CCS Prep for American MD s/p Clinical Intern Year

[QofQuimica]

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Question for any American MD grads who completed most or all of an intern year in a broad clinical specialty like FM, EM, or IM (or did a transition year/medicine prelim) prior to taking Step 3. Do you think it's necessary to buy the CCS case questions from UW, or will the 6 cases from the USMLE website be sufficient preparation? I was going to get the UW CCS cases, but it's $80 for a month even though I only want it for a week, and it seems like 50+ cases is way more than I'd need, let alone have time to do.

FWIW, I've read all of MTB and done about half the MCQs in the Kaplan Step 3 Qbook. I'm planning to do all of the USMLE website practice materials over the next few days. My test is in a week. I'm a good test-taker.

Thanks in advance.

 

[Punkn]

Question for any American MD grads who completed most or all of an intern year in a broad clinical specialty like FM, EM, or IM (or did a transition year/medicine prelim) prior to taking Step 3. Do you think it's necessary to buy the CCS case questions from UW, or will the 6 cases from the USMLE website be sufficient preparation? I was going to get the UW CCS cases, but it's $80 for a month even though I only want it for a week, and it seems like 50+ cases is way more than I'd need, let alone have time to do.

FWIW, I've read all of MTB and done about half the MCQs in the Kaplan Step 3 Qbook. I'm planning to do all of the USMLE website practice materials over the next few days. My test is in a week. I'm a good test-taker.

Thanks in advance.

Hey Q,
Since you've only got a week, I'd save your $$. I took the exam yesterday (see score vs uw thread) and felt the cases were very straight forward. Being familiar with the software is important, but it's more about having a system to approaching each case.

-Case gives you CC and History (make note if pt is smoker/drinker/risky behavior/what preventative stuff they need if office visit)
-Decide if pt needs emergency stabilization before PE
-PE
-Decide if pt needs to be moved to different location
-Orders (CBC/BMP vs CMP/UA for basically everyone; Imaging; Therapy +/- case specific)
-Select when next result available to get through the case

 

[QofQuimica]

Hey Q,
Since you've only got a week, I'd save your $$. I took the exam yesterday (see score vs uw thread) and felt the cases were very straight forward. Being familiar with the software is important, but it's more about having a system to approaching each case.

-Case gives you CC and History (make note if pt is smoker/drinker/risky behavior/what preventative stuff they need if office visit)
-Decide if pt needs emergency stabilization before PE
-PE
-Decide if pt needs to be moved to different location
-Orders (CBC/BMP vs CMP/UA for basically everyone; Imaging; Therapy +/- case specific)
-Select when next result available to get through the case

Thanks, Punkn. I tried doing the USMLE website cases tonight (take the test tomorrow and Tues), and I feel like those were probably enough to get the general gist of what to do. I came up with a similar technique to what you suggested.

1) Read case (obviously!)
2) Order appropriate physical exam
3) Decide whether to treat first vs. order studies first. In the office patients, you usually have the time and low enough acuity to do a full PE and order all the tests you might want to rule out anything on your differential. In the ER, you sometimes have to stabilize the patient based just on the PE and presentation. You also need to get everything done in the ER more quickly since those are acutely ill patients.
4) Give meds as appropriate. (You need to know administration routes but not doses.) Always treat the patient's pain.
5) Reassess the patient after an appropriate time interval to see how your interventions are working.
6) Order consults if appropriate
7) Admit patient if appropriate (or make new appointment for office patients)
8) Counseling for any bad habits and education for any chronic diseases.

I found that all of my practice cases ended early once I got the hang of doing this. It's actually kind of fun.

Edit: Took the test earlier this week. I felt like the online practice cases were very similar to the real test and were probably sufficient preparation for someone who has done an American allo intern year. Most of my cases on the real test ended early, similar to the practice cases. The software and interface was identical. Will try to remember to update this thread once I get my score in June.

Edit #2: Got my score back today. Update for US allo grads wondering about whether buying the USMLE World cases is necessary: at least for me, no. I scored well on the CSS section just with having used the USMLE website practice cases to familiarize myself with the software. If you've had a clinical intern year and you're a US allo grad, I'd suggest saving your money.