Hi, I just want to share with you my step 3 experience.
I'm an IMG, graduated in 2011 from medical school. I attended a forensic pathology residency program in my country. Then I moved to the US in 2018 to start a residency program in Anatomic pathology. So basically, I don't have a lot of clinical experience.
So, for me, step 3 was by far the hardest USMLE step ever...
I took it two times, the first time last year and I failed by 2 points...........
On my first attempt, I used UW and MTB.
After the exam, I felt pretty comfortable, and I was sure I passed. I was wrong... I'm sure I failed because I didn't give enough importance to CCS.
My second attempt was a couple of weeks ago. I did again UW two more times, ending with an overall score of 88%. Both USWA1 and 2 ended up with a score of 220.
This time, I worked more on the CCS to avoid the same mistakes I did on my first attempt. I use UW cases and the software from CCScases. I know that their grading system is not accurate, but the thing is that you don't care about that score. It would be best if you used that software to remember the orders, and it worked with me.
Day one was terrible. They changed the pool of questions since my previous attempt, and I found the new one harder. As expected, a lot of biostats, but while in my first attempt, they were mostly basic formula questions, this time I had just 2 or 3 of them, and the vast majority were about particular stuff regarding research study design. And if you are thinking about something like "what is the best study to carry out this research" you are wrong, there were a very few like that. There was a lot of stuff not covered in UW, even if you buy the special biostats section.
Other questions on day 1 were mostly "step 1 style" questions and some weird prognosis questions.
Day 2 was a little more similar to UW, but there were still many questions and topics uncovered by UW Qbank.
The real problem is that, in my opinion, UW QBank needs to be updated to cover other topics. As I said, I used UW QBank for both attempts, and after 1 year, the UW questions were exactly the same (there were just 5 or 10 new questions maybe). I know that UW is considered the best resource, and I'm not saying that it is not. I'm just saying that, probably, people who get a high score on step 3 just studying UW have a solid clinical background.
CCS cases on day two were a little longer than the previous attempts. They were pretty straightforward, but only two or three of them finished earlier. Others kept going, although the patient was feeling better.
This time, I exited the text center, sure that I failed. Compared to the first attempt, I found this one way harder, and I didn't feel comfortable with almost half of the questions, despite the fact that I studied way more than the first time.
I got my score earlier than expected (after just two weeks from my day 2), and I passed with 203. I just needed to pass it, so I'm more than happy with that! UWSA1 and 2 overestimated my score by 17 points.
To be honest, I'm pretty sure that the CCS cases improved my score. In my score report, I had everything in the middle part, but the CCS cases were in the higher performance side (right).
So, please, DO NOT NEGLECT CCS CASES!!!! They can save your back. If it weren't for them, I would have probably failed a second time.
Just to let you know: the "score trick" did NOT work for me the first time. I had a gray box saying: "Your Eligibility Extension has been approved. You may schedule your exam on any date prior to your new extended expiration date. No additional extensions will be granted for this Step 3 application." There was NO link to reapply, so I was pretty sure that I passed. But I failed, so be careful when you use the trick.
I'm not sure why it not worked with me, but one explanation can be that I asked for an extension, and I know nobody knows if the trick can be applied in case of extensions.
On my second attempt, I had the same situation: I asked for an extension, and I had a gray box saying: "Your Eligibility Extension has been approved. You may schedule your exam on any date prior to your new extended expiration date. No additional extensions will be granted for this Step 3 application.".
In both cases, on Sunday before the score release, status changed from "approved" to expired," and there was no link to reapply.
My suggestion is that if you don't have a solid clinical base or are in a residency that is not clinical-oriented (like pathology), it would be worth using UW as basics Qbank, but also trying different ones (Kaplan, BoardVitals, etc...). You don't want to take the exam to find out that half of the questions are just WTF questions! (But maybe it was just my problem...).
Finally, again, study CCS cases as much as you can, they can save you. I found the CCSsoftware better than the UW one for my preparation.
Regarding how long you need to study for step 3, it really depends on you. For me it took about 2 months, during my second year of residency.
Finally, I don't know if the age is a limit for fellowships. I'm 35, and I recently got a spot in one of the biggest forensic pathology fellowship. Maybe it depends on the fellowship program.
I hope my experience can be helpful.
If you have any questions, feel free to ask!
Good luck.
