Step 3 . 2 attempts. Help needed.

[ped1493]

Advice please . 2 attempts.

I took step 3 twice and both the times it’s the same score 189.
I studied really hard second time and got 230 and 225 on my assessments.
Did ccscases.com and uw ccs .
Did uworld twice with 69 percent average first time and did all the incorrects.
Felt confident of passing atleast the second time but ended up same score. Took second attempt three months after first attempt.
All the bars are in the middle. It was the same both the times.
Step 1 and 2 in 220s. Both first attempt. CS pass. In pediatric residency.

Can any kind ppl out there help me out cuz I feel messed up, completely. I don’t know what to make of the score. I’m not a bad test taker nor do I have anxiety.

Where do I go from here??? What do you suggest my study plan and resources be like??? I’m blank right now.

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[Spectreman]

I haven’t taken Step 3, but something just doesn’t add up. The fact that it spit out an identical score is very odd. I would pay for a re-evaluation, I know for the other step exams it’s $50 and rarely changes anything, but there could legit be a clerical error that reported the old score.

 

[Redpancreas]

Advice please . 2 attempts.

I took step 3 twice and both the times it’s the same score 189.
I studied really hard second time and got 230 and 225 on my assessments.
Did ccscases.com and uw ccs .
Did uworld twice with 69 percent average first time and did all the incorrects.
Felt confident of passing atleast the second time but ended up same score. Took second attempt three months after first attempt.
All the bars are in the middle. It was the same both the times.
Step 1 and 2 in 220s. Both first attempt. CS pass. In pediatric residency.

Can any kind ppl out there help me out cuz I feel messed up, completely. I don’t know what to make of the score. I’m not a bad test taker nor do I have anxiety.

Where do I go from here??? What do you suggest my study plan and resources be like??? I’m blank right now.

EDIT: Agree with the recheck.

Sorry this happened to you today. On the bright side, you're in Peds and I don't think your PD cares unless your program contract requires you to pass by July 1st. If that's the case you still have time. Even if you don't it's imperative you pass the next time because if you don't you may have trouble getting licensed in 21/50 US territories/states (FSMB | State Specific Requirements for Initial Medical Licensure). See below as I've compiled the ones.

Your Step 1 is OK...Step 2 CK is actually kind of low and is only 10 pts above passing. It seems you've been dipping every since Step 1. You need to do a comprehensive review of the material (especially given most of the material is not in your field) and it may be time to shell out some serious $$$ in getting a private tutor from a reputable source). I know it's expensive but if your career is on the line, the money shouldn't be important. If you opt to not do that, I personally really liked MedQuest. It's basically Conrad Fischer doing a giant review of all the Step 3 topics covered in Master the Boards. It's updated and more comprehensive than OnlineMedEd.

I also recommend you study these topics at the last minute:

1) Know biostats in and out. It needs to be a strength. I anticipate you already have done lots of it between your two attempts. Triple down. Find more videos.
2) Know USPSTF guidelines and the exceptions. They're not going to ask you what age a girl gets her PAP. Step 3 will test awkward scenarios. People generally know these guidelines, but just like biostats, it helps to look at them last minute.
3) Acid-Base. People screw this up because they forget steps. You don't have to know compensations but it helps
4) Really focus on adult medicine as I'm hoping your peds was strong.


Do UWorld again but find a way to spice it up so it's not like you're doing it a third time. Maybe mix in some Kaplan (they have a bank) as well as AMBOSS. UW sadly doesn't really prepare you for Step 3 as the topics overlap very little at least from my experience so you may not . All UW did for me was jog my memory on things I needed to brush up on and help with the recognition of certain topics. Doing/reading UW explanations was not particularly high yield for my test.


States where you need to pass within 3 attempts or else there's either no license offered, it triggers an investigation, or no license is offered unless you've gotten one in another state: (Unofficial, use official site for confirmation)
Arkansas, Washington DC, Georgia, Illinois, Indiana, Iowa, Maine, Massachussets, Michigan, Minnesota, Mississippi, Missouri, Nevada, North Carolina, Oklahoma, Tennessee, Texas, Utah, Vermont, Washington State, and Wisconsin).

 

[goberdoc1]

EDIT: Agree with the recheck.

Sorry this happened to you today. On the bright side, you're in Peds and I don't think your PD cares unless your program contract requires you to pass by July 1st. If that's the case you still have time. Even if you don't it's imperative you pass the next time because if you don't you may have trouble getting licensed in 21/50 US territories/states (FSMB | State Specific Requirements for Initial Medical Licensure). See below as I've compiled the ones.

