First of all thank you everyone for posting your level 3 experiences. I just took my exam last week and I think I did well. I have yet to break the 600 mark in my previous exams so I was hoping just to beat my previous scores. I probably prepared for 4 weeks during a light rotation but I did most of my studying over 4 weekends.
For the prep I used Step 2 secrets ( I used it for level 2 and had lots of good notes in it), Strong Medicine, Combank, Comsae, High Yield OB/GYN and Savares.
1) Personally Step 2 secrets(same as Crush 2) was very comprehensive and contained all the information I needed to do well on the level 3. The only difference was that since Level 3 has a little more focus on management so I went through Strong Medicine and just added that information into my secrets.
2) Strong medicine - Went through the whole thing in 2 days. Its very a very easy read and personally I like the way the information was presented. There were some mistakes in the book especially the ID chapter but over all I think the book was worth going over.
3) Combank - Excellent choice for Level 3. As someone mentioned earlier even though there are only 850 or so questions in the combank they are all high yield. I think 5-10 questions were very very similar to the combank on the real exam. The question format was also very similar and there is heavy emphasis on OB/GYN and peds on both the combank and comlex. I finished the combank once and got 70%. I had some extra time so went through the high yield points and answers a few days before the exam. The writer are pretty spot on as far as there advice after each question is concerned.
4) OB/GYN high yield - I am really glad I went though the book. I swear it seemed like I had 80+ OB/GYN questions on the exam. Know this book and you will breeze through most of the exam. Its a very easy read and should not take more than 2 days.
5) Savares - its a given that this book is extremely high yield and the best way to get free points. I had notes from level 2 so didnt really use the book this time. Even if you did go over the book it should not take more than 5 hours. Surprisingly a broad range of OMM knowledge was tested on the exam which I will talk about later but its worth it to go over the book/notes. I used the comlex cram sheet as well(
http://pages.prodigy.net/stn1/Downloads.htm). It was good to look at the night before.
5) Comase - kinda pricey. But I guess worth it for some people. Honestly I am not sure if it helped me. I mean you go through the exam (its not timed) at your own pace and get a score in the end. You dont get the correct answers and all you get is a break down of what sections you did well on etc. I think the format was simlar to the real thing but the questions were not. I scored a 550 on the exam.
6) I bought swanson family practive review. What a waste of money. The book is for someone who has a month off and wants to prep for the exam during it. I am sure if you go through it you will do well because it is very comprehensive and comlex is all about primary care.
Overall I think the exam was fair. I felt like it was better than level 1 but about the same as level 2. If you did well on level 2 you should be fine on level 3. There was just a tad bit more emphasis on management.
In order of importance
OB/GYN (80+ q's) My God does comlex love babies and vaginas. Tons of bleeds, discharges, PROM, cervix dilations, abnormal ultra sound, GBS, uterine atony,PID, fibroids, endometriosis, molar pregnancies, gestational DM, preeclampsia, ammenorrhae, urinary incontenece, I could go on and on. Pretty much EVERYTHING was tested. I think if there is one book you need to know inside out is HY OB/GYN. I am glad I did a month of OB/GYN before the exam. And don't forget the breasts. Just a couple of questions on breast masses and management ( biopsy vs aspiration vs f/u)
Visuals - There were tons (alteast 30+) visuals on the exam from obscure skin lesions, tons of EKGS (for some reason I had alteast 4 third degree blocks ekg questions), heart sounds(the answer is in the question, really no need to hear the sound), winged scapula(again visual aid not necessary), CXR (wide mediastinum, penumothorax, sarcoidosis, CHF, pneumonia), a dead featus (hydrops fetalis), a couple of OB ultrasounds(one visual of I think the broad ligament with endometriosis), head CTs (know all the bleeds, diagnosis, treatment, radiology). The quality of pictures was improved over the previous exams but I was still unhappy with some of them.
