I had third for third year and bought fourth for step 2. I'd say they're 90 % the same although I didn't make it a point to compare. About the only thing I can think of that's different is fourth has new pap smear guidelines (21 vs onset of serial activity). Other than that there literally nothing I can think of that's any different. Not saying there isn't. Just that it didn't jump out at me. Beyond preventative guidelines I can't really think of much that changes year to year anyway
I've been using 4th edition and loved it thus far, though I can't say I've read the 3rd edition to compare. I have noticed a few typos that snuck through, and one conceptual error (says "in hypospadias, the urethra opens on the dorsal (under) side of the penis"). But overall, it's been a great book for review, very concise and in the Q/A-Bullet format I like.
I would definitely get the 4th edition because of some minor updates and new chapters...for example there is a radiology section that lays out screening tests / confirmation tests for diagnoses from all organ systems.
I used step 2 secrets throughout M3 year for shelf exams and personally didn't really find any of their "secrets" on any of the shelf exams. I just read it b/c it was the fastest way to get through a topic and some of the questions were pimp questions.
I think my problem with step 2 secrets is that it doesn't ask the question in a "USMLE sytle" if that makes any sense. And some chapters are severely lacking material - i.e. Peds, Emergency Medicine. So basically it is not a very comprehensive book for step 2
Nevertheless I guess it is a good option if you get tired of UWORLD or your other resources and want some relaxxing material
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