Your Step 1 is OK...Step 2 CK is actually kind of low and is only 10 pts above passing. It seems you've been dipping every since Step 1. You need to do a comprehensive review of the material (especially given most of the material is not in your field) and it may be time to shell out some serious $$$ in getting a private tutor from a reputable source). I know it's expensive but if your career is on the line, the money shouldn't be important. If you opt to not do that, I personally really liked MedQuest. It's basically Conrad Fischer doing a giant review of all the Step 3 topics covered in Master the Boards. It's updated and more comprehensive than OnlineMedEd.

I also recommend you study these topics at the last minute:

1) Know biostats in and out. It needs to be a strength. I anticipate you already have done lots of it between your two attempts. Triple down. Find more videos.
2) Know USPSTF guidelines and the exceptions. They're not going to ask you what age a girl gets her PAP. Step 3 will test awkward scenarios. People generally know these guidelines, but just like biostats, it helps to look at them last minute.
3) Acid-Base. People screw this up because they forget steps. You don't have to know compensations but it helps
4) Really focus on adult medicine as I'm hoping your peds was strong.


Do UWorld again but find a way to spice it up so it's not like you're doing it a third time. Maybe mix in some Kaplan (they have a bank) as well as AMBOSS. UW sadly doesn't really prepare you for Step 3 as the topics overlap very little at least from my experience so you may not . All UW did for me was jog my memory on things I needed to brush up on and help with the recognition of certain topics. Doing/reading UW explanations was not particularly high yield for my test.


States where you need to pass within 3 attempts or else there's either no license offered, it triggers an investigation, or no license is offered unless you've gotten one in another state: (Unofficial, use official site for confirmation)
Arkansas, Washington DC, Georgia, Illinois, Indiana, Iowa, Maine, Massachussets, Michigan, Minnesota, Mississippi, Missouri, Nevada, North Carolina, Oklahoma, Tennessee, Texas, Utah, Vermont, Washington State, and Wisconsin).

Redpancreas, what’s easier way to gain points on this test. This indiv says he scored 189 with bars all saying “same.” If this is the case, then it seems he/she needs to practice more multiple choice questions. People say ccs will make or break your score but if you are in the avg, prob need more points on Mcq. Because if ccs is “same,” maybe not too much you can do to improve. So for a 189 score this person prob needs like 10 more correct multiple choice questions to pass given ccs is “same” still. What do you think?

 

[ped1493]

Redpancreas, what’s easier way to gain points on this test. This indiv says he scored 189 with bars all saying “same.” If this is the case, then it seems he/she needs to practice more multiple choice questions. People say ccs will make or break your score but if you are in the avg, prob need more points on Mcq. Because if ccs is “same,” maybe not too much you can do to improve. So for a 189 score this person prob needs like 10 more correct multiple choice questions to pass given ccs is “same” still. What do you think?

The only thing I can’t understand is how I can get 225 and 230 on assessments and flunk so bad? And both my attempt scores are same with same middle bars. It’s a distraught feeling. And I’m more so in a panicky scary mode to take the exam again. I don’t know what els I need to do and how much time do I need to pass? It’s all confusing .

 

[Redpancreas]

Redpancreas, what’s easier way to gain points on this test. This indiv says he scored 189 with bars all saying “same.” If this is the case, then it seems he/she needs to practice more multiple choice questions. People say ccs will make or break your score but if you are in the avg, prob need more points on Mcq. Because if ccs is “same,” maybe not too much you can do to improve. So for a 189 score this person prob needs like 10 more correct multiple choice questions to pass given ccs is “same” still. What do you think?

Fair point. I agree that OP is not uniquely deficient in 1-2 areas because the bars are relative to ones own performance so OP is just doing poorly in all aspects, while not neglecting the others. OP needs to make sure he/she does a comprehensive review of IM and potentially OB/GYN. That said, OP is in residency and can't afford to sit 9-5 learning all of IM and OB. He needs structure, volume, but also time-effective prep. There are two options. OnlineMedEd (OME) which is an awesome resources that focused on the fundamentals, but it lacks to details MedQuest has in it (less comprehensive) and Conrad Fischer in person highlights the fundamentals in his video series more than any MTB book did. (I'm actually not a fan of his MTB books, I think the whole most accurate test is never tested on the real deal, but it's emphasized so much in the books). Going through it, it seems like Fischer's targer audience in IMGs/AMGs doing USMLE Step 3 so they don't lose their contract as he jokes about that at one point. OME is more for Step 2 CK/Step 3 and covers foundational principles and essentials of work-ups. On the real deal, there is a mix of foundational knowledge and minutiae.

The only thing I can’t understand is how I can get 225 and 230 on assessments and flunk so bad? And both my attempt scores are same with same middle bars. It’s a distraught feeling. And I’m more so in a panicky scary mode to take the exam again. I don’t know what els I need to do and how much time do I need to pass? It’s all confusing .

