Asking for study time for Step 3?

[ari202]

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Has anyone ever asked for some dedicated study time for Step 3? I'm graduating and will be going into Psychiatry. I feel like I have already lost all of my Pediatrics and Ob knowledge, and did not do so swell on a practice exam --didn't even pass. I was wondering if I should request vacation time during the year by asking someone in the program? I'm not even sure if I will be getting weekends because on the weekends that I have off during non-psych rotations, I'm suppose to be doing calls for Psychiatry service.

My program is filled with immigrants who have graduated from foreign medical schools in the past , and finished step 3 before matriculating into the program...I was even asked to sign a form indicating that I realize that I would have to attempt step 3 before finishing PGY1.

All of our rotations are much heavier in terms of hours than I was used to in medical school, otherwise I would have been confident in my ability to do it during a lighter rotation. Obviously because I'm an employee I don't get the same leniencies I was afforded in med school.

I feel like the most ideal thing for me to do would be to have 2 weeks of uninterrupted vacation, I just need to hammer some points in and take the test. I don't even care if its paid or not.

Does anyone have any experiences about this? I need more time to study for exams in general compared to my peers, I cut back on other things like spending time with friends and family, TV etc...in order to do this during med school. In rotations, my attendings and preceptors, would have no issue giving me the day before shelf exams or letting me go home a little early because obviously my absence didn't affect the completion of work---however now I'm an employee and I don't want to take a risk offending faculty and possibly wrecking my entire career.

 

[Doctor Bob]

Do you have time between graduation and starting internship? That would be the easiest time.

 

[ari202]

Do you have time between graduation and starting internship? That would be the easiest time.

I have about 4 weeks, in that time, I have to also do residency orientation modules, find a place to live, pack up all my items, move them 1800 miles and get situated there. Then I have about 2 weeks of orientation.

So I would love to do it, but I'm not sure how it would work out.

 

[michaelrack]

I have about 4 weeks, in that time, I have to also do residency orientation modules, find a place to live, pack up all my items, move them 1800 miles and get situated there. Then I have about 2 weeks of orientation.

So I would love to do it, but I'm not sure how it would work out.

you should have several hours of free time each day during the 4 weeks, use that time

 

[michaelrack]

I have about 4 weeks, in that time, I have to also do residency orientation modules, find a place to live, pack up all my items, move them 1800 miles and get situated there. Then I have about 2 weeks of orientation.

So I would love to do it, but I'm not sure how it would work out.

you should have several hours of free time each day during the 4 weeks, use that time

 

[colbgw02]

Don't ask for extra time off to study. Arrange whatever vacation time you will have, if necessary, to study. Or better yet, just find other ways to maintain or rehabilitate your non-psych knowledge at night or on off days - just like the thousands of other interns in psych, OB/GYN, or peds whose fields minimize exposure to step III topics.

 

[Winged Scapula]

Don't ask for extra time off to study. Arrange whatever vacation time you will have, if necessary, to study. Or better yet, just find other ways to maintain or rehabilitate your non-psych knowledge at night or on off days - just like the thousands of other interns in psych, OB/GYN, or peds whose fields minimize exposure to step III topics.

This.

Don't ask for extra time. Use the nights during orientation to study and then your vacation time if you need to. There are thousands of people every year going in the surgical specialties and other fields not
heavily tested on the exam that seem to do just fine.

 

[Winged Scapula]

Don't ask for extra time off to study. Arrange whatever vacation time you will have, if necessary, to study. Or better yet, just find other ways to maintain or rehabilitate your non-psych knowledge at night or on off days - just like the thousands of other interns in psych, OB/GYN, or peds whose fields minimize exposure to step III topics.

This.

Don't ask for extra time. Use the nights during orientation to study and then your vacation time if you need to. There are thousands of people every year going in the surgical specialties and other fields not
heavily tested on the exam that seem to do just fine.

 

[psych72]

I'm a bit confused though, don't we need knowledge of intern year to take step 3? The clinical decision making is not going to be there, why not take it at the end of the year?

