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USMLE Official USMLE Step 3 Experiences Thread

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Redpancreas

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Score: 243
Study Period: 2 months
Step 2CK: 245
Step 1: 252.
UW Step 3 Average: 69% timed tutor, random. Repeated Peds/OB+GYN/Endo.
UWSA 1 (4 weeks out): 206 (Fun fact: there's an option to score recheck your practice exam. When I clicked it my score went from 196 to 206). I hate practice exams and think I split this one up into two days. I mainly used it for more questions.
Demographics: US MD, 2 years of IM residency experience
Study time: Two month time period, studied 9-5 most days but took maybe 20-30 days off just goofing off or focusing on other things in life.

Resources:
1.) UWorld Step 3 ($300)
2.) UWorld Step 2 CK (Peds/OBGYN mainly but I literally went clicked through other sections the day before my exam)
3.) OnlineMedEd videos for some review
4.) CCScases.com for CCS ($60)
5.) $25 Biostats package.
6.) MedQuest [new] by Conrad Fischer/Niket Sonpal (Video lecture series based off 2020 Master the Boards). Warning $$$ (300).

Study Period:
Out of all the Step exams, this one was the most lonely/isolating one with no real dedicated resources other than UWorld that I'd heard of. I studied January/Feb for most the day. Most PGYs won't be able to do this, but my advice is to not take the exam lightly. It seems like a lot of people seem to fail it or drop scores and I felt the exam was actually quite difficult despite all the sentiment from attendings that it's a breeze or whatever. For those interested in IM fellowship, your score probably doesn't matter BUT score too low and you could get screened out for a competitive fellowship so I wouldn't go in there with a #2 pencil as the saying goes.

I started with UW questions and mixed in some OB/GYN + Peds independent review and things were going slow. One thing that sped me up was I met an IMG on the USMLE Step 3 FB group and we basically started doing UW and CCS together over Zoom and I went at a pace of 80UW+4CCS a day. She was super good with Peds/OB-GYN and had just taken Step 2. We chose to use CCScases.com instead of UW because it gave way more feedback to learn from and gave us an exactly percentage on each case based on a detailed analysis of how we managed the patient and the order we did it in. After we completed this, we kind of split up and went our own way after re-doing some Uworld questions from my weak areas (OB/GYN, Endo, Peds). I ended up not using Anki. TBH near the end I kind of slacked and maybe 10-15 days off the month, I did not really study. I spent most my time redoing a bit of UWorld and watching the Peds, OB/GYN, Endocrine, Hematology, Cardiology, and ID sections of MedQuest (new 2020 resource).

Strategy:
There are 3 unique elements/curveballs to this exam aside from what is in UW Step 3 some don't expect.

1.) Biostats Emphasis (Day 1):
I think what's most in your control on this exam is biostats yet no one wants to spend time on it. I did UW random tutor so I was exposed to biostats consistently throughout and spent more time figuring out why I got these questions wrong. There are a few recurring themes like it a confidence interval cross 1, that's not the answer and to never pick X causes Y as an answer. A week before the exam, I purchased the biostats UW package which also helped a bit to drill down less common concepts like predictive values, NNH/T, and definitions and test taking strategies for biostats. I felt this helped me on the real thing. Definitely memorize the 2x2 table and learn how to manipulate it. As someone pretty good at math, it felt humiliating to memorize a 2x2 table and formulas I could just derive/reason through but you are gonna get questions testing sensitivity/specifity so you may as well get super accustomed to doing these calculations fast instead of wasting minutes trying to reason through stuff.

2.) Basic Science (Day 1)
A lot of IMGs were advising me to read First Aid and I pulled out my old copy but didn't use it too much. I figured I'd either know it or I didn't and spending all day reading First Aid for Step 1 wasn't an active learning strategy and too low yield to be worth my time. I didn't review any of the First Aid Micro/etc. people said to. What helped me in some cases were the MedQuest lectures where Conrad Fischer hits on high yield basic topics simultaneously while covering the higher level stuff like diagnosis & management/etc.

3.) CCS cases (Day 2)
Start prep early. I preferred CCScases.com to UWorld because the CCScases software gave me way more feedback than UWorld and gave me insight as to how one loses points. A lot of people seemed to get bogged down by details like preventative care/vaccines/smoking cessation when in reality that's like maybe 5% of the points based on CCScases. The key thing to CCS I think is your treatment. Per CCScases, it accounted for about half your score. Missing a one key step like prescribing a medication or calling surgery to do something costs you 30-40% of the points Don't worry about dosing as you only need to know routes and for antibiotics, multiple answers are accepted as long as you're covering the right bug. Work-up was second most important. It's important to not only order what's indicated to make a diagnosis but order what's needed to figure out why things happened in the first place or further complications. For example, with AFib (not on my test) it's important to order TSH and BMP even though it doesn't contribute to the diagnosis. As an IM resident, this came naturally but to others it may be a refresher. The diagnosis itself is not actually tested (I did not have to type it in a box even when the case ended like I think they used to have you do). I actually scored near full points on a practice CCScases case where I didn't have an exact diagnosis in my head but had a gist it was some kind of ovarian mass and did the right things to manage it. The best thing to do is to develop your own system for orders and practice this. This is a bit like a video game in that speed/accuracy come with time. Practice a lot of cases. The real test had different order sets than CCScases though and CCS cases were a little too obvious about what the diagnosis was were my only two knocks on them. Definitely download the official USMLE software which has 6 cases to review to get a sense of what the real order sets are like, but unfortunately the real cases are a bit more challenging than those on that software too. On the real deal the cases are a bit difficult because they kind of "evolve" as one diagnosis turns out to be another whereas CCScases the diagnoses were fairly straight forward.

Experience:
I took it on a Wed/Friday. I don't think the time between matters and it's probably more of a mental thing.

Day 1:
Honestly, I really felt good about this day which was eery because everyone said this was the worst day. On my exam, there were probably 7-10 biostats questions PER block on Day 1 ONLY and covered a range of biostats material. A decent amount of it was pretty basic 2x2 table stuff so don't neglect that. There was some basic science material on there. It may have hit on strengths but I felt it was stuff residents should still know like MOAs of drugs, etc. The way basic science was often tested was in the form of a 2-3 order MCQ where they gave you a clinical scenario. You had to get the diagnosis (1) and the treatment (2) and the answer choices would be the mechanism of action of the treatment. I honestly found these to be easier because you can reason through them. Some of the questions were super random but that's with any Step exam. Some of those random ones were actually random factoids I had a gestalt about based off something I remembered way back in the M1/M2 classroom. All the ethics questions were on day 1 for me as well and there were some tough ones. I did run of time on a few blocks with 1-2 questions left that I had to skim/guess on but that's not atypical for me. I came out of day 1 with a 8/10 confidence level.

Day 2:
The Day 2 MCQs absolutely shattered my confidence. My Step 1 score was way better than my Step 2 score so maybe this is different for everyone because it seems like a lot of people are saying these questions are like Step 2CK whereas Day 1 is a microcosm of Step 1. I spent a lot of time with Uworld Step 3 and even CK but it still felt like I was guessing on way too much. The answer choices I was looking for just weren't there and I walked out of the first set of 30 (my exam had 6 sets of 30) and was like holy **** I don't think I was sure of a single answer (slight exaggeration but still that's how it felt). I went 2 blocks at a time from then on and honestly things got a little better but it was still pretty bad overall and had to guess on the last 3-4Q on some blocks (another sign Day 2 was harder) and honestly I just did not know what some questions were trying to test or didn't see an answer I liked. Another thing that messed with my head was there were these two-part questions where answering one locks your answer and most of the time the next question reveals the answer to the previous question in the first sentence (ex. The physician orders [insert answer choice from last question]). I think I was like 7 for 9 on them between both days. There were more pairs than that but others didn't necessarily give away the answer. I couldn't help but take more time on these knowing I would know if I got them wrong in a few seconds so be ready for that mentally. Anyhow, this whole day felt super tough. While I used some clinical reasoning from residency I did not think the questions made as much sense as UWorld Step 3. I just thought questions were more vague...obviously I did well enough so something went right though so don't be super discouraged if this happens to you. When I left the center, no one on Reddit or SDN seemed to share this experience. Finally CCS came along. Note that you get a 45 min cumulative break time on day 2 for MCQs and a separate 45 min break time for CCS. I personally used very minimal break time which I think was a good idea because I think my performance on an exam gets worse the later it gets into the day and I finished at 2pm instead of 4 pm which was optimal. The real CCS cases felt better than the D2 MCQs I just ranted about but just not as slam-dunk diagnosis types as CCScases.com. One case had two separate diseases! I have residency experience and that helped a ton. One case was a pretty realistic scenario I see a lot in the ICU I didn't think CCS would test on. I was perturbed when I had a case I knew exactly how to manage end promptly after my first round of orders when it said the patient was feeling better. There was also a peds case that was a very rare dz i didn't realize until midway through. I also stumbled on cant'-miss diagnoses three times presenting atypically (which is why it's so important to do a fundamental workup on everyone and not anchor on a diagnosis at the beginning). It’s also true that shot gunning takes time because you are shown results for everything you order so you have to know when to shot gun and when not to. Overall, most cases ended early and most got better through patient feedback. I didn't feel the need to take many breaks between CCS. I ended the day 1.5 hrs early (there is separate break timer for MCQ section and CCS). I felt that was a good way to do it.