Another thing to consider is the private tutor. I suggest that because if the verification comes back at 189, it seems based on what OP wrote that they were blindsided by the scores and didn't know what's going wrong. A tutor or fresh set of eyes can maybe help elucidate why OP is struggling. I also suggest on finding a study partner on Zoom who you can work with daily to go through UWorld questions more efficiently. This personally helped me blaze through 80-120 UW questions in 2-3 hrs a day. They were weaker in some areas and stronger in other areas and bring new strategies and perspectives into the picture. The more sets of eyes the better.

 

[goberdoc1]

Fair point. I agree that OP is not uniquely deficient in 1-2 areas because the bars are relative to ones own performance so OP is just doing poorly in all aspects, while not neglecting the others. OP needs to make sure he/she does a comprehensive review of IM and potentially OB/GYN. That said, OP is in residency and can't afford to sit 9-5 learning all of IM and OB. He needs structure, volume, but also time-effective prep. There are two options. OnlineMedEd (OME) which is an awesome resources that focused on the fundamentals, but it lacks to details MedQuest has in it (less comprehensive) and Conrad Fischer in person highlights the fundamentals in his video series more than any MTB book did. (I'm actually not a fan of his MTB books, I think the whole most accurate test is never tested on the real deal, but it's emphasized so much in the books). Going through it, it seems like Fischer's targer audience in IMGs/AMGs doing USMLE Step 3 so they don't lose their contract as he jokes about that at one point. OME is more for Step 2 CK/Step 3 and covers foundational principles and essentials of work-ups. On the real deal, there is a mix of foundational knowledge and minutiae.



Another thing to consider is the private tutor. I suggest that because if the verification comes back at 189, it seems based on what OP wrote that they were blindsided by the scores and didn't know what's going wrong. A tutor or fresh set of eyes can maybe help elucidate why OP is struggling. I also suggest on finding a study partner on Zoom who you can work with daily to go through UWorld questions more efficiently. This personally helped me blaze through 80-120 UW questions in 2-3 hrs a day. They were weaker in some areas and stronger in other areas and bring new strategies and perspectives into the picture. The more sets of eyes the better.

A lot of people score low on biostats. Let’s talk biostats strategy. We know about the 25 dollar uworld n first aid step 1 biostats, etc. how about approaching drug ad questions. I have personally been leaving them to the end, then guessing if I don’t have time or making educated guesses after narrowing. Redpancreas, did you do the drug ads towards the end and were the drug ad questions your bread n butter uworld type of questions where you refer to the ad just based on the question stem, no need to read whole thing? Ped1493 what was your experience with biostats and drug ads?

 

[Redpancreas]

A lot of people score low on biostats. Let’s talk biostats strategy. We know about the 25 dollar uworld n first aid step 1 biostats, etc. how about approaching drug ad questions. I have personally been leaving them to the end, then guessing if I don’t have time or making educated guesses after narrowing. Redpancreas, did you do the drug ads towards the end and were the drug ad questions your bread n butter uworld type of questions where you refer to the ad just based on the question stem, no need to read whole thing? Ped1493 what was your experience with biostats and drug ads?

To some extent it’s out of your control. You learn the fundamental concepts in biostatistics and then afterwards it becomes an ACT/SAT like test where it’s about reading comprehension and interpreting graphs. If you really want to improve, you have to do a lot of practice and get used to the types of things they ask. The problem is I’m yet to find any high quality/high question volume practice material for the drug ads. I suppose you could subscribe to the NEJM and read every article to get used to drug ads. Anyways, since OP doesn’t seem to be scoring particularly low in biostats, I wouldn’t recommend this to him.

Your second question is your own and I can answer in more detail in PM if you want to have a detailed discussion on this, but for most biostats questions I quickly figured out the study type, saw what variables the graphs were relating, and went right to the questions and referred back to the graphs PRN. It was effective for me. I did not leave biostats to the end. Personally biostats was a strength.

 

[Ozone2552]

I failed Psych resident. I did uworld once and my incorrect. Did all the uworld cases twice and did half of the ccscases.com. Never failed a previous USMLE. I don't have test anxiety, but now I feel the next months will be full of anxiety and putting a happy face for residency in-between. I am the only one in my class that's failed and will be starting 3rd year soon, was planning on submitting fellowship applications in July and now this.

I scored 197. What are your opinions on score re-check? Advise on how to prepare? Was thinking MTB videos and uworld step 2ck bank.

I used the MTB Step 3 book with a focus on two things: 1) to go over subjects that were historically more difficult for me and focus on those first; and 2) reference for more background than what UW Step 3 explanations had. Also used, as mentioned, UW Step 3; went through it twice and took the UWSA 1. I am always a little leery of score rechecks; could go the other way, too.

 

[oldimg2]

Passed step 3 finally. I had failure too.
Practice CCS cases though it is not accurately scored, watch archer CC’s videos. Do questions.. more the better. I watched all kind of videos on YouTube.. helpful to refresh memory especially if u don’t have a study partner. All the best. Study hard pray hard.