 

[anonperson]

Time to sack up. You generally won't get the luxury of excess time off for tests in residency (in training exam etc). If you are really adamant about taking time off, then it would have to be vacation time.

Regardless, you already know you need to take this test. You have several months to prepare if you feel you need that time. You should be able to construct a study schedule and use USMLE World to pass this test even with a busy residency in place. If you plan well, it shouldn't be an issue even with someone who has issues with test taking.

 

[BoardingDoc]

Has anyone ever asked for some dedicated study time for Step 3? I'm graduating and will be going into Psychiatry. I feel like I have already lost all of my Pediatrics and Ob knowledge, and did not do so swell on a practice exam --didn't even pass. I was wondering if I should request vacation time during the year by asking someone in the program? I'm not even sure if I will be getting weekends because on the weekends that I have off during non-psych rotations, I'm suppose to be doing calls for Psychiatry service.

My program is filled with immigrants who have graduated from foreign medical schools in the past , and finished step 3 before matriculating into the program...I was even asked to sign a form indicating that I realize that I would have to attempt step 3 before finishing PGY1.

All of our rotations are much heavier in terms of hours than I was used to in medical school, otherwise I would have been confident in my ability to do it during a lighter rotation. Obviously because I'm an employee I don't get the same leniencies I was afforded in med school.

I feel like the most ideal thing for me to do would be to have 2 weeks of uninterrupted vacation, I just need to hammer some points in and take the test. I don't even care if its paid or not.

Does anyone have any experiences about this? I need more time to study for exams in general compared to my peers, I cut back on other things like spending time with friends and family, TV etc...in order to do this during med school. In rotations, my attendings and preceptors, would have no issue giving me the day before shelf exams or letting me go home a little early because obviously my absence didn't affect the completion of work---however now I'm an employee and I don't want to take a risk offending faculty and possibly wrecking my entire career.

If you want to ask for dedicated study time, that's called "vacation requests." Otherwise, you're expected to be able to study when you aren't working. I'm sorry if that comes across as harsh, but your original post seems like you're asking if you should be allowed to have a vacation to study but not have it count as vacation time which is utterly absurd.

 

[Taurus]

Welcome to the real world. You want time off to study? It's called your vacation time. Most places it's 20 days per year. Use it wisely. No place is going to give you more vacation days simply because you are a special flower.

 

[dozitgetchahi]

Plus the test itself just ain't that damn hard.

 

[ari202]

No I was referring to vacation time and educational leave (which is not in the contract, but on the website for some reason). I went on some interviews where the PGY4's were telling me they had some easy Neurology rotation where they took it because the guy was outpatient and gave them time off. Not going to happen in my case. But oh well, will study during vacation. I just wish I could take it during the first month.

 

[so721]

Let's say you take the exam before intern year and you fail it. Does your program find out about the fail? Or do is that between you and the NBOME?

 

[link2swim06]

I'm a bit confused though, don't we need knowledge of intern year to take step 3? The clinical decision making is not going to be there, why not take it at the end of the year?

You can take it at the beginning or end. It's basically just step 2 CK content and basic orders/management for common diseases.

 

[mercaptovizadeh]

Either take it before starting or during vacation or on an ambulatory month. Don't ask for extra time. It will get you off on the wrong foot - totally - and would be far worse than a mediocre step 3 score.

 

[kchan99]

I used an elective rotation to study for Step 3. This elective rotation was all outpatient work so I had more time to study.

 

[so721]

Just curious, I am looking for dates to schedule my step 3 exam, and I see a bunch of them during the first month I start. I also noticed that on Frieda, my program had listed July,flexible as the start date, does this mean, I could postpone the start date in order to take the exam (by using some of my vacation)?

 

[Raryn]

I don't get it. You're a psych resident, which means your first 6 months will almost entirely be internal medicine (which is >half the test) and neurology. You'll be just fine on the psych portions most likely, and a few hours here and there is more than enough to brush up on the peds/ob you need. At some point during the year, you'll have a light rotation (ER? elective month? whatever) during which time you can study a few hrs a day and take it at the end of the month. That test is practically impossible to fail, especially if you've been doing IM...