Results Experience:
Bonus section lol. There's a lot of confusion about this which leads to anxiety. I've combed through tons of reddit/sdn threads including SDNs very own "The Trick Works!" thread and here is what seems to be the case:

1.) Your score report will show up on a Wednesday at 12:00AM EST on Interactive Website. No email will prompt you to look. Log into linked website and click "Print Score Report". It will download a PDF which will be your numerical score, P/F, and some performance graphs you may be interested in. The NBME/FSMB doesn't make this an exact science, but from looking at everyone's experience, the general principle is reporting goes 3 Wednesdays from the 2nd test date if that was a day after Wednesday and 4 Wednesdays from the 2nd test date if that was a day before Wednesday. The exception to this is if you tested in January/February (see point #3).

2.) The Trick: The Sunday before your results come, the "scheduling permit" link disappears from your USMLE Step 3 row on the "Check Exam Status" link of the same website: Interactive Website.
Previously people thought if the link disappeared, then you passed. This seems to be wrong. The "scheduling permit" link still seems to disappear even when people failed the exam recently per many recent reports which I imagine leads to situations of a false sense of hope. What's not clear is whether the "scheduling permit" link not disappearing means you've failed. There is like one person who has said it did not disappear the week they got their score and they said they failed. The thing is in the moment, you don't really know if the permit didn't disappear because you failed or if it's just that you're not getting your results that week (more likely and not many people followed up to give us that info).

3.) Per FSMB "necessary annual modifications to the test item pool will result in a delay in reporting Step 3 scores for examinees who test in early in the year. The target date for reporting scores for most examinees testing in January and February 20XX is Wednesday, March XX, 20XX (AKA: Delayed reporting date). After this, the normal score reporting schedule (see point #1) will resume.

Take Home Points:
1.Emphasize biostats. You don't have to buy another biostats resource or watch biostats specific videos. Just get comfortable doing basic biostats questions and understand key definitions, etc. It's pretty similar to UW. I also recommend the UW extension package for $25.
2. Emphasize CCS. Practice this regularly and don't wait until this last minute. UW is great but I recommend CCScases. I have heard good things about Archer/Crush but haven't used those.
3. MedQuest USMLE Step 3 is an expensive, but valuable resource IMO worth more than OnlineMedEd for Step 3 because it's more comprehensive which I needed for OB/GYN & Peds.
4. The exam's just like the other steps except for exceptions above and 95% pass, but I would not take it too lightly. For those in IM, I would wait until after intern year to take it. Do they use it for fellowship? Probably not...but they may screen out low scores (a cards program I saw said on their website they screen out anyone with <220 on any Step). Remember, there's no rush to take this. I remember trying to take this at the beginning of my intern year duringa pretty poorly assigned vacation and it felt like way too much new information and was unsure what source to learn it (i.e. I just needed more residency time), but now after revisiting it, things just made a whole lot of sense. IMGs may not struggle the same way because many have intern year built into their medical school training. The test tests clinical reasoning you usually gain as an intern. You'll run into questions where your Step 1/2 brain will tell you to do X or Y but your residency experience will tell you to do Z and Zs usually the answer.
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Despite me writing this novel, 95% of US MDs passed Step 3 with an average score of 228 last year per my 2021 score report. Your mentors/attendings will tell you they didn't study and aced the exam or that all you need to do is pass. On here, there seem to be a lot of people failing (probably as a selection bias). The reality's probably closer to the actual data, but do note the exam has a higher passing threshold than Step 1 and a lower average so if you were in the 200-220s on your prior Steps, you probably should invest some time just to be sure you pass. I think 2 weeks of dedicated study in residency or 2 months of interval studying in residency is plenty. In my position though, I was taking it 3.5 years after CK without and plan on pursuing an IM fellowship so I didn't want to take any chances because I know some places screen scores.
 
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cj_cregg

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Score: 239!

Study period and strategy:
-Initially was planning on taking the exam in spring/summer 2020, but due to COVID delayed it to spring 2021. Studied sporadically over that entire time.
-Resources: UWorld Step 3 qbank, UWorld 3 CCS interactive cases only, UWorld stats review, Anki, also did some FM boards review (AAFP and ABFM questions) along with this
-Did UWorld blocks on days off on heavy rotations, most days on lighter rotations. Finished it all a month or two prior to exam, got 62% correct.
-Made Anki cards from UWorld incorrects, was pretty consistent with those at first but then kinda slowed down and stopped
-Over the last month before the exam: all UWorld CCS cases (I really struggled with getting the hang of the software), UWorld stats review, and redid incorrects from qbank.

Other scores:
-Step 1: 20X
-Step 2CK: 23X
-UW Step 3 Average: 62%, untimed random. Went back and did all olds, 71% average after that.
-UWSA1: 207. Took 1 yr before exam due to COVID (thought I would be taking the exam in the next few months).
-UWSA2: 229. 1-2 weeks before exam.

Test experience:
-took day 1 and day 2 one right after the other
-Day 1: Pretty tough. Felt very much like step 1. Mostly second and third order questions on things like drug mechanisms and pathophys. Some biostats most of which was fairly basic. Some WEIRD ethics stuff. 1-2 drug ads or abstracts in each block.
-Day 2 MCQs: Much more reasonable imo. More step 2-esque. What's the next step, what test or treatment do you want, etc. Lots of preventive care as well which is certainly my jam. No drug ads or abstracts.
-Day 2 CCS: Mostly pretty straightforward, bread and butter type stuff with the exception of one case that was more of a zebra. Cases seemed to end pretty quickly, even sometimes when I was still waiting for some key lab results that weren't supposed to come back until day 2 or 3...not sure if that's because I made the right choices for empiric tx or because I was just that far off base lol. I wrote out an algorithm/flowsheet on my scratch paper at the beginning of the cases to help keep me organized (e.g. if they're unstable, order iv access, tele, oximetry, morphine if severe pain, etc. before anything else, if you admit don't forget to order dvt ppx, diet and activity orders, routine labs, etc.), which was really helpful in keeping me from getting ahead of myself and keeping things systematic.

Results: 239
-Took my test on a Monday & Tuesday, if the next day was Weds #1 I got my score on Weds #4.
-Score posted right after midnight on Weds morning and I got an email about it at 9am.
-My scheduling permit disappeared I think Monday. IMO I think it disappears the week you get your score regardless of whether you passed, if you look at some of the recent posts in the step 3 trick thread there are some people who failed after their permit disappeared...most people whose permit disappeared probably pass because most people who take step 3 pass.
-Very happy with my score :)
 
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Ryuzaki

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Score: 205
Study Period: 4.5 weeks (causal uWorld mixed), 2 weeks dedicated
Step 1: 231
Step 2 CK: 239
UW Step 3 Average: 70% timed tutor, subject oriented (for the most part, only finished 1200 questions, skipped all the ethics/social science and most of the psychiatry stuff )
UWSA-1 (5 days out): 183

Resources:
1. uWorld Step 3
2. CCScases.com for CCS (Did approximately 10-15 cases, found out about it too late but would highly recommend this over uWorld), did uWorld CCS for the most part (40 cases)
3. $25 Bio-stats package (bought it but never got around to using it), instead did the uWorld Biostats about 80 questions followed by this YouTube video series (approximately 4 total ~1 hour)

Study Period:
2-4 weeks, but given my ICU rotations it was split over 2 months

Strategy:
Honestly, was a cram session for me, I basically went through about roughly 80% of uWorld, but given the time crunch, I touched every topic to some extent (however, didn't finish it, e.g. Infectious Disease had 168 questions, I did about 120 of them and skipped the last set. However, I did completely skip Social Sciences, Psychiatry, Poisons, Miscellaneous and General Systems. I just didn't have time to go through it. I read through master the boards step 3 throughout the time while I was at work (when the patients weren't crashing).

Experience:
Days: Friday/Monday for me.

