Is Step 3 hard for psych?

[CariBeaner]

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Is it true that psych residents have alot of trouble with step 3? I was going to take it in advance so that I would have more time to commit to studying but then residents at one of my interviews acted like that would be crazy and said its the easiest of the 3 steps. Anyone know what the truth is?

 

[jjbmsiv]

I just started a new thread on the usmle step 3 board of SDN (asking about the best books/sources to use) because I am scared silly by this test. SILLY. After reading the sdn board, it seems to be the most illogical of them all, with poor poor answer choices and obscure topics with awful photographs. I strugles with 1 and 2 to begin with- I feel that my meager 2 months of inpatient interning next year aren't going to be enough. Well, that or I should schedule to take the test the last day of my rotation. I second the cry for help, or at least more info from a shrink's perspective!!

 

[Hurricane]

I'll let you know how hard it was when I get my score back 😉

I imagine it would be pretty easy if you were taking it at the tail end of an emergency medicine rotation, but as a psych intern, I had to study for it. (Unfortunately, I was sick and vomiting for half of my scheduled study time, so I didn't get to study as much as I'd have liked to.) I do think it's probably best to take it during intern year before you're too far removed from the rest of medicine. I took it after my EM rotation, and that was good practical prep.

Still, I found the test highly annoying. Many of the questions ended in "what is the immediate next best step in the management of this patient?" then had a list of things that in reality, you'd write on the order sheet all at the same time and they'd get done in whatever order the nurses got to it. So the question was basically "read our mind." 😡 Oh and yeah, the xray images were absolutely horrible, no matter I did to the monitor. 😡 😡 And I only stayed to do the optional survey at the end so I could vent about the images, and then there was no free text space to do it. 😡 😡 😡

Anyway, the best thing is to do lots and lots of questions from usmleword.com in tutor mode (gives you the answer and explanation after you do each question) so you can learn what they're looking for. Wish I had had time to do more of them. And of course do the CCS questions on the CD to familiarize yourself with the format. The other thing that helped was this little Blueprints book about the CCS exam. Explained the confusing format and outlined a simple strategy to do them, and you can easily read it one evening. Still I got flustered and f'ed up my first one. Sigh.

 

[Boofus4L]

i had a different experience. i actually found the test to be much easier than steps 1 or 2 - very primary-care based and pretty straightforward. my residency program has a march 1 deadline for taking the test, and i had some last minute schedule changes, so i pretty much had to take it when i did and didn't have a chance to study. what i did do was review the provided cd with the simulated cases on it, which was very helpful. i ended up passing the test comfortably, so i wouldn't worry so much about being disadvantaged as a psych resident!

 

[whopper]

From my experience, it seems psyche residents do worse on Step III because we don't deal much with medicine.

My own advice to all new psyche residents is to not consider psyche something where you don't have to know IM or primary care. You do, especially in hospital & consult psychiatry.

You're going to have times where the IM or ER doc want to dump a medically unstable patient that they think should go to psyche, but really shouldn't (e.g. delirium due to hepatic encephalopathy). If you don't know what you're talking about, you're going to look stupid.

You're also going to occasionally see psychosis or depression 2ndary to medical causes.

You're going to have inpatients who have chronic medical problems and since they're in the psyche unit, you're their primary.

And hey, yes it will help you on step III.

I am though noticing that Step III seems to be easier than step II at least by the Kaplan questions I'm working on!

 

[Anasazi23]

The test is stupid, but definately passable. All the psych residents in my class passed it first time...which is not true for some of my IM friends.

I rented a cabin in the Adirondacks, studied for two weeks solid, did a little hiking and boating, and passed with some room to spare.

Focus on basic stuff, and don't read into questions.

You know the old adage:

Study 2 months for step I.
Study 2 weeks for step II.
Bring a #2 pencil to step III.

It's not quite that simple....but I used it as my battle cry to help me get through.

 

[jjbmsiv]

Would you guys mind posting more speccifically what sources you used? I tried to start a similar thread on the sdn step 3 boards, but didn't get many responses. Plus, well, I'd rather hear it from a fellow shrink, who understands that we might be somewhat 'disadvantaged' by a much smaller internal medicine timeline/standard to meet.

First Aid vs Crush, USMLEWorld vs Kaplan, what to use for CCS, et cetera...

 

[whopper]

I'm going to take it very soon, and I've been tallying what other residents have been saying.

USMLE WORLD is better than Kaplan, though both are still good.

Study for it, but its easier than Step I or II.

Its pretty much clinically based unlike I & II. There isn't much theoretical stuff. ITs mostly stuff like---what test do you order next?

You have to practice the CCS simulator that's given to you or during the exam you'll freak out while trying to figure out how it works.

There is a USMLE section on this board. May as well check it out.

 

[Quijotemd]

Step 3 is EASY. Read crush twice, do at least a third of USMLEworld questions, and you're set.

 

[sunlioness]

The practice cd, as someone mentioned, is key.

 

[whopper]

I've been using the CD.

You absolutely need to practice that CD for the CCS cases.

All the CCS cases I knew what the patient had but I was screwing up because this program has its own type of OS format. Kinda like using windows for the first time. THe program's not hard but you don't want to learn it under the testing conditions.

Practiced it for about 3 hrs and there's still a few kinks I'm figuring out to it.

 

[Hurricane]

Well, for all my bitchin' and moanin' I got my scores back yesterday and a I passed. So, take it from me, a psych intern can be febrile and vomiting the week before, study only 3 full days (mostly usmleworld questions and the CD, I didn't have time to finish Crush), and still pass just fine.

Now, on to licensing. That looks like quite the adventure.