USMLE 204 on UWSA 1, 4 weeks until Step III

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Aug 14, 2020
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So I just finished the UWSA 1 for step 3 and score a 204 (58% correct), which is exactly the 50th percentile.

I have around 4 weeks left until day 1 and 5 weeks until day 2. I have completed around 80% of the uworld questions.

Other than optimizing biostats and hitting the CCS cases hard, what else should I do over the next month? I will be on an inpatient rotation so study time will be limited. Also, should I be worried about passing the test?


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Dec 28, 2010
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Write all the biostats formulas out on a white board and continually look at that board. You don't have to go down a rabbit hole of biostats lectures or buy additional biostats qbanks outside UW. The topics are fairly predictable and there should be no excuse for bombing biostats. See every biostats Q on UW as an opportunity to learn things and buy the UW biostats package for more questions. Invest in CCScases website. It's a good software with 120 cases (the real deal won't have as many buzzwords and the cases will have less hints but you need to practice the procedure of CCS). In my opinion, the best predictors of Step 3 are really your Step 1/2 scores. You already have a potential score based on your Step 1/2 now studying will ensure you meet that potential. Biostats is the one exception to that and studying that can boost you. It's one thing which if you practice a lot of the week before, it may make a decent difference in your score.

Disclaimer: None of the following were representative of real cases on my CCS exam. Practice really high yield CCS topics:
-Ovarian mass (ectopic, normal preg, gestational cancers, PID, etc.)
-DKA Management 1.) ABG+ BMPx1 +q4H for gap, sugar, and potassium. 2.) IV insulin until gap closed. 3.) normal saline -> sugar fluids when sugars <200 4.) ICU 5.) Supplement K if its <5.5. Supplement HCO3 pH<6.9.
-Undifferentiated Fever with Localizing History/Exam, UA, CXR, Cultures (less common: meningitis, DVT, dental.. neurological = dx of exclusion). For sepsis: fluids (bolus at 30cc/kg), cultures->abx, disposition (floor v. ICU) and then think.

For CCS, be thorough and on your toes. Slam dunk diagnoses for one thing end up being something else (or an additional diagnosis to the original correct one) masquerading atypically. I stumbled on 3 diagnoses incidentally when doing the standard work up for something else. You need to do thorough work ups but shot gun too much and you're going to waste a lot of time. Diagnoses don't count.
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