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Failed Step 3

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FlamingSteak

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So about a week ago I got my Step 3 back, and unfortunately for me, I got a score of 182.

Long story short, I had to have my exam rescheduled about a month ago due to a issue out of my control. So I was burned out to begin with so I didn't get much in the room of review in to pass this exam (busy rotation plus other events prevented me from reviewing much for about a month and a half).

In terms of my score break down, it seems that the MCQ is the biggest culprit. I did above average on my CCS (kind of makes sense, as CCS is more of an "integrative" aspect of the exam, whereas the MCQ is more of a selective recall at times). My step one score was a 249, and my step two was a 220 (Had to rush this exam, god my life sucks).

Lot's of bad luck, but hey it's life and this needs to be taken care of.

So now, I have given myself 2 months to take this exam again. I am on a relatively relaxed duty hours for the next two months (8-5 w/o call).

I was gonna go through UWORLD/Kaplan QBank/Master the Boards.

I feel that I need to tackle this in a more comprehensive manner, so I was going to brute force through First Aid 2 CK (What are your guys thoughts on using FA 2CK? FA 3 seems very sparse in info).

Any further resources or help would be greatly appreciated.
 

eyegotlucky

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Ophtha resident, FMG

2010
April Step 1 -89
June Step 2 CK - 90
July CS - Pass

2011-2013, Residency Training

January 2014 - Study

Feb 2nd week, 2014
Step 3 - 192 (PASS)

Experience:
I'm posting this as guide for things not to do on taking Step 3. What I did was kamikaze. I had very limited time in preparing for this exam since I still have other local certifying exams to do in a couple of months to come. I studied for barely a month, after 3.5 years from taking CK and for doing ophtha residency outside the US. My father is sick so I still have to manage him, take him to the hospital 2x for admission, and go back and forth again to the clinics for his follow up. So my preparation, unsurprisingly, was a disaster. I read MTB once, went over selected topics on First Aid (and not on its CCS cases), Did Uworld for 3 weeks, finishing only 70% of its MCQ content and averaging 50%. I did all of their CCS cases and read its online printable contents ONCE.

Day 1 was a nightmare. I finished 3 or 4 blocks by clicking a random answer at the end of those blocks due to lack of time. Time management is very essential in Step 3. Honestly, I think the exam is a bit unfair for having lengthy clinical questions (and abstracts hello??) to answer in a very limited timeframe. But I guess I can't do anything about it. So I just crossed my fingers and went on. There were fortunately a lot of ophtha questions which I readily answered. But there were also questions in ortho, etc. which I think I bombed. I was VERY NAUSEATED at the end of the day, perhaps due to lack of sleep, stress, and jet lag. My head ached. I was not able to eat dinner properly later.

Day 2 was more forgiving. MCQs were still difficult. I found it easy to answer the CCS though. I had only 1 case of a hypotensive infant that can't seem to improve in spite of all managements that I did. Everything else was quite a walk in the park for me. BUT STILL, my results show that I just did average on this part of the exam, so I really don't know how they score it. Funny how a case turned out quite similar to what my dad has, so management of it came easy for me.

So after the exam, I knew that it could turn out either way. I had a good feeling on CCS, but bad on MCQ. So I was really happy when I got the passing mark! I just need to pass and my grade won't be really significant. My advice to anyone who would take this is for you to have enough time studying. You really need to focus on this. I think 2 months would be enough if you're an IM or Fam Med resident, but in my case, I would have gotten a better grade if I study for 3-4 months. Better take it a few weeks after taking Step 2 CK because topics are quite the same. Another downside here is that it's been 3.5 years since i took CK so I had really a difficult time. But I passed thankfully! Although barely. But what the heck, I'm done! But I know I just got very lucky on this one. :)
 

TGF beta1

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I have been in your shoes several months ago. May 2013 took step 3 first time - failed 180. Thought that I have to read a bit more and than pass. Studied for 3 months, mostly MCQ and 2 weeks for CSS, had a graet score on UWORLD assessment, failed again with score 183 in November. And had reasanable CSS spread on results on both attempts. Do not repeat my mistake. Do not go through MTB and UWORLD again - won't help. Despite you mentioning that CSS is above average it is not enough. CSS is 25% of you exam score. If you fail 1 case you need to answer 2-3 more questions correctly in EACH block to compensate for that. If you fail more than 2 or 3 it is hard to pass the exam. For my third attempt I took Kaplan courrse, Archer CSS workshop and did usmleconsult cases, with emphasis on cases. Conclusions. Best book to study - Kaplan lecture notes, if you done Uworld once - don't do it again - worthless, take something else, like Kaplan Qbank. Concentrate on CSS, especially on sequence of orders. For example, for a kid with osteomyelitis Xray first MRI only after. If you order them in the same order - MRI will not count, or may even subtract points. UWORLD CSS doesn't teach you sequence, Archer CSS and usmleconsult - do. So yesterday I got results of my third attempt - 201/PASS - extremely happy! Main difference from 2nd attempt - seriously improved CSS component of the score.
 

FlamingSteak

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Thanks for your reply TGF-1 beta! My first attempt was very sloppy, I went in not looking over UWORLD for a few weeks due to circumstances. I am taking the exam again in a couple of weeks.

I did the following:
- I looked at my score report, and went back and really reviewed the topics I am weak on from scratch. Everything was around borderline, with some of my topics being all the way to the left (near poor performance). So I opened up my old Kaplan Step 2 CK notes, and studied those topics from scratch. This has helped me immensely.
- I used about 40% of Kaplan and Consult Qbank for each of my topics. I made sure to read and understand every wrong answer and question.
- I am hitting above average scores consistently on all UWORLD blocks mainly because I might remember 2-3 questions but also, many questions I can answer with some information I just had to review. Anyways, I finished UWORLD. I got a couple of weeks left, gonna memorize my new UWORLD notes (believe it or not, I have annotated and read so much, that I don't think I even learned much from UWORLD first go other than memorize the notes). In fact, for every question, I probably opened up the AAFP website and read guidelines specific for that ailment. Methods, diagnosis, and management.

With that said I have read the whole Kaplan Step 2 CK book in the past month. I made flashcards for relevant for major pathologies, where I list steps of management and diagnostic procedures. Again, I am playing with the CCS software again, and I feel I can tossing in more order, picking up on more things.

I agree with you, CSS is an easy part of the exam to improve upon. I feel I need a little bit more of an "oomph" when it comes. What do you recommend? the 88 dollar archer course? I think I am hitting on all the basic info, I just need more CCS practice.
 
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