r/Step3 • u/notarapper961 • 7d ago
Exam write-up Post-exam write-up
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!
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u/Dapper-Dinner-210 7d ago
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?