 

[dozitgetchahi]

Just curious, I am looking for dates to schedule my step 3 exam, and I see a bunch of them during the first month I start. I also noticed that on Frieda, my program had listed July,flexible as the start date, does this mean, I could postpone the start date in order to take the exam (by using some of my vacation)?

No. You start when the program wants you to start. Nobody is going to let you start off on vacation just so you can take this test.

I saw your post in the osteopathic forum - looks like you may have ended up in an FMG sweatshop as a DO. This is somewhat unfortunate; however, it means you should be very careful not to piss these people off as these seem to be the type of programs where people get fired if they cross the wrong people etc. This means you don't ask for special accommodations like being given extra time off to take a board exam that some people pass with no studying whatsoever.

Just take the test. I understand you had COMLEX troubles in the past, but really step 3 is easier and the pass cutoff is 350 rather than 400 like it was for COMLEX I/II.

 

[so721]

I don't get it. You're a psych resident, which means your first 6 months will almost entirely be internal medicine (which is >half the test) and neurology. You'll be just fine on the psych portions most likely, and a few hours here and there is more than enough to brush up on the peds/ob you need. At some point during the year, you'll have a light rotation (ER? elective month? whatever) during which time you can study a few hrs a day and take it at the end of the month. That test is practically impossible to fail, especially if you've been doing IM...

No the first 6 months are not IM. It's mixed psych medicine etc

 

[Raryn]

No the first 6 months are not IM. It's mixed psych medicine etc

Even better. During the mixed intern year, you'll have the opportunity to cover >3/4 of the test. You'll need a few weeks part-time to review the rest, but you'll be fine. I recommend taking it sometime in the spring of next year.

Just imagine what it would be if you were a pathologist, where you are exposed to some laughably low proportion of the material during your residency.

 

[so721]

No. You start when the program wants you to start. Nobody is going to let you start off on vacation just so you can take this test.

I saw your post in the osteopathic forum - looks like you may have ended up in an FMG sweatshop as a DO. This is somewhat unfortunate; however, it means you should be very careful not to piss these people off as these seem to be the type of programs where people get fired if they cross the wrong people etc. This means you don't ask for special accommodations like being given extra time off to take a board exam that some people pass with no studying whatsoever.

Just take the test. I understand you had COMLEX troubles in the past, but really step 3 is easier and the pass cutoff is 350 rather than 400 like it was for COMLEX I/II.

Yes, I agree with you. I have been very careful about even talking to the program coordinator and the chief, when they asked me for vacation leave. I really feel my luck is rotten to be ending up in such a political program that is unfriendly. Multiple residents have been let go in the past.

I'm just holding on to the hope that they wanted me due to the fact that I am an american graduate without language/visa issues and hopefully they will treat me better.

 

[so721]

All right, look, you really need to get a handle on both your expectations and your attitude about your new program. Deciding that they are a "political program that is unfriendly" before you even start is a foolish way to approach your internship, even if it ultimately proves true.

I am also from a program where "multiple residents have been let go in the past," and there were very good reasons for all of them departing. You seem to portray termination/resignation as some kind of maliciousness on the part of the program, and I would argue that in most cases this is simply not true. Every time a resident leaves a program, it creates big hassles for the PD, department, and fellow residents, and I highly doubt that any program would regularly put themselves through those difficulties just out of spite.

I am likely not the only person reading through this thread who feels like you are setting yourself up for failure. You seem to think that you deserve time off to study for a test that nearly everyone else in the country takes and passes without "dedicated study time". You seem to be expecting to do poorly on Step 3, expecting that you will have a bad experience with your new program, and expecting that you will ultimately be fired. This is a bad way to approach what should be a very happy and hopeful time in your life. If you have a genuine desire to perform well and take care of patients, you need to alter your outlook.

You're right. If I don't stop, I'm going to be thinking myself into misery and will totally have a recipe for disaster.