Day 1:
As everyone said, lots of Step 1 and Biostats murdered me on this one. If I could go back and do it again, I would have taken Biostats significantly more seriously than I did. I would have spent a solid 3-days on it, instead of 3 hours. I felt like that dragged my score into the gutter, which it probably did.

Day 2:
They did have 6 blocks of multiple choice questions, completely different from Day I. Thankfully, no more biostats and afterwards I ended up doing the CCS Cases, somehow finished 3 hours early and basically left after that. However, still felt completely crappy.
 
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.Lisfranc

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Score: 250-255

Step 1: 265+
Step 2 CK: 265+
UW Step 3 Average: 68% timed tutor, random
UWSA-1: 217
UWSA-1: 237

NBME 4: 680
NBME 5: 700

Resources:
1. uWorld Step 3
2. Zanki step 2ck cards
3. CCScases.com for CCS [Did all of them, CCS is 25% of the exam so make sure you study]

Study Period:
One month on a very chill elective.

Experience:
Days: Thursday/Friday.

Day 1:
Day one felt super hard, way more guessing than expected. You could be scoring very well and still feel this way so don't feel bad!

Day 2:
Honestly felt easier than the first day, all clinically relevant stuff that you've been doing during your intern year. CCS felt fairly straight forward but I did spend a decent amount of time preparing.
 
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Redpancreas

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More 2021 experiences:

Other Experience 1:

Oof. Took Step 3 this week. Day 1 on Tuesday and Day 2 on Thursday.

UW: averaged 57% correct and 20th percentile, got 74% of the way done. Read through all interactive CCS cases, practiced about 20 (after using CCScases).
UWSA1: 199
CCScases.com: used about 40ish% of their cases.

Day 1 was pretty rough. I was hoping that their would be more calculations with biostats. LOTS of interpretation and there was one where I wasn't sure the abstract matched my questions it was so odd lol. But there were lots of method of action questions, some genetics/inheritance/mutations Step 1 type stuff on there. Felt very much like I was narrowing down 50/50 and guessing. Ethics...crazy scenarios.

Day 2 more of the same, though more clinically relevant and reasonable. Lots of "next best step/test/medication", side effects, prognosis/risks. CCS was more difficult than I had imagined, don't be overly confident going in. Also, I would shy away from a shotgun lab approach merely because of how long it takes for you to get labs back/click through them, especially the 10 min cases.

Never really felt confident after taking any of the steps, but this one made me feel embarrassed I've gotten this far! I'm just hoping the curve is as generous as people discuss. UWSA1 was 199 so hopefully that will translate to the low 200s at least, though I'd be happy with a 198! --> OP he posted later saying "Got a 22X on the real deal guys. You will feel horrible after both days, CCS cases don't necessarily end early, but things often turn out to be okay!"

Other Experience 2:
Got a lot of reassurance from this thread. Thank you to those who contributed to it.

Numbers:
PGY-1
Step1: 23x
Step2:22x
UWSA1:210 (1.5week before)
UWSA2:239 (4days before)
Actual step 3: 221

Study:
4months on and off throughout lighter rotations and vacations(total ~2w of step2 study time for reference)
-Uworld 63% untimed tutor; repeat about 70% of wrong, particularly the stats
-Crush step 3 CCS x1 and UWorld CCS only did the simulations

Test day:
Day1:
~6% of random pathology slide/step1 q
-Marked 40-50% of the questions each blocks; barely finished each block on time
-Lots of stats, was sure for 70% of them
-Drug ads sucks, too many words not enough time marked all of them
-Walking out feeling horrible
Day2:
-Lots of prognosis questions. 2 MCQ blocks went well, the rest marked up to 75% of the block
-CCS cases were straightforward all but one ended early
-Finished the test 1.5 hours early. Still feel horrible due to the MCQ blocks being disasters

Most people pass. do take time to study for it if you're not the best test taker (like me).

Other Experience 3:
Uworld: was sharing with my gf, so did UWorld about 1.5 times, average was 76 the second time round when I was the only one doing it so probs not accurate.

UWSA 1: 213
UWSA 2: 225


Other Experience 4:

Just posting this for whoever is feeling distressed about their upcoming exam and has very little time to study.

Step 1: 240s
Step 2: 240s
Step 3: Pass

Studied for 2-3 weeks, maybe 1-2 hours after work M-F and maybe 4 hours on the weekend after work. Did about 80% of UWORLD only scoring about 50% correct, most helpful section was biostats as I had forgotten everything about it. Nothing on UWORLD was truly reflective of what was on the exam aside from the biostats. Did about 50% of the ccscases which I found to be very helpful and very similar to the actual CCS component of the exam.

Waited 2 weeks and got my score, this was the quickest turnaround the NBME has ever provided and I am very grateful for it.

My 5 cents on the exam is that it's tough, but the bar to passing is probably not too high. There are more than 400 questions, you can probably miss 150 questions and still pass the exam, given you do decent on the CCS component.

Hope this helps somebody! If anyone has further questions feel free to reach out.
NBME 5 124/176 (70.5%) - 430

Step 3: 219

Other Experience 5:
PGY2 in generalist field

Uworld untimed tutor mode first time pass: 66%

Score: 240

Did UWorld 1.5x, biostats module, and all the interactive cases. Briefly skimmed the print only ones. Did the 6 official USMLE ones.

Other Experience 6:
Appreciated all the contributions to this thread and have tried to make some as my timeline progressed.

Got my score a few weeks ago. Check earlier posts for how the questions felt (spoilers terrible).

UWorld 1st pass 66% mostly on Tutor
UWSA1: 225
UWSA2: 231 i think

Real Deal Step 3: 238

The test felt brutal. I made some of the dumbest mistakes possible on the cases but all is well and I never have to think about this garbage again. Goodbye USMLE.

Experience 7:

Hello everyone!

First time typing my experience here so please be patient with me. A little about myself - an IMG, graduated med school in 2018 and took all my boards along the way (Step 1, 2 CK, 2 CS and 3). I just passed step 3 June 2021. While studying for step 3, SDN helped me SO SO SO much! I came here often to read others' experiences so I figured I can give back to future students who will be taking step 3
Currently: working as an Interdisciplinary Group Coordinator at a hospice agency as I worked on studying and taking my boards.
Next: Residency applications and prep

My experience on step 3:

Study materials: UWorld Qbank, bio stats review and the CCS interactive cases (did not really help), master the boards, and ccscases.com
Uworld was unitimed and tutor mode for about 20 blocks (I did time myself on each question and my goal was to answer in 60 secs or less). Then did only subject-based incorrect based on the uworld statistics. I did about 75% of UWorld overall.

Day 1: Brutal. I was calling out to God with every other question. I was marking at least 20 questions in each block. Like everyone says, bio stats is heavily emphasized since I had a couple of questions in each block. However, the questions are basic stats: sensitivity, specificity, likelihood ratio. Master the boards helped me in this but I also repeatedly made my own notes until I understood the concepts. I also had a lot of article based questions - 1 in most blocks and 2 in a couple of blocks - I marked these and came back to them at the end so I do not waste time and run out of time to obtain easy points on other mcqs. I did not read the articles, instead, jumped to the questions to look for the answers and it worked for me personally. Three step pharmacy questions asking mechanism of action of drugs - read the prompt, ID the disease, ID the medication required for treatment, ID the mechanism of action. I had about 1-2 per block but the medications were commonly used in practice in the US today - beta agonist, antibacterial agents, antihypertensive medications. I did finish each block several minutes early so I was able to review a couple of my marked questions. However, based on my practice experience in uworld, changing my answers has never been in my favor so I refrained from acting on that impulse

Six days in between the two days: Practiced ccscases.com cases - went through about half of them, esp the 10 minute cases to practice optimal time management

Day 2: Easier but I was going through an asthma exacerbation at the time so I feel like my focus was not all there. Regardless, I feel the question stems were a little bit more straightforward and to the point. I had a couple of drug interaction/allergy questions that were a little tricky.

CCS cases go fast! One thing I would suggest is READ THE HPI AND PE VERY CAREFULLY! I had one case where I could not make the patient feel better and her symptoms were not stabilizing. I decided to go back and read the PE in detail again and realized there was one small four letter line on the right end of the page that gave away the diagnosis and treatment. Luckily I still had a minute before the 2 min screen to add the treatment. I did not take too many breaks because once I did a couple of cases, I got a little more comfortable with the pace and timing. I mostly received feedback stating "the patient hopes this treatment will help" and I managed not to kill any patients on the software. I did, however, make one patient worse and was unable to figure what I could do to make them feel better. Only about 3 cases ended early for me and the rest I was able to get treatments and counseling in prior to the case timing out.

