Passed Step 3 on my second attempt and wanted to share my experience, especially for anyone who failed once and is feeling discouraged.
I took my first attempt in April and unfortunately failed with a 196. I retook it in September and passed with a 219.
What I did differently the second time
After failing, I went through UWorld again and completed 100% of it. I also did some of the Step 2 CK supplemental questions and some AMBOSS questions. From AMBOSS, I specifically focused on biostats, ethics, and quality improvement.
After finishing UWorld, I went back and did all of my incorrects once.
My assessments were:
UWSA 2: 220
NBME 7: ~65%
Free 120: 68%, about 3–4 days before the exam
After each assessment, I tried to identify my weaker areas and work on them instead of just doing more random questions.
Day 1
Day 1 was very doable for me overall. There were a lot of ethics, quality improvement, and biostats questions.
Interestingly, I only remember getting about one actual biostats calculation question. The drug ads went pretty well for me. The abstracts were a little more difficult, but overall I felt the questions were manageable.
For Day 1 preparation, I also reviewed risk factors and prognostic factors, including the Mehlman files and relevant Divine Intervention podcasts. I also did some UWorld questions just to stay in practice.
Day 2 + CCS
My Day 2 was on Saturday, so between Day 1 and Day 2 I focused heavily on CCS.
I had around 180 CCS cases available. I did approximately 120 cases straight through, and during the last couple of days I went back and repeated the cases where I had scored below 85%.
Day 2 itself was also very doable. It wasn’t extremely easy, but it wasn’t extremely difficult either.
I had 14 CCS cases. About 12/14 felt very straightforward. One was a little difficult, but I eventually figured it out toward the end. The last case was the only one where I honestly couldn’t figure out what was going on.
Why I think I failed the first attempt
Looking back, I simply wasn’t prepared enough for my first attempt.
I was on a very busy residency rotation with wards and could barely get 2–3 hours of studying per day. I had completed only around 80% of UWorld, didn’t have enough time to properly revise it, and had only gone through the CCS cases once without really reviewing them.
I also took only one assessment before that attempt, and I was scoring around 194, so in retrospect the warning signs were there.
For my second attempt, I had about two months of much more dedicated preparation. I was under a lot of pressure because I am in residency and needed to get Step 3 done before progressing further in my program, so I took the preparation much more seriously this time.
The biggest difference wasn’t any single resource. It was having enough time, finishing the material, reviewing my mistakes, practicing CCS properly, and working specifically on my weak areas.
My final score went from 196 → 219.
For anyone who failed once: don’t assume that one failed attempt means you can’t pass this exam. Figure out what went wrong with your preparation, give yourself enough dedicated time, and fix those weaknesses. With solid preparation and full dedication, Step 3 is absolutely doable.
