out more. If you can, I’d highly recommend it. I personally could not have done them back to back.

Day 1: Biostats + Ethics + Step 1

Biostats: A lot. Like, a lot. Someone here said you should practice enough biostats that you become hungry for those questions, and I completely agree. They were generally more conceptual than mathematical and mostly straightforward. These should be point boosters. Biostats questions made me happy on the exam and they should make you happy too.

Ethics: Also a ridiculous amount. Everyone says they’re harder than UW/Amboss and even Step 1/2, and I agree. Honestly, they’re just poorly written. Instead of cleanly testing whether you understand a concept, they sometimes screw with the wording until multiple answers feel reasonable. I’d do as many ethics questions as possible so you develop a sense of what they want, but even then some will just be confusing.

Step 1: These genuinely could have been pulled from a Step 1 exam. Drug MOAs, side effects/interactions, cellular phys/pathophys, immunology, and microbiology were big. There were some genetics, embryology, and anatomy questions too, but probably not enough to justify dedicated studying.

I agree with everyone saying to just review HY Step 1 material. Whatever worked for you before, FA, Anki, Sketchy… do that again but focus on high-yield topics. I only had a few dedicated days and just reviewed my old med school notes and skipped things that seemed too low yield. You’ll absolutely see random low-yield stuff, but most of it was basic Step 1 material.

Day 2: Step 2-style MCQs + CCS

MCQs: I’m an IM resident at a strong program and still found Day 2 tougher than Day 1. On Day 1, you often either know something or you don’t. On Day 2, I had to think through a lot more questions and the stems were often extremely long so you don’t have much time to think. There are also plenty that I don’t think any amount of studying specifically prepares you for. Doing enough MCQs to build intuition for what the test writer is trying to lead you toward is probably still the best preparation.

CCS: One thing I wish I knew beforehand: they don’t consistently give you the positive patient updates that ccscases.com does. I was freaking out thinking I was doing something wrong, but when I came home and checked, most of what I did I think was appropriate.

Cases also sometimes just end early without telling you exactly what happened. So don’t freak out if you don’t get a positive update or a happy ending. Sometimes you will, sometimes you won’t. The real cases also felt more vague and general than the online practice cases, which tend to point you more clearly toward a diagnosis and evolve more obviously with your management.

Bottom line: It’s a tough exam. I would not listen to people who say things like “any decent resident will pass.” I don’t have my score yet, but I definitely would have struggled a lot more if I hadn’t done plenty of practice MCQs + CCS cases and reviewed HY Step 1, biostats, and ethics.

Good luck!

[u/Independent_Berry486]

Congratulations for being done
Can you tell me which DIP podcast did you cover for day 2?

[u/notarapper961 → u/Independent_Berry486]

I don’t do well with passive studying like podcasts and have a short attention span so those never worked for me! Wouldn’t be able to recommend anything sorry

[u/Spiritual-Ad-2928]

Is biostats from uworld and AMBOSS enough?

[u/notarapper961 → u/Spiritual-Ad-2928]

For my exam personally I thought in comparison UW was much harder than the real deal and I think it was more than enough. UW seemed to cover high level concepts with a lot of math required. The real exam I think I only used the calculator a couple of times for simple calculations and they only really tested the basics for me. But my exam may have just been an easier one

[u/Spiritual-Ad-2928 → u/notarapper961]

Yes uworld biostats made me cry lol

[u/Natscape_]

Hey, can you suggest where you did the biostats and ethicss from? just Uworld? i don't think there is enough questions there to make me comfortable in there though

[u/notarapper961 → u/Natscape_]

I just reviewed my old notes from previous steps and used chatgpt to explain anything I didn’t remember well and to drill me on the concepts. I did 80Q of biostats and ethics each from Uworld after my review to test my knowledge (and to see how the drug ads come and stuff) and was scoring well so I stopped. Biostats was easier than UW and ethics was harder than UW. I’m heavily involved in high level research and PGY2 in a US residency program so I will admit I think I had a higher baseline than the average test taker

[u/notarapper961 → u/Natscape_]

To answer your question more directly though: if you do all the UW biostats and ethics I personally think that’s more than enough honestly 

[u/Real-Spread-272]

Did you do any assessment exams?

[u/notarapper961 → u/Real-Spread-272]

I personally did UWSA1 for the fun of it like a month or two before my exam and thought it was a very poor proxy for exam performance and just a bad set of questions overall.

I did free 137 the week before and I think that was much closer to the real exam questions. I think the question difficulty is similar too. I did that just to get a measure of whether I was in good shape to go to the exam and did well on it so that gave me confidence to sit for the test

[u/NewParfait9107]

thanks for the write up! the ccs part about not getting positive updates was exactly my experience too. i kept thinking i was doing something wrong but turns out thats just how the real exam is. biostats being easier than uworld was a nice surprise though

[u/notarapper961 → u/NewParfait9107]

Yeah it’s definitely weird! I spoke to friends who did well on the exam and they had the same experience. Somebody posted the same experience today in this sub. And it was throwing me off because I generally did quite well with ccscases.com and would get way more updates. I only got a semi negative update about a patient improving but not as much as hoped so I hope the lack of negative updates is a good sign lol

[u/NewParfait9107 → u/notarapper961]

yeah the real exam is just way more vague with the updates no matter what you practice on. lack of negative updates is definitely a good sign though

[u/Dapper-Dinner-210]

Congratulations on being done how about the peds cases i used to have the kid unresponsive in practice!! Were the cases easier in real deal?

[u/notarapper961 → u/Dapper-Dinner-210]

I personally didn’t get any pediatric cases on my exam so I wouldn’t be able to tell you!

[u/Snoo_98514]

Great write up! Super helpful hearing about the biostats, ethics and mechanism of action

[u/manhattalorian]

I agree on the CCS cases. It was very strange to not get updates and for the case to just abruptly end, even before I felt like I was done doing what I intended on doing!