Know when to keep your patient in the ER, transfer them to the floor or send them home! ccscases.com is a really good source as the software gives you feedback on where you went wrong and where you were right. I eventually started to see a pattern in my weakness after doing so many cases. I feel the actual exam is not testing whether you know EVERYTHING. It tests if you can MANAGE a patient, stabilize them and provide the necessary treatment for their disease process. Not if you can cure them. It is looking for in-the-moment-what-would-you-do type of care for the patient. Sort of a step up from step 2 CS. MANAGEMENT/STABILIZATION more than CURE. Can you at least start the basic lab work, tests, imaging and treatment and at least BEGIN to move in the right direction to helping your patients?

Some topics from my day 1/day 2 even though most of it seems like a blur - diabetes (Type 1 AND Type 2) - KNOW THEM IN AND OUT, HTN, nephrotic syndrome, acute thyroiditis, autoimmune diseases such as SLE/RA/Ankylosing spondylitis/Lyme disease, rabies vaccination protocol, COPD, asthma exacerbation, neonatal jaundice, preeclampsia/eclampsia, gallstone/kidney stone protocols, epiglottis, croup - not sure how much this will help because the topics on these exams are so unpredictable and can come from anywhere and everywhere but uworld is a one of the best sources I've used on ALL of my step exams
 
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PantherPride

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Step 3 impressions

Step 1: 255-260
Step 2 CK: 245-250
Step 3: 250-255
Total study time: 2-3 weeks

Resources:
UWorld for Step 3- all questions 40 q blocks timed, first pass 71%
UWorld ccs cases- did a handful of cases each day for a week leading up to the test, ended up doing like 70% of interactive and brushed through peds and OBGYN cases in the non-interactive list.
UWorld biostats
First aid for step 1 -briefly brushed through the pharm micro and random path portions of systems chapters as a refresher for pathophys, mechanisms, etc
NBME officials ccs cases
Skipped UWSA 1/2

I bought half a year UWorld subscription and did an almost negligible amount of blocks in intern year during free time on wards (in theory I planned chip away at it all year..). I had a super chill elective and had about 2 1/2 weeks dedicated study just prior to my test during which I did two blocks of UWorld (40qs each timed, testing conditions) a day. Previously I used anki to study for the boards but i didn’t really want to dedicate the time making cards and doing reviews during intern year. Instead I had a tiny hand sized notebook where I’d divide the pages in half and write anki style questions on one half with answers on the other. I’d write down any incorrects or useful tidbits of knowledge from UWorld into it. This notebook proved to be extremely valuable as in my last few days of study I reviewed it thoroughly and had multiple questions pop up on the test from it. For ccs, previous posts and videos online cover what you need to know, just practice a good amount in UWorld to get comfortable, I felt no need to buy any additional cases for practice outside of UWorld. UWorld ccs cases felt on par and sometimes slightly more difficult compared with cases on the actual exam.

For biostats I have a research background which I think helped the most out of anything. There isn’t really a way to practice interpreting studies or drug ads outside of uworlds resources and biostats package. That being said uWorld’s questions feel similar to what you see on the real test and the biostats module is an absolute must to have down cold. These resources were good for 90% of the biostats on my exam.

I think one thing that was absolutely useful was brushing through first aid for 2-3 days prior to the test. I didn’t want to redo all of sketchy pharm and micro. Just remember broad strokes mechanisms for drugs and pathophys (e.g, increased ACh, GABA, decreased X receptor activity) because, as others have alluded to, random things from step 1 will pop up on the first day. I didn’t dive deep and read/memorize things from first aid, but laying eyes on certain buzzwords and basic science principles was more than enough to help me with the exam. A lot of people report day 1 being insane but having a basic science refresher made it very manageable. Day 2 was harder for me because though the clinical questions were more familiar/in line with uworld they were still very vague or nitpicky at times.

I’m prelim medicine intern at an academic hospital that has really solid didactics and wards teaching. Because of that I feel like I overstudied and probably would have passed comfortably doing less than half what I did above. Stuff learned on wards, ED, and specialty electives (rheum, DM, ID) gave me a good clinical foundation for the test. The thing I’m most happy about was really only studying hard for a couple of weeks and not wasting any more time on this pointless test. If you have a strong medicine background I could see you completing half of uworld MCQs with ccs practice and passing comfortably.
 
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Redpancreas

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Step 3 impressions

Step 1: 255-260
Step 2 CK: 245-250
Step 3: 250-255
Total study time: 2-3 weeks

Resources:
UWorld for Step 3- all questions 40 q blocks timed, first pass 71%
UWorld ccs cases- did a handful of cases each day for a week leading up to the test, ended up doing like 70% of interactive and brushed through peds and OBGYN cases in the non-interactive list.
UWorld biostats
First aid for step 1 -briefly brushed through the pharm micro and random path portions of systems chapters as a refresher for pathophys, mechanisms, etc
NBME officials ccs cases
Skipped UWSA 1/2

I bought half a year UWorld subscription and did an almost negligible amount of blocks in intern year during free time on wards (in theory I planned chip away at it all year..). I had a super chill elective and had about 2 1/2 weeks dedicated study just prior to my test during which I did two blocks of UWorld (40qs each timed, testing conditions) a day. Previously I used anki to study for the boards but i didn’t really want to dedicate the time making cards and doing reviews during intern year. Instead I had a tiny hand sized notebook where I’d divide the pages in half and write anki style questions on one half with answers on the other. I’d write down any incorrects or useful tidbits of knowledge from UWorld into it. This notebook proved to be extremely valuable as in my last few days of study I reviewed it thoroughly and had multiple questions pop up on the test from it. For ccs, previous posts and videos online cover what you need to know, just practice a good amount in UWorld to get comfortable, I felt no need to buy any additional cases for practice outside of UWorld. UWorld ccs cases felt on par and sometimes slightly more difficult compared with cases on the actual exam.

For biostats I have a research background which I think helped the most out of anything. There isn’t really a way to practice interpreting studies or drug ads outside of uworlds resources and biostats package. That being said uWorld’s questions feel similar to what you see on the real test and the biostats module is an absolute must to have down cold. These resources were good for 90% of the biostats on my exam.

I think one thing that was absolutely useful was brushing through first aid for 2-3 days prior to the test. I didn’t want to redo all of sketchy pharm and micro. Just remember broad strokes mechanisms for drugs and pathophys (e.g, increased ACh, GABA, decreased X receptor activity) because, as others have alluded to, random things from step 1 will pop up on the first day. I didn’t dive deep and read/memorize things from first aid, but laying eyes on certain buzzwords and basic science principles was more than enough to help me with the exam. A lot of people report day 1 being insane but having a basic science refresher made it very manageable. Day 2 was harder for me because though the clinical questions were more familiar/in line with uworld they were still very vague or nitpicky at times.

I’m prelim medicine intern at an academic hospital that has really solid didactics and wards teaching. Because of that I feel like I overstudied and probably would have passed comfortably doing less than half what I did above. Stuff learned on wards, ED, and specialty electives (rheum, DM, ID) gave me a good clinical foundation for the test. The thing I’m most happy about was really only studying hard for a couple of weeks and not wasting any more time on this pointless test. If you have a strong medicine background I could see you completing half of uworld MCQs with ccs practice and passing comfortably.
Definitely better results with far less time than me. Solid work! I also was one of the few that felt day 2 was harder and noticed both us have Step 1 percentiles much higher than Step 2 CK. It may just be a thing that Day 1 resembles Step 1 more vs. Day 2 resembles Step 2 CK more. That's seemed more and more apparent the more impressions I see on here. I didn't know how to describe what was wrong with the Day 2 questions but yeah...I think just vague is the right word. Like there was no answer that popped out and I had to kind of just guess based off a 60% hunch one way vs a 40% hunch another way. Anyway, you're basically done with medicine now! Congrats!
 

Nephronlearner

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I took the exam in early March and got the score today. My experience differed somewhat from what has been described so far so hopefully a slightly different perspective is useful to someone.
Final score: 247 (for reference: Step 1 250+, CK 260+). UWSA2: 241
Resources: UW, CCSCases

Day 1:
Spent the day prior to the exam telling myself not to panic over micro and pharm questions because most people will find them tough anyway and biostats is definitely a strength of mine. Well, to my surprise I got maybe... 2 of those all day?! And maybe 2-3 biostats questions per block. Definitely nowhere near what I had expected. They did throw in a couple of gross anatomy questions for good measure which was... well... gross. The rest of the questions were clinical.

Day 2:
Felt literally like the continuation of day 1, just without any biostats. Definitely not what I expected.

