How tough was it to pass Step 3 as a resident?

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I'm contemplating taking Step 3 to get it out of the way before I start internship. Yes, I know I should take it since I got the time right now, but I don't want to squander my last few months of vacation studying.

How tough was it to prepare and pass this test as a R1/R2/R3? Did you just take it w/out studying? I mean you come home post call dead tired, the last thing you want to do is study pediatrics right? Or you finally get a day off, you really don't want to do Qs on USMLEWorld. And of course you don't want to waste vacation studying. Those are just the scenarios that I can imagine myself in.

One thing that scares me is that a resident told me he got fired from his program because he failed it, and he failed it because he had no time to study. How common is this and is this legal?

Thanks.

 

[Pilot Doc]

Don't study for that test - you'll hate yourself in the morning. It's not hard. I studied not at all and made 20 points lower than my Step I/II scores. Assuming you passed I & II without problems, III should be easy.

 

[Winged Scapula]

I agree with Pilot Doc. I bought a review book (can't remember which one), skimmed through it the week before just to brush up on Peds, Ob-Gyn and IM and passed the exam (which I took at the beginning of PGY3). So few Surgery questions that you should skip that section.

I wouldn't worry about it...the old saw, " Step 1 two months, Step 2 two weeks, Step 3 number two pencil" still holds true!😀

 

[Winged Scapula]

One thing that scares me is that a resident told me he got fired from his program because he failed it, and he failed it because he had no time to study. How common is this and is this legal?

Thanks.

Programs are not supposed to use any standardized tests as a factor in contract decisions. However, they certainly do.

Technically, a program faced with a problem resident is supposed to put the resident on probation, which includes a written description of the problem and a mutual plan to correct the problem.

I doubt the resident you speak of was fired soley because of failing Step 3, even if the program had a policy that stated you had to pass it before moving onto PGY-3 (a common scenario). Programs generally will work hard to keep good residents. What is more likely is that this resident had other problems and the program used the failure of Step 3 as a "reason" to fire him. Is it legal? Well, it can be done if the contract or residency requires that you pass the exam; however, most policies are not clear on this.

I don't think it common, because most people pass it, although I know some who have taken more than 1 try to do so...but since they were "good" and valued residents, they were kept on. The only requirement my program had was that we pass it before we started 3rd year...since my score didn't come back until early August of my 3rd year, I was a PGY2 on paper (and in paycheck) for an extra month...along with several of my co-horts who put it off as long as possible.

The argument of not having enough time to study for Step 3 is not likely...after all, most will tell you that the questions, even non-surgical ones, are pretty basic, and it wouldn't take more than a few days to review...a weekend here or there. Surely he had enough time to study, but probably didn't until right before the exam and therefore, paid the price by not passing.

Its not like you need a month off to study for Step 3...you should do fine with some brushing up...if anyone had totally blocked out all memories of Peds, it was me!

 

[maxheadroom]

You won't need to study, especially if you take it sometime in the next few months. Get it out of the way early. Take it by the end of your intern year. Taking it in the first couple of months of internship would be a pretty good idea. the only reason that I can think of to wait until after Jan 1 would be that it's a decent tax write-off. Your income for the second 6 months of this year, plus moving expenses and buying a home will put you past your allowable deductions.


Just get the official prep CD that NBME sends out and practice the free response portion. I know a few people who screwed up the first one or two modules because they didn't understand the system.

 

[Tigger14]

I wouldn't worry about it...the old saw, " Step 1 two months, Step 2 two weeks, Step 3 number two pencil" still holds true!😀

Mine was on computer!

Anyway, I will chime in with agreement. I used Swanson's Family Medicine to review in the couple of weeks before the test and did fine. Only got 2 surgery questions..."what is the most common cause of post op hypotension?" and "what is the tx for the most common cause of post op hypotension?". Also, definitely get the CD and practice the scenarios, just so you know how to function and don't waste time with it during the exam (these are the second half of the second day of the exam).

 

[Winged Scapula]

Mine was on computer!

So was mine, but I conveniently forgot about that, obviously! 😀

Anyway, I will chime in with agreement. I used Swanson's Family Medicine to review in the couple of weeks before the test and did fine.

That was the text that was so often recommended and as I recall was what I used as well.

Only got 2 surgery questions..."what is the most common cause of post op hypotension?" and "what is the tx for the most common cause of post op hypotension?".

