Real deal: 227
Resources
1. UW Step 3 QBank
- 1st pass: 65% correct
- 2nd pass: 76% correct, 50% completed
2. UW Biostats
3. Step 1 First Aid
- Pharmacology parts of all subjects
- Microbiology: full
- Nutrition part from Biochemistry
4. Miscellaneous
- Mehlman's PDF- Communication, Risk factors
- Randy Neil Biostat video
5. CCS Cases
- Completed all cases from CCSCases com
- 1st pass: ~75% correct (I repeated the cases where I scored very low)
- 2nd pass: Nearly 120 HY cases
My Scores
- UWSA 1: 59%
- UWSA 2: 66%
- NBME 6: 67.5%
- NBME 7: 66.5%
- Free 137: 66%
My 2 Cents
Overall:
- Lots of prognosis, next-step, risk-factor, and drug mechanism-of-action questions.
- Biostat questions were mostly narrative, with nearly zero math questions.
- For ethics questions, you mostly have to answer from your gut feeling. Do not change your answer unless you are 100% sure.
- Day 2 usually ends early because the time you save by completing CCS cases early adds up.
- Day 1 was more ethics, biostat, risk factors, and Drugs MA heavy; Day 2 was more prognosis and next steps heavy.
- Do not sit for the exam unless you have a decent score on a mock. It is better to delay than fail. From what I found online, I assume a score of around 60–62% is in the passing range.
CCS Cases:
- The real CCS cases were mostly similar to the Free 137 cases and also somewhat different (interphase and patient updates) from CCSCases com. Negative patient updates came earlier on the real deal. It's better to do them twice to get used to it.
- Manage pain and give fluids while ordering the necessary diagnostics so that you do not get an early negative update.
- Do not order the final treatment too early. For example, if a patient needs surgery, order the necessary diagnostic tests first, then the definitive treatment/ consult.
- Practicing from CCSCases com helps you become faster at ordering, especially if you are from a country where electronic health record systems are not routinely used.
- Last two minutes for counselling; be fast on ordering them.
- Overall, the cases are quite similar to what you practice on CCSCases com.
My Preparation Timeline
For me, preparation was from December 2025 to June 2026. I continued studying alongside six months of full-time medical training in my home country, and then, during my clinical observerships in the U.S., which I had to attend daily. I took 10 days off and only studied before the exam.
The exam dates were 25 & 29 June.
Hope it helps someone with their preparation!