Thoughts:
A TON of questions on risk factors and complications. Mostly obscure or something that you just don't think about - ever. Like imagine you have 5 kids and one of them is always the trouble maker. They ask you which one of them is most likely to chew your residency contract. You see the question and you are thrilled you know the answer. But then you look at the answer choices and they left that one out and make you pick between the other 4 - but you thought they were all fine kids. So you pick Fred because he kinda sounds like he could be a troublemaker. And then the next question starts with: "after Jim chewed on your contract, which of the following would be the most appropriate way to approach him?" It wasn't Fred after all. That's kinda how I felt throughout the test. I was marking probably 50% of the questions in many blocks. There were blocks where I was sure of maybe 30-40% of questions. Some were a bit better. The main message: don't stress it if you feel you didn't know anything.

CCS: pretty straight forward. I can't believe I am saying this but UW's proposed case solutions are just... too good and CCSCases may be closer to what they expect and how dramatic they can be. Had big plans to make a ton of orders for a bunch of them. Then the case ended the second I gave them the appropriate treatment. Definitely missed a few important orders here and there. Had a couple of negative updates in total but every patient eventually got better. Rarely put anything on the 2-min screen, counselled during the case. The temptation to just end the case was too strong when the 2 min screen showed up. Most cases lasted literally 5 min.

Left the exam center wondering what had just happened. Knew I would fall somewhere between 170 and 270 so definitely thought odds were in my favor to break the passing mark. Ended up close to my UWSA... so I guess... trust your practice scores?

Best of luck everyone! Kudos to everyone getting super high scores on this one! Well done to everyone for passing! I can't imagine the score on this thing really reflects one's clinical abilities in any meaningful way.
 
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Redpancreas

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Like imagine you have 5 kids and one of them is always the trouble maker. They ask you which one of them is most likely to chew your residency contract. You see the question and you are thrilled you know the answer. But then you look at the answer choices and they left that one out and make you pick between the other 4 - but you thought they were all fine kids. So you pick Fred because he kinda sounds like he could be a troublemaker. And then the next question starts with: "after Jim chewed on your contract, which of the following would be the most appropriate way to approach him?" It wasn't Fred after all. That's kinda how I felt throughout the test.
This allegory's the funniest thing I've read today. So true about Day 2 mainly for me. Different perspectives are good! It makes me nervous when I come out of a test expecting one thing people told me, but I experienced another. Hopefully more people feel good about this test moving forward after reading stuff like this. Congrats on being done! Glad to see more high scores! Coming into this exam I didn't see too many and felt most people were posting borderline passing scores which made me anticipate the same thing for myself.
 
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cj_cregg

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Score: TBD, will post when I get it

Study period and strategy:
-Initially was planning on taking the exam in spring/summer 2020, but due to COVID delayed it to spring 2021. Studied sporadically over that entire time.
-Resources: UWorld Step 3 qbank, UWorld 3 CCS interactive cases only, UWorld stats review, Anki, also did some FM boards review (AAFP and ABFM questions) along with this
-Did UWorld blocks on days off on heavy rotations, most days on lighter rotations. Finished it all a month or two prior to exam, got 62% correct.
-Made Anki cards from UWorld incorrects, was pretty consistent with those at first but then kinda slowed down and stopped
-Over the last month before the exam: all UWorld CCS cases (I really struggled with getting the hang of the software), UWorld stats review, and redid incorrects from qbank.

Other scores:
-Step 1: 20X
-Step 2CK: 23X
-UW Step 3 Average: 62%, untimed random. Went back and did all olds, 71% average after that.
-UWSA1: 207. Took 1 yr before exam due to COVID (thought I would be taking the exam in the next few months).
-UWSA2: 229. 1-2 weeks before exam.

Test experience:
-took day 1 and day 2 one right after the other
-Day 1: Pretty tough. Felt very much like step 1. Mostly second and third order questions on things like drug mechanisms and pathophys. Some biostats most of which was fairly basic. Some WEIRD ethics stuff. 1-2 drug ads or abstracts in each block.
-Day 2 MCQs: Much more reasonable imo. More step 2-esque. What's the next step, what test or treatment do you want, etc. Lots of preventive care as well which is certainly my jam. No drug ads or abstracts.
-Day 2 CCS: Mostly pretty straightforward, bread and butter type stuff with the exception of one case that was more of a zebra. Cases seemed to end pretty quickly, even sometimes when I was still waiting for some key lab results that weren't supposed to come back until day 2 or 3...not sure if that's because I made the right choices for empiric tx or because I was just that far off base lol. I wrote out an algorithm/flowsheet on my scratch paper at the beginning of the cases to help keep me organized (e.g. if they're unstable, order iv access, tele, oximetry, morphine if severe pain, etc. before anything else, if you admit don't forget to order dvt ppx, diet and activity orders, routine labs, etc.), which was really helpful in keeping me from getting ahead of myself and keeping things systematic.

Results: will post timing etc when I get the score!
I got a 239! Super happy with that especially given my less than stellar performance on step 1/2. Will be updating my original post shortly with more info.
 
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mudpiles

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I got a 239! Super happy with that especially given my less than stellar performance on step 1/2. Will be updating my original post shortly with more info.
CONGRATS! Do you mind sharing your algorithm/flowsheet that you wrote out before the cases? Can I message you? thanks!
 

cj_cregg

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CONGRATS! Do you mind sharing your algorithm/flowsheet that you wrote out before the cases? Can I message you? thanks!
Yes, feel free to message me!

Here's the algorithm to the best of my memory at this point lol. It is probably a little more detailed than I remembered off the top of my head on test day but the general idea is there. For me it was very much worth taking a few minutes to write out during a break before I left my station just to keep me organized and methodical about things.
 

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sylvanasw1ndrunner

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I took mine in late March and got scores back this week. It felt like a hard test and I left feeling like I failed.
USWA1: 235
Step 3 real deal: 250

I just used uworld (taking notes) and CCS cases. Studied for 2-3 months. Step 1 was 250+ and step 2 was 270+.
 
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me16

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I took mine in late March and got scores back this week. It felt like a hard test and I left feeling like I failed.
USWA1: 235
Step 3 real deal: 250

I just used uworld (taking notes) and CCS cases. Studied for 2-3 months. Step 1 was 250+ and step 2 was 270+.
How late in March ?

took it late March as well but still don’t have scores back yet :/
 

mudpiles

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Yes, feel free to message me!

Here's the algorithm to the best of my memory at this point lol. It is probably a little more detailed than I remembered off the top of my head on test day but the general idea is there. For me it was very much worth taking a few minutes to write out during a break before I left my station just to keep me organized and methodical about things.
You are SO awesome. Thank you!
 
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carty_in

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So my permit link has disappeared on nbme however the Status is APPROVED on FSMB website with grey link at the bottom and no link to reapply. Day 1 was 13 April and day 2 was 16 April. From everything that i have read i think i should expect my result this Wednesday ? Am i right ? Seems too early imo....
 

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So my permit link has disappeared on nbme however the Status is APPROVED on FSMB website with grey link at the bottom and no link to reapply. Day 1 was 13 April and day 2 was 16 April. From everything that i have read i think i should expect my result this Wednesday ? Am i right ? Seems too early imo....
Yup, result should be out Wednesday 0000hrs.
 
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7Epinephrine

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Hello,
I am an unmatched US IMG and am preparing for Step 3 to boost my chances of matching this upcoming cycle. Exam booked for July-August-September. I am currently doing UW and am averaging 50% (40% done with qbank) and I have not read MTB Step 3 or any other books and am just focused on questions and making my own notes (this worked for my CK prep).
However, in addition to CCS Cases, did anyone supplement their studies with DIT Step 3, ABIM prep, Kaplan or anything else? And did you find it helpful? I'm thinking about it because the uworld qbank is less than 1700 q's and I'm wondering if I need any other resources to pass this exam with a decent-high score.

Thank you in advance.
Best of luck to all!
 

Redpancreas

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Hello,
I am an unmatched US IMG and am preparing for Step 3 to boost my chances of matching this upcoming cycle. Exam booked for July-August-September. I am currently doing UW and am averaging 50% (40% done with qbank) and I have not read MTB Step 3 or any other books and am just focused on questions and making my own notes (this worked for my CK prep).
However, in addition to CCS Cases, did anyone supplement their studies with DIT Step 3, ABIM prep, Kaplan or anything else? And did you find it helpful? I'm thinking about it because the uworld qbank is less than 1700 q's and I'm wondering if I need any other resources to pass this exam with a decent-high score.

Thank you in advance.
Best of luck to all!
I don't like anything you have listed outside maybe the Kaplan QBank near the end if you need more questions. Don’t buy ABIM or DIT. DIT isn’t that good. ABIM isn’t even the same test, even if medicine overlaps. I also don't really like MTB. The whole thing in there about the most accurate test is hardly ever asked on Step 3 but Fischer keeps emphasizing it.

