STEP 3 - What is this exam? How it is important ?
What should be
game plan for it?:
An Insight Into the first Resident exam-step 3 by: Waqas Nawaz MD
In this post , I will try to explain facts related to step 3 . Most of people don't know
about step 3 at the start of step journey . It is a step exam that is mandatory to
pass while doing residency not for applying it. But recently it has gained
unprecedented importance among IMGs because of increasing competition for
residency
1- it is 2 day exam - one day of clinical exam similar to Ck and second day of exam
containing simulated cases in which u behave as a physician , order labs and
treatment on computer , get Instant results and you are tested how you proceed
with a case straying from history till management -it's not live interaction with
patients as in cs rather it is computer based cases
2- step 3 can only be taken in USA and can only be taken if you are an MD- means
after u have passed step 1 , step 2 Ck and Cs
3- one can apply for residency match after Md without step 3 . They have to pass
step 3 before completing residency . But people who are done with step 3 before
applying match are preferred over those who have not . This is because most
programs want that their residents should be done with step 3 before starting so
that they can give full attention to patients not to exam during residency
4- it takes 2-3 months to prepare for step 3- even less for people who recently took
step 2 ck as most if knowledge is same except that ck tests diagnosis more while
step 3 tests your ability manage the cases
5- another thing that makes step 3 really important is it's relation with H1b visa .
People who are MD are eligible only for j1 visa that is sponsored by ECFMG . On the
other hand , if a resident wants H1b visa , he must have passed step 3 before match
day . H1b is sponsored by respective hospital . It is complex discussion that how h1
b is better than j1 especially for Pakistanis . We will have separate discussion on it .
Summary is that h1b is relatively Bette than j 1 as it is never rejected and one is not
bound to do waiver
How one should prepare for step 3 and what is it's scheme - will discuss in next post
in few days
USMLE STEP 3 EXAM PREP SCHEM:
Duration: 3months = 50 days (1st read) +35 days (2nd read) +10 DAYS (3rd
read) 1 days (NBME) 1 DAY (Derm Net)+ 1 day (drug adds/biostats website)
Materials Needed:
Kaplan series
MTB STEP3
U-WORLD SERIES
[Link] and drug adds
CCS course
25 dollar course for biostats available on USMLE. official NBME website
SCORES: Unlike step 1 and step 2, it is really tough to have 99 (>226) in step
3. Any score >225 is considered very good in step 3. So don't get
disappointed
FIRST READ: 50 days (approximate)
In 1st read, one should read system wise. e.g Cardiology, gastroenterology
etc. When one system is finished, don't rush to next system. Rather read it
from MTB step3. This will cover MTB along with. (Remember, MTB in STEP 3
is equivalent to First Aid in step 1, rather MTB is little bit more important)
1st read is similar to 1st read of step 2 ck. If you recently took step 2; it will
be easier and will need just 1 and half month.
Medicine: 5 weeks
Cardiology 4 days (3+1)-3 days of Kaplan and 1 day of MTB
Gastroenterology and Hepatology 4 days (3+1)
Pulmonology 3 days (2+1)
Infectious Disease 3 days (2+1)
Nephrology & Electrolytes 3 days (2 +1)
Endocrinology 2 days (1+1)
Rheumatology 3 days (2+1)
Hematology /Oncology 2 days (1+1)
Neurology 4 days (3+1)
Emergency Medicine 3days (2 +1)
Preventive Medicine 1 day
Dermatology-1 day
Opthalmology-1 day
Rdaiology-1 day
Surgery: 5 DAYS (3 +2 days)
Pediatrics: 4 days (3 days +1)
Gynecology+ Obstetrics: 5 days (2+2 days of Kaplan +1 day of MTB)
Psychiatry/ Behavioral sciences (statistics part): 4 days (1+1 days of Kaplan
+ 1 day of MTB +1 day of drug adds-you can find these drug adds on usmle
forums .At least 4 adds are asked in exam.
SECOND READ: 35 days
In second read, DO NOT REVISE KAPLANS as was advised in CK. Rather 2nd
read should be focused on U WORLDS AND START PREPARING CCS -2nd part
of step 3 exam. U world is very imp in step 3 almost as imp as text books.
Every day , reserve 1-2 hours for 2 cases of CCS-there are total 45 cases ; if
you do 2 cases each day ; you will finish CCS 1st read in this read. CCS is
very interesting part; playing around computer ; will upload CCS instructions
in few days ;it is CCS that makes difference in step 3 scores. MTB step 3
should also be read with respective unit in this read. e.g; if reading
cardiology u world; also revise cardiology unit of MTB that will take just few
hours.
+ CCS 1-2 case every day that takes 1-2 hours
Medicine: about 23 days
Cardiology 3days
Gastroenterology and Hepatology 3 days
Pulmonology 2 days
Infectious Disease 2 days
Nephrology & Electrolytes 2 days
Endocrinology 1
Rheumatology 2 days
Hematology /Oncology 1 day
Neurology 2 days
Emergency Medicine 3 days
Preventive Medicine /radiology 1 day
Dermatology-& Opthalmology-1 day
Surgery: 3DAYS
Pediatrics: 3days
Gyn/OBS: 4 days(2+2)
Psychiatry/ Behavioral sciences (statistics part): 3days (2 for psych and 1 for
stats)
THIRD READ: 12 DAYS (7 days of U world 4-5 days of CCS)
One is supposed to go through U worlds and CCS in this read . No need of
going through MTB3 in this read .
MEDICINE UWORLDS: 4 DAYS
SURGERY U WORLD: 1 DAY
GYN/OBS U WORLD: 1DAY
PEDS+PSYCH+BEHAVIORALSCIENCE U WORLD:1 DAY
After completing u worlds; give 3-4 days to CCS cases. One can easily do 10
cases of CCS in this read in one day ; so finish 45 cases in 4-5 days (CCS is
very technical thing. Will post a separate article on how to solve CCS-this is
only exam in which residents perform better than non residents)
MTB3
After 3rd read, one should read MTB 3 continuously that will take 3 days .
After that Take NBME that will test your step 3 but not CCS. (NBME of Step 3
does not predict the exam score really )
DERM NET:
Keep one day for derma net- this si a web site that has pictures of skin
manifestations of all systemic diseases. Highly useful ; will take just 7 hours
to go through but will really help in exam as lot of diagrammatic questions
[Link]
Now one can take exam. CCS part comes on 2nd day ; so after 1st day of
exam , one can revise ccs cases and can appear on 2nd day for ccs.
There is option ; one can have 1-2 days in between 2 days of exam as well.
Means exam then 2 days break then 2nd day of exam. But it is not
recommended as it breaks tampo.
This scheme can be variable ; but summary :
1st read: Kaplan + MTB3
2ND read: Uworld +MTB +CCS
3RD READ: Uworld + CCS
Registration of Step 3: This is important to mention here that Step 3 is not
ECFMG exam unlike step 1, step 2. It is FSMB exam- for registration ; please
go to FSMB website.