Peds - The milestones are annoying to learn and I am glad I had none on my exam. I had a few questions on otitis media and complications (Mastoiditis). Just a couple of congential heart defect questions ( Tetraolgy of Fellot, VSD). Obvious high yield questions like pyloric stenosis (I think I had 3-4 questions on it) symptoms, diagnosis and treatment. CF is high yield. I think I had 4-5 questions on CF symptoms and diagnosis.
OMM (20+) classic sympathetic innervation/referral questions, several
name-that-nerve/organ based on presumed viscerosomatic lesion, lots of chapman's points (appendix, kidneys, adrenal glads, colon)KNOW THE POSITINING FOR CERVICAL MUSCLE ENERGY and COUNTERSTRAIN(anterior and posterior points). I had 2-3 cranial questions, 2-3 rib dysfunction question (which rib to work on -upper or lower). Maybe 2-3 sacral dysfunction questions.
Preventative med -Lots of questions on immunization(vaccines for HIV, nursing home, immigrant, egg allergy), CA screening (colon, prostate, breast, cervical). Surprsingly I had 5-7 questions on medicaid/Medicare (how qualifies for which). Maybe 5 ethical questions. I think most of the questions are common sense but this is a high yield topic so I would suggest spending a few hours on this.
EM - Quite a few questions start of with XYZ presents to the ER with XYZ. I had a few trauma questions but just remeber your ABCD's and the answers are pretty easy. I had a few ACLS questions (V tach, asystole) but relatively easy management questions.
Cardio - As I mentioed before quite a few EKGs. KNOW YOUR MURMURS. I had 5-10 murmur questions I think. Pretty straight forward as always with buzz words (holosystolic, radiation to carotids, midsystolic click etc). Very easy points so just know them well.
GI - Not a lot of diarrhea. Just a few simple SBO, rectal bleed (Colitis, Cancer, anal fissure), lower abdominal pain (PID, hernia). Mostly straight forward. I think I had a question on Giardia dx and treatment. Hep B, celaic disease, IBS and ascending cholangitis had a few questions
Psych - The psych meds are definetly high yield. TCA, SSRI, MAOI, anti psychotics side effects are a must to know and alteast 5-10 questions. Not much depression, bipolar stuff but a few bulemia and anorexia questions.
Ortho/Neuro - My favorite subject. Alteast 5 questions on lumbar stenois, ridiculopathy and sciatica. 5-10 questions on Bleeds, Parkinsons diagnosis and treatment, dementia cerebral palsy, neuropathy and dermatomes. Some questions on neuropathies, ALS, MS, Guillan Barree.
Renal - management of hematuria in various age groups but not many electrolyte imbalance or acid/base questions. I don't get the comlex. The vast majority of us are in Medicine heavy internships while they test us on OB/GYN and not CRF, HF, MI, COPD. Oh well.
Rheumatology - some questions on MS, RA, OA, lupus and dermatomytosis. Most straighforward with buzz words.
Immunology - Some level 1 questions about immunological reactions. I didnt even bother trying too hard cause I honestly dont remember that stuff.
Epidemiology - Worst section of the comlex for me. I must have had 4-5 WTF questions. Questions that usually belong in the USMLE are creaping over to the COMLEX side. I had a few questions about cohort studies, P values etc. I totally bombed those questions cause I had no idea they would test them. Oh well. I really dont know how anyone would study for those questions.
Optho - Not much. I think a question on "cotton wool spots", "curtain falling over eyes" - amaurosis fugax - get carotid ultra sound etc.
Resp - ASTHMA is very HY. I had 10 questions on various presentations of Asthma with diagnosis and treatment. Short term and long term treatment etc. Some questions on CF, COPD, sarcoidosis.
Well I wrote down everything I could remember. Sorry if I wasnt too specific. Over all the exam seemed fair but there were 20 questions that were honestly not answerable (alteast with the amount of prep I did). Best of luck!!!