General Strategy in a Nutshell:
1.) Do UWorld as you did for everything else.
2.) Go through a video series fully. The only two I can recommend are OME and MedQuest (similar to DIT in $, but much more recent). I personally don't think OME is really for Step 3 even if it's labeled as such. It is better at framing things in a basic way, but MedQuest is more comprehensive but has a lot of ranting by Fischer which is a little funny at times. No source is amazing.
3.) Drill CCS and Biostats regularly and not just the week before test day. Biostats is like every 5th question on day 1 and doing well on it when you sucked at it previously can really improve your score. Step 3 CCS is a blackbox, but it's apparently 20% of your score so if you bomb it it doesn't matter how good you are at MCQs.

Don’t take the exam unless you’re certain you’ll score well. Yes...taking Step 3 is pretty much the only thing you can do if you're reapplying to add to your app...but if you fail it especially with decent Step 1 and 2CK, you've caused created a major problem for yourself.

Everyone's experiences are different for Step 3 so it's hard to give generic advice. Step 3 is not like Step 1 in that it's not as "studiable for" IMO. Some questions draw on your intern/residency experience and you know it or you don't. Others draw on factoids you somehow still remember from medical school or Step prep. Also performance generally correlates with previous Step scores as you can see some people who didn't even do IM/FM are scoring 250s with minimal prep while some IMGs or AMGs who struggled with prior Steps are failing it despite being in a primary care residency that tests Step 3 knowledge daily.
 
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7Epinephrine

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I don't like anything you have listed outside maybe the Kaplan QBank near the end if you need more questions. Don’t buy ABIM or DIT. DIT isn’t that good. ABIM isn’t even the same test, even if medicine overlaps. I also don't really like MTB. The whole thing in there about the most accurate test is hardly ever asked on Step 3 but Fischer keeps emphasizing it.

General Strategy in a Nutshell:
1.) Do UWorld as you did for everything else.
2.) Go through a video series fully. The only two I can recommend are OME and MedQuest (similar to DIT in $, but much more recent). I personally don't think OME is really for Step 3 even if it's labeled as such. It is better at framing things in a basic way, but MedQuest is more comprehensive but has a lot of ranting by Fischer which is a little funny at times. No source is amazing.
3.) Drill CCS and Biostats regularly and not just the week before test day. Biostats is like every 5th question on day 1 and doing well on it when you sucked at it previously can really improve your score. Step 3 CCS is a blackbox, but it's apparently 20% of your score so if you bomb it it doesn't matter how good you are at MCQs.

Don’t take the exam unless you’re certain you’ll score well. Yes...taking Step 3 is pretty much the only thing you can do if you're reapplying to add to your app...but if you fail it especially with decent Step 1 and 2CK, you've caused created a major problem for yourself.

Everyone's experiences are different for Step 3 so it's hard to give generic advice. Step 3 is not like Step 1 in that it's not as "studiable for" IMO. Some questions draw on your intern/residency experience and you know it or you don't. Others draw on factoids you somehow still remember from medical school or Step prep. Also performance generally correlates with previous Step scores as you can see some people who didn't even do IM/FM are scoring 250s with minimal prep while some IMGs or AMGs who struggled with prior Steps are failing it.

Thank you so much, this was very helpful! I’ve never used medquest but I’ll give it a shot. I used OME in my CK prep and though some swear by it , it didn’t work out that great for me. I’m having some anxiety with this test, as I’ve had with steps but I can do this, it’s just a matter of preparing well and going in for the test clear minded. Thank you again for your response!
 
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BazingaHero

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UWorld Step 2 CK (Peds/OBGYN mainly but I literally went clicked through other sections the day before my exam)

I am terrible at Peds and Obgyn. I have finished UW and Kaplan question bank but feel it did not cover these two well enough. Reading MTB Step 3 (detailed but) alone is not satisfying enough since questions are important.


Worth doing UW Step 2 IM for additional questions before repeating incorrect/marked UW Step 3? Or use UW Step 2 IM for weak topics?

Perhaps, use UW Step 2 pediatrics/obgyn questions?

Any specific strategy to tackle abstract biostatistics questions? I hate those

I do whole heartedly agree with going overboard with biostatistics because that's one subject thats guaranteed to show up and can help overall.

Thanks
 

Redpancreas

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I am terrible at Peds and Obgyn. I have finished UW and Kaplan question bank but feel it did not cover these two well enough. Reading MTB Step 3 (detailed but) alone is not satisfying enough since questions are important.


Worth doing UW Step 2 IM for additional questions before repeating incorrect/marked UW Step 3? Or use UW Step 2 IM for weak topics?

Perhaps, use UW Step 2 pediatrics/obgyn questions?

Any specific strategy to tackle abstract biostatistics questions? I hate those

I do whole heartedly agree with going overboard with biostatistics because that's one subject thats guaranteed to show up and can help overall.

Thanks
I am IM and share the predicament re: Peds and OB/GYN. So much material I hadn't seen since M3. I think the more questions the better.

I did the Ped/ObGYN Step 2 UW bank. If you have time and paid for the Step 2 bank already I think it's fine to do the IM questions there too, but I wouldn't buy it just for that.

For Biostatistics, you need to just really drop your pace of study and figure out why you're getting the question wrong and get a pen and paper out and do some math or watch some video until you understand the concept. It's not like the rest of medicine where you memorize some facts about diseases. Here you need to get good at problem solving and developing a sense of statistics takes time. I did UW Biostats, watched tons of videos to get different perspectives (OnlineMedEd, MedQuest, YouTube, etc.)

For most, all this above isn't needed but if you have time and nothing better to do, it's what worked for me.
 

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I take this in a week and debating about post-poning
All I need to do is pass, though

NBME 5: 420 (1-week before test)->correlated to 217-220?
UWorld: 66% on timed, tutor mode. Took notes on almost all section. Reviewed noted x 3
CCS: have like 30ish cases left, but doing fairly well on them
Did the Biostats section
Finished Biostats and tried to drill it as much as possible

Step I: low
Step 2 > 240

Should I post-pone or just take it?
 

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I take this in a week and debating about post-poning
All I need to do is pass, though

NBME 5: 420 (1-week before test)->correlated to 217-220?
UWorld: 66% on timed, tutor mode. Took notes on almost all section. Reviewed noted x 3
CCS: have like 30ish cases left, but doing fairly well on them
Did the Biostats section
Finished Biostats and tried to drill it as much as possible

Step I: low
Step 2 > 240

Should I post-pone or just take it?
DId you take any UWSA?
 

dartmed

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DId you take any UWSA?
I took the last practice test the one from USMLE (the free 137) and got 81%

I didn't do UWSA. I haven't done them in the years past for the other Steps as they consistently under-predicted and I don't need that for my confidence right now. Ha
 

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Here's my experience for those that would like my 2 cents:

Step 1: low
Step 2CK: >240
Step 3: TBD
NBME 5: 420 (~217)
Free practice questions: 79%
Predicted score based on algorithms: 225-230

Day 1 experience: it was hard. There were multiple questions that I absolutely had no idea what they were looking for. Some blocks, I probably flagged like half the questions. UWorld didn't have the topics covered as some of the questions were completely left-field. There was a significant amount of Biostats, rougly 4-5 questions per block. There were a lot of MOA questions, which was somewhat unreasonable to ask, i.e. you can get the diagnosis and know the treatment but they will test you on the MOA. I guessed and moved on because there was a fairly good chance most people taking the test probably also were as clueless on them. If I were to re-do the studying, I would actually crank out my Step 1 book and learn the MOA of all the drugs as well as the Pharm

Day 2: much, much better. There were definitely some questions that I was between two options, but this was a reasonable test of knowledge questions and I think I got most of them right. CCS was fairly reasonable. All of my cases ended early, which I hope is a good sign.

Here's to hoping that I passed this and it's past me.
 
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BazingaHero

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I am IM and share the predicament re: Peds and OB/GYN. So much material I hadn't seen since M3. I think the more questions the better.

I did the Ped/ObGYN Step 2 UW bank. If you have time and paid for the Step 2 bank already I think it's fine to do the IM questions there too, but I wouldn't buy it just for that.

For Biostatistics, you need to just really drop your pace of study and figure out why you're getting the question wrong and get a pen and paper out and do some math or watch some video until you understand the concept. It's not like the rest of medicine where you memorize some facts about diseases. Here you need to get good at problem solving and developing a sense of statistics takes time. I did UW Biostats, watched tons of videos to get different perspectives (OnlineMedEd, MedQuest, YouTube, etc.)

For most, all this above isn't needed but if you have time and nothing better to do, it's what worked for me.


Thank you.
 