 

[Mass Effect]

I don't get it. You're a psych resident, which means your first 6 months will almost entirely be internal medicine (which is >half the test) and neurology. You'll be just fine on the psych portions most likely, and a few hours here and there is more than enough to brush up on the peds/ob you need. At some point during the year, you'll have a light rotation (ER? elective month? whatever) during which time you can study a few hrs a day and take it at the end of the month. That test is practically impossible to fail, especially if you've been doing IM...

I agree with your overall point, but when did ER become a light rotation for an intern? LOL. Just to play devil's advocate, the OP is a DO and will be taking COMLEX which is notorious for an overload of OB and peds as opposed to IM. That said, OP, I agree, just study during your psych months. The medicine months will help augment your studying.

 

[Mass Effect]

ED has lower hour limits above and beyond the ACGME restrictions.

While the shifts are no doubt tough, you also end up with a lot more off time between them.

For the IM and anesthesia residents at my hospital who rotate in the ED it is generally considered an easier month.

I guess that's true. I'm just thinking ED shifts left me exhausted. The hours were less, but they seemed like much more, especially when I was scheduled for 6 (or one week 7) in a row.

 

[Raryn]

I guess that's true. I'm just thinking ED shifts left me exhausted. The hours were less, but they seemed like much more, especially when I was scheduled for 6 (or one week 7) in a row.

*shrug* Institution dependent. ED at the couple that I'm familiar with is a reasonably low-hours experience for interns that isn't too bad. Frequently, the patient's are triaged by someone else at the door and you don't get all that many trainwrecks as a PGY1. I studied for step 3 during my ED month and it turned out just fine. Doesn't really matter though, any non-surgical specialty will have at least one month (and probably more) where you are less busy and can fit in step 3 studying. The surgical ones would probably have more time fitting it in, but even still they usually manage it.

 

[so721]

And I'll tell you, I've seen it happen a couple times. When you expect everything to be terrible, your body language communicates that to everyone around you, whether you mean to or not.

Let me offer a counter-interpretation of your future program, based on what you've described: Perhaps your program is not considered a highly desirable place, and they have been forced to take a lot of FMGs in order to keep their slots filled. However, they also are interested in maintaining high academic and patient-care standards, and so they tend to scrutinize these folks much more closely than you have seen in other programs. While termination is never a good thing for anyone, letting go of substandard FMGs is how they ensure that their program remains healthy, and that incoming juniors are not being taught by poor seniors.

It may be that your program is not malignant, but rather recognizes that they are in a tough recruiting position but are unwilling to hurt the education of their good residents by keeping around the poor residents.

Internship is stressful, but also amazing. Embrace the pain with the knowledge that it's going to make you stronger, and only lasts for a little while. Then when it's done, you can look back on it with a mixture of pride (that you made it through and did good things for people who needed help) and relief (that you will never have to do it again).

I wish you the best of luck!

Thank you, I appreciate your perspective. I think I have been focusing on the negatives (high patient population, run down county facility with low funds etc.), and I haven't seen that perhaps it will make me all the more efficient and competent by providing me with the exposure I need.

 

[johndoe44]

The best thing to do would to set a date later during internship during an elective rotation (March or April) and the last week of that month, take a week vacation and schedule the test at the end of that week.

That way, you won't have to "ask" for time to study and as far as anyone else is concerned you were just on vacation. When you start internship, just read UTD as you admit and learn to manage patients and do UWorld about a month or two before your test date and you're solid.

 

[ari202]

The best thing to do would to set a date later during internship during an elective rotation (March or April) and the last week of that month, take a week vacation and schedule the test at the end of that week.

That way, you won't have to "ask" for time to study and as far as anyone else is concerned you were just on vacation. When you start internship, just read UTD as you admit and learn to manage patients and do UWorld about a month or two before your test date and you're solid.

That seems like a good plan. I have had to struggle with COMLEX in the past and the frustrating thing is I just don't know how to accurately assess my score. Like there is no practice test available to ensure that I'd pass...just one old COMSAE. Pretty frustrating.