Hi!
I found other people's comments reassuring while preparing for step 3, so I will post mine to balance the reporting bias.
I realized I seldom had time to study and that I should prioritize in-training exams, so I bought the yearly Uworld. I had a steady 62 percentile for months and then at the end cramming (2 days) it dropped to 55 when I was doing some category I can't remember and started running out of time in the tests. I think the percentage was in the 60s. I trained myself to stop overthinking and to think about the context and how it is practiced by current doctors. When I knew I didn't know the answer, I used pathophysiology to take an educated guess.
I agree with the advice above only if you have recent clinical experience and you have not been doing research for years. That is the reason I waited. I decided to learn from my colleagues in other specialties by reading their notes and learning patient by patient for the past 2 years. Technique-wise, I just did the interactive cases of Uworld to figure out how it worked. I think I made a mistake by not realizing I was in the outpatient setting and ordering IV medications (In the real world, nurses would have surely let you know what they don't do in their unit/clinic!). I corrected it when trying to advance the clock. I felt very comfortable about the CCS cases otherwise.
If I had had more time, I would have done the other half of uworld that I never went through, gone through my wrong answers, the other practice cases and a review of flashcards. Alas, residency is busy and it is more important to prevent Mr. X from losing his ability to walk than scoring high on a test with my short term memory.
My score was 224, SEM 216-232, very average.
Neuro PGY-3