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dartmed

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Score it out! I passed! 222!
Goodbye USMLE!
I am not a great test-taker so I put my time and effort-in and took it seriously.
For those that are about to take it—here’s what I did: Uworld x 1 (didn’t finish like 250 questions), CCS cases (did about 70 of them) and half of the Biostats module. If I probably finished UWorld and spent more time reviewing Step I material, I could have probably cracked 230 but all I needed was a Pass. Onto Boards next year!
 
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Hi. I never write online but given my experience and the help this thread rendered, I will do so.
YOG: 2008
Step 1: 205/85 (2010) April
step 2 CK: 202/83 (2010) August
Step 2 CS: first attempt September (2010)
all first attempt. Currently an infectious disease fellow but haven`t done IM residency in the U.S. I am applying for the residency match this year 2021/2022.
Step 3: came out today (14th July): 210 first pass. Exam June 23rd and 29th (biostats were below average and ccs was above average)
Study timed: Dedicated study half of April, May, June. Full work schedule
Materials: uworld: could only finish 50% of the Q bank (mixture of timed and untimed), uworld . I HAVE NEVER FINSHED uworld Q bank. Could only do about 834 questions
CCScases, ccscases.com, (practised 85 cases), all of uworld interactive cases

uworld biostats: I only read mean, median, mode, sensitivity, specificity and npv,ppv in biostats.
first aid step three. read every chapter except peds, OB (read gyne), psych, biostat, oncology, neurologty. Didn`t read through the cases at the end
I only did UWSA form 1 and only did three blocks: 35%, 58% and 46%
I did better on the NBME free download blocks. 66%, 67%, 70%. I forgot to practice the ccs portion!

Day 1 as an absolute disaster. It felt like I was reading another language. It was really bad. I I had a minimum of 5 biostats per block. I left those for last and when I nearly ran out of time so just picked random answers.
The biostats were drug ads which were two-three pages. NO CALCULATIONS!!!!!. Forger PPV,NPV,snesitivity and specificity, they ain`t gonna ask.
They didn`t ask for causative drug in the other questions but the receptors at which the drug worked. So you had to guess the offending agent then determine MOA. I marked a significant portion of the block. Nearly ran out of time on 4 blocks. The ethics questions were just bizarre...a previous post gave a hilarious example which I agree with.

I was unaware of the biostats youtube videos and couldn`t understand the Uworld biostats (I struggle with abstract ****) so I felt I will just fail it and do well in the other areas. I did fail it.

Day 2 was significantly better. Significantly. These were actual clinical medicine questions. And they were reasonable enough that I could check the answers after the exam. I couldn`t do that after day 1 because I couldn`t remember the questions. No ****ing biostats. I barely saw hematology questions.

All my 20min CCScases finished early which was really disconcerting. What helped was my UK clinical experience. All my patients got better. Though I can`t remember 2 cases. I did make some mistakes and forget stuff like neuro checks, I/O chart, daily weights
I did this a week after day 1. I did all my ccs practice from ccscases.com during this period.

I felt so bad about day 1 I spent most of my time online reading step 3 experience cos I was in absolute shock. I had already gotten permission to take time off to repeat the exam and had just begun studying again. I lost sleep and had minor PTSD, I kept calling my friends to stress about it, I had nightmares. I got score reports of others to try and calculate my avereage. I even emailed usmle /fsmb to ask if they could keep my step 3 score off my transcript for my application. To make matters worse two IM residents in my hospital failed

I advise CCScases. You are assessed and that will help know what to focus on best like exam, diagnostic tests and treatment.
Also, my ccs cases weren`t straightforward. Of the 11 I remember 6 had more than one problem I needed to solve. By the way, most were up to date on vaccination schedule! All my orders were placed for that the time. I didn`t do Q24 or whatever cos I didn`t know to do that. Practice with NBME ccs software cos it is a bit different from CCS cases.

Watch the biostat videos so you can feel better about your day one.

Good luck! I am ****ing done. **** step three, it was ****ing meaningless

Like me, if you feel your exam was horrible, you`re probable right but you may still pass!

1
 
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Dopamine023

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I wanted to write this for anyone struggling to find the time for this exam during your intern year. I’ll be honest and say that I am not a good exam taker.

UW assessment 1 week prior: 198
Real exam: 220

I just wanted to emphasize that it is possible. I didn’t have much time to study due to my last 4 months of being in busy inpatient/ICU. I studied for about 1 week on/off mostly UW MCQ. I was only able to complete Cardio, GI, Resp, ObGyn, Bio stat.

I had two days off before the 2nd day of the exam.
For CCS, I highly recommend getting CCS cases, it gives you feedback which is great. I got through about 65 of the cases.
I did about 5-6 UW CCS cases.

I hope you guys find this somewhat helpful.
 
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qwertyuiop78

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My experience: took the exam my last month of my PGY1 year in FM, so pretty good review of all systems during the whole year. I only did like 120 questions of uworld total, did a UWSA 1 about 5 days out and scored 182. In the exam I got 206.
During those 5 days I did the bio stats section in uworld and a few CCS cases, including the ones from NBME. I also did the free questions by NBME.
 
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7Epinephrine

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Last month of prep.
Finished CCS cases (qbank and book), made notes of the cases not listed in the book and reset UW and doing it over again.
I'm doing 1 block of FIP and 2 blocks of ACM per day so I don't run out of FIP cases before Day 1.
No video lectures, mostly UW, and making my own notes. No practice tests yet, waiting to finish my 2nd round of q's and don't want to freak myself out, it seems the UWSA are underpredicting, and they don't incorporate CCS so I'll take them a week before Day 1. Just fyi for those going through the same thing.
Stay strong, finish strong.
 
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AzBasRad

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Score: 244
Study Period: 2 months (mid-June till mid August)
Steps I + II: Both ~255
UW Step 3 Average: 72% untimed, tutor, topic based non-random blocks
About me: Brand new TY intern

All the Resources I used:

(1) UWorld Step 3 (essential)
Studied for 2 months from mid June until mid August. First month of residency was inpatient wards(July), but I still managed to do 20-40 questions everyday. I did more question on weekends. I did all of my questions on untimed, tutor mode with non-random, topic based blocks. Finished UWorld in about 1.5 months and made my own flashcards, which helped the most. Did not do a second pass or incorrect.

(2) First Aid for Step 1 - microbiology + antimicrobials (essential), immunology (optional).
Lots of mode of action of antimicrobials (and other drugs too) especially what they inhibited, microbe characteristics (DNA/RNA virus, gram stain, etc). For some reason, my exam had a lot of basic science immunology questions, so a cursory review of FA immunology section would have made the exam less painful.

(3) CCSCases (essential)
Definitely the gold standard for CCS prep. Did 80 CCSCases in the last 2 weeks. In retrospect, I strongly recommend doing them all and spreading them throughout my dedicated. Focus on knowing the cases and the presentation, what common labs/consults to order for cardiac, pulmonary, GI, GU, OB, pediatric patients etc. Pregnancy test, mammography for women. Vaccination for all patients. Other screening/ preventative health stuff per pt age.

(4)Crush CCSCases book (Not necessary)
Read on SDN that this book is a must. Read through all of it w/i 1 week, and did not feel that I needed it. CCSCases should be enough

(5) UWorld Biostats module (not necessary).
I bought it but did not use it. My own flashcards from UWorld were sufficient. However, perusing through it now, its certainly not a bad investment if you are seeking extra help on biostats.

(6) Others I did not use but could be helpful:
If I had more time/energy, I would have gone through Sketchy micro + pharm. I had mode of action of other drugs as well, not just antimicrobials.

(7) Practice tests: None! No NBME or UWorld Sims. I had >250 in Steps I + II, so I knew I would pass.

Exam days:
Day 1 (Saturday)

Questions felt more like Step 1, lots of mechanism of action for antimicrobials + other drugs, immunology questions, ethics/biostats/drug adds (4-6 questions per block), path sides (3-4 total). Left all of drug add questions toward the end. Finished all blocks with 1-5 min to spare and flagged 5-7 per block max. Only questions I flagged were those where I was 50-50 between 2 choices. If I was between 3 or more choices, I made an educated guess and moved on. Felt pretty good after first day.

Day 2 (48 hours later, Monday)
Felt more awful. I felt my exam was OB heavy (which is confirmed by the results report). Lots of questions on preventative medicine, primary care, “which of the following is the worst risk factor among all of the patient’s co-morbidities”. No biostats, no drug adds, no basic science.

CCSCases: All of my cases finished early. 2 cases were exactly the same as those from CCSCases. If you do all of the CCSCases and review them prior to your exam day, you should be good here. Finished my exam 1.5 hours early.
 