I got a traumatic pneumothorax question and a couple of others, details of which I don't recall. Really no surgical questions to speak of/worry about.

Also, definitely get the CD and practice the scenarios, just so you know how to function and don't waste time with it during the exam (these are the second half of the second day of the exam).

Very important; I don't know why anyone would register and not get the practice scenarios or read the pamphlet the NBME provides, but I guess people do that. As noted, you will waste time and possibly be confused about how to answer the questions.

 

[purplefish]

How many free response questions are there?

 

[Pilot Doc]

Very important; I don't know why anyone would register and not get the practice scenarios or read the pamphlet the NBME provides, but I guess people do that. As noted, you will waste time and possibly be confused about how to answer the questions.

I can confirm that from painful experience. About 25% of the test is free- answer scenario-based questions.

 

[njbmd]

I took Step III in Feb right after ABSITE of my PGY-1 year. I used Crush USMLE Step 3 and really made sure that I could work the software. I did the practice cases on the disk that you get with Step III registration. Working with the software was the most useful thing that I did to prepare for this exam. I found the questions straight-forward and not particularly difficult.

I used a couple of Saturday's to review and had no problems with the test. If you are not in medicine/family medicine, get Step III out of the way as soon as you can. It's just a nuisance and money sink. My cases were meningitis in a 18-month-old, appendicitis in a 22-year-old, menorrhagia in a 16-year-old, dementia in a 75-year-old, congestive heart failure in a 50-year-old hospitilized patient, rectal bleeding in a 40-year-old woman, acute MI in a 60-year-old, osteoarthritis in a 78-year-old and hypertension in a 45-year-old.

 

[Winged Scapula]

My cases were....

Please tell me you didn't actually remember those but rather had written them down after the exam!😱

 

[njbmd]

Please tell me you didn't actually remember those but rather had written them down after the exam!😱

I wrote them down as soon as I walked out of the exam. My memory is 5 minutes long these days. 😱

 

[phoenix77]

As someone who lost his residency position due to not having Step 3 completed by July 1 of his PGY-3 year, I can attest to the fact that you CAN lose your residency for this. In retrospect, I gave my program some concern due to my poor ABSITEs, but that was a program-wide problem (i.e. chiefs sign contracts saying they understand they won't graduate without breaking a certain ABSITE score, entire classes averaging less than 20%, people not being promoted in the past). My former program had a long history of poor ABSITE scores and first-time board failures, and I think the RRC was on its case about that. Since my contract did say that I had to have Step 3 done by July 1, I gave the program a perfect way out. My evaluations were good and I have good letters of recommendation, clinically I had shown myself to be "a hard worker and clinically sound..."

Bottom line, especially all the new surgery interns, get Step 3 out of the way!

 

[NDESTRUKT]

what program were you in if you don't mind me asking.

 

[surgdo]

Were you at the copa cabana?

 

[Skylizard]

I took step III as soon as I could... especially since my program was footing the bill.

Anyways, I had purchased the "crush step III" book/manual but found the "Swanson's Family Practice Review" manual more useful. Surprisingly, it was my colleagues from my prelim GSurge program that recommended Swanson's. It definately covers alot of vaginosis, otitis media, pneumonia, strep throat, OB/Gyn, etc...
Since Step III is a general test for all specialties, Swanson's worked, my friends in surgery proved their smarts again by recommending it😎 .

 

[Blade28]

I skimmed the clinical cases section of First Aid in a Borders one day, then spent a weekend skimming through Crush Step 3. That worked for me.

I'd also advise taking it early...I took it in September of second year (should have taken it earlier!), before I'd totally forgotten all my peds/psych/OB-GYN.

 

[SocialistMD]

I echo the previous posts; I couldn't listen to PilotDoc's "seriously, don't study" completely (mostly because he is wicked smart and I don't trust people like that 😉), so I read the peds section in a borrowed copy of Crush Step 3 (I literally studied for <1 hour one night on call at the VA), took the test the next day (half-way through my R-2 year) and only dropped 10 points from step 2.

Interestingly enough, on steps 1 & 2 my behavioral science/psych scores were nearly as high as my surgery/anatomy scores, but were in the "marginal acceptance (or whatever that grey box is called)" on step 3. Oh, how a surgery residency changes you...