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7Epinephrine

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Last month of prep.
Finished CCS cases (qbank and book), made notes of the cases not listed in the book and reset UW and doing it over again.
I'm doing 1 block of FIP and 2 blocks of ACM per day so I don't run out of FIP cases before Day 1.
No video lectures, mostly UW, and making my own notes. No practice tests yet, waiting to finish my 2nd round of q's and don't want to freak myself out, it seems the UWSA are underpredicting, and they don't incorporate CCS so I'll take them a week before Day 1. Just fyi for those going through the same thing.
Stay strong, finish strong.
Okay wow. Took UWSA 2 (2 Days ago) - 199, and just finished UWSA 1 - 188. WTF?
Im going to have to postpone, my exam was originally scheduled for this Saturday but my confidence is crushed. Postpone at least a few weeks and review CK and Step 1 material. WOW. All I have to say.
This does jeopardize my plans for applying to residency, I won't get my score back in time, I can always reauthorize my USMLE transcript on ERAS but programs may have sent out invitations for interviews... this really sucks. This exam is NOT a joke.

My first pass of UW - 50%
2nd pass - 66%

I still have a lot of work ahead of me, I've noticed a trend that the UWSA are underpredicting but still it is a confidence crusher... I've been heavily focused on UW and my step 3 notes that I haven't looked over any Step 1 or CK material.... wow. Hope everyone is doing a lot better than me.
 

kablemach2o

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Score: 241 (9/22/21 release)
Study Period: 6 weeks (evenings and weekends)
Step 1: 251
Step 2: 244
UW Step 3 Average: 65% untimed, tutor, set blocks, completed 50% of the Qbank
About me: Brand new PGY1 ophtho intern

UWSA1: 225 (7 days before)
USWA2: 235 (4 days before)
 
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jordan789

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Step 3: 260
Step 2: 269
Step 1: 265
Current dermatology resident, took it PGY3.
Studied 45 mins a day for 3 months, increased to a couple hours a day the last couple weeks before test. I went through UWorld once (75% correct at the end, started off more like 60-65% right and then started going up), did both UWorld practice exams (projected 250s for both I think), did the UWorld cases (both the interactive and the review format they have), and reviewed my 2016 FA step 1 book for biostats.

The exam was long and grueling obviously. I took day 1 and 2 a few days apart which was nice, definitely glad I did...catch back up on sleep if you're someone like me who never falls asleep before big tests. The cases felt very easy but the multiple choice questions were tough. They were long and I was crunched for time every section (one of the sections I had to guess the last 3 questions quickly). Day 1 just felt like a combo of Step 1 and 2 all over again. Day 2 questions were very specific clinical questions that I felt like I was just guessing on all of them. I actually thought I was going to do worse on the exam than I did. I knew I'd pass but I thought I'd be average or below. For me, I heard all the books (First aid and master step 3) are pretty useless so I just focused on UWorld and I was happy with the result. Good luck everyone. It's stressful like always but you got it.
 
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redsox93

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Doesn’t look like anyone uses this lol but I’m taking it next Monday just looking for advice.
UW average 70%
Uw1 203
Uw2 222
Free 138 77%
Not feeling great but honestly just want to pass. Should I just hammer CCS this last week? Is it worth looking over some step 1 stuff like micro and pharm?
 

ciestar

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Doesn’t look like anyone uses this lol but I’m taking it next Monday just looking for advice.
UW average 70%
Uw1 203
Uw2 222
Free 138 77%
Not feeling great but honestly just want to pass. Should I just hammer CCS this last week? Is it worth looking over some step 1 stuff like micro and pharm?
Do some cases, stats review
 
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ciestar

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Welp, I passed.
Got a 210 on UWSA1, 234 on the real deal
 
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SinghMD

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Passed USMLE step 3 exam on the 5th attempt:

Back Ground:
IMG, Graduated in 2012.
(2014) Step 1 : 199 (1st attempt)
(2014) Step CS: Passed (1st attempt)
(2015) Step 2: 209 (1st attempt)

(2016) Attempt 1: Was before I got into residency. UW once or twice.
(2017) Attempt 2: Got into residency. Took the exam towards the end of my internship: Did UW once or twice +/- MTB 3. Thought that one year of internship experience would tip the scales, but it didn’t.
(2019) Attempt 3: Took the exam early PGY-3 year, Did UW once or twice +/- MTB 3. Same approach as before. Might’ve studied bit longer and harder but got the same result.
(2020) Attempt 4: (4 month preparation) Conrad Fisher MedQuest Videos, MTB3, UW x2, Crush USMLE Step 3 CCS book. But didn’t pass.

(2021) Attempt 5: (4 month preparation):
1) HIRED @Dr. USMLE as my Tutor ( ~once weekly for 14 weeks): We worked on test taking skills, and how to read and analyze questions. Also discussed study material to use, and study strategy.
2) Did all the NBME questions (2000+) from NBME.org including the CK questions
3) USMLE Step 3 secrets x 5-6 passes.
4) AMBOSS library only (not the Q bank)
5) UW CCS and Biostat (didn’t do the Q bank this time)
6) Crush USMLE Step 3 CCS book.

Self Assessment Scores:
FORM 8: 5/8/2021: 167 (before starting exam prep)
FORM 6: 5/18/2021: 182
UWSA1: 5/27/2021: 199
UWSA 2: 6/6/2021: 199
FORM 5: 6/22/2021: 400 ~ 190?
---------> Here is when I started working with @Dr. USMLE on test taking strategies. I also postponed my exam here.
FORM 10: 9/2/2021: 217
FORM 9: 9/5/2021: 214.
FORM 11: 9/7/2021: 229.
Actual Exam: 9/8/2021: 216

Lessons I Learned:
  1. Hire a Tutor. This really tipped the scales for me. I tried many tutors, and learned that there are many bad ones who will waste your time and money, but I got lucky in finding the right one for me.
  2. If you have multiple attempts under your belt. Test taking skills is probably worth assessing. How to improve that? Refer to point number one.
  3. DO NOT Rely heavily on USMLE World Question Bank if you have already done it 2 times max. I’m glad I didn’t waste more time doing it on my fifth attempt, since i completed it more than 4 times total over the years to no avail.
  4. USE NBME.org questions. It doesn’t matter if they’re designed for step 2 CK or step 3. They are all the same when it comes to the exam, and there is no difference. There are 2000+ questions. They have many free sample questions, and even more forms to buy. Many of these forms come with EXPLANATIONs. This was a game changer for me. It helps you learn high yield concepts that show up in the exam, and how the question writers think.
  5. USMLE Step 3 secrets and Crush USMLE Step 3 CCS are hidden gems and way underutilized IMO. Both are incredibly high yield.
  6. Passing USMLE takes precedence over Residency commitments. I hope your program director is supportive and understanding, and will make necessary accommodations to maximally support you.
  7. Postpone the exam if NBME scores indicate that you’re not ready. I had originally planned to take the exam in late June 2021, but NBME scores were not promising. I postponed it 3 times till Assessment scores were more than 210’s consistently.
  8. I think my biggest mistake in my first 4 attempts is not using NBME questions (i didn’t want to stress myself out in case the scores were low, which is ignorant on my part), and not hiring a Tutor.
Thank you for sharing this detailed information, I my self failed once after PGY3 just thinking it was a breeze and experience gets you through, Its certainly not the case. Makes sense though, why not just do NBME questions and learn from them especially when they give you explanations. Uworld didn't help me at all, what probably did is my experiences.
 

donovank730

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step 1: 261
step 2: 276
step 3: ???

took last week

day 1: biostats, random pathoma style path/histo questions, a couple immunodeficiencies, just very random and hard. Biostats is mostly conceptual with a decent amount of things I have never ever even heard of, like weird biases.

day 2: more like the isoteric NBME factoid type questions. Every other questions is " pick out of 5 risk factors and choose the biggest one." Everything is either know it or don't. Or they ask a pharm question and test a rare side effect you can only identify if you under stand the MOA


CCS is the part giving me concern. I finished within like 2 hours of the possible 3.5 hours, but several of my cases WOULD NOT END. No matter what I did. Identified the infection, got the microbial sensitivities, treated the pain and gave fluids, literally nothing left to do, yet the case would not end. Kinda threw me off and makes me concerned because I didn't study CCS a ton and just got the general feel for how to do it from ccscases, only did like 30. Now I am worried my work flow was off and I missed a major component. I had 4 cases that just wouldn't end no matter what I threw at them although every case said XXX is feeling improved so they all atleast started to improve.

Not really worried I wont pass, just shamelessly want a high score and feel like I crushed this exam other than CCS and since I have enjoyed doing well on NBME exams and want to finish my USMLE series strong.
 
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