I recently took Step 3 and wanted to share my experience here as reading this thread has given me a glimmer of hope, but also some anxiety. I am currently not in residency and took the exam in 2 consecutive days.
Prep:
Materials used: UW, MTB3, Crush Step 3 CCS, FRED
I studied for about 4 months in total. 1st month was packed with graduation-related activities and other events I could not avoid, so my studying was sporadic at best. I did Qbank in tutor mode whenever I could squeeze it in. I was also typing notes as I read through the explanations for each question. The second month involved relocating, but once I was settled into my new place, my studying became more consistent. By the middle of the 3rd month, I had finished my Qbank and instead of re-setting it, I created timed tests of my incorrects by topic. Concomitantly, I read MTB3 and made flashcards for the topic I was doing questions on. By month 4, I was pretty burned out and only reviewed my homemade flashcards. For CCS, I had been reading Crush on and off for the 4 months, taking in 2-3 cases a day until I covered all 120 cases. I also did all of the 51 interactive CCS cases in UW and the 6 cases in FRED. I really wanted to cover my bases well as I'm trying to match this year. Also, I am not the strongest test taker.
Test Day 1
I will echo what everybody else has already said about biostats on Day 1 - it has a pretty big presence, but mostly in the form of drug ads. For every block, I got maybe 2-3 drug ads and each drug ad was associated with 2-3 questions. To get through the drug ads, I just skimmed the questions and then scanned the ads to find the answer. And for the biostats calculations, I did several NNTs. Also, something I don't see mentioned a lot on here is the presence of ethics questions, of which there were plenty. The questions would start out like a clinical vignette but when you got to the bottom of the stem, you realize it was an ethics question. After running into a few of these, I decided to save on time by just reading the last sentence of each stem and/or scan the answer choices. As for the basic science questions, I felt as though there were a few per block. A lot of them tested your knowledge of drug mechanisms, which I did not review because I didn't think to do that. Stupid. Overall, it was a long and tiring day with a fair amount of guessing and feeling as though I knew nothing. Also, I felt like 1/3 of the questions were not answerable. I found myself striking out every answer choice for these questions and then having to go back and un-strike out the answers until I could just settle on one. The guessing never felt educated or safe to me.
Test Day 2
I was exhausted after Day 1 and didn't study much more for Day 2, though I wished I had. Day 2 was definitely more clinical management focused, as everybody else has stated. Unfortunately, the question stems were either too vague or they had 2 very similar and possibly correct answer choices. I had a great example of one that I can't even remember now but when I went home to look it up, there was no definitive answer. Who knows? After the 1st block, I was wiped out. I would say that stems were shorter for Day 2 MCQs, but still require a great deal of concentration to get through...definitely not 1-2 liners. Also, they were usually not laden with lab results and extraneous info. I had guessed on most of the 1st block and felt doomed going into the subsequent blocks. After a while, I just was on auto-pilot guessing and feeling absolutely drained of brain power. I took a long break after the MCQs and felt so sick I couldn't even eat lunch. I went outside, prayed for a hail mary and then went back in to tackle CCS.
CCS: For some reason, I felt extremely nervous going into CCS. I think it was partly knowing how much weight it carried and also knowing that I could possibly forget essential steps and screw this whole thing up. The first case was very straightforward and from Crush/UW so I knew exactly what to order and the case ended within 2 minutes. The next case was seemingly obvious based on the HPI until I ordered imaging and it was revealed to be something else. I panicked because I had forgotten how to manage the condition. I ordered pain meds because the patient was in pain and he somewhat improved. Then nothing happened so I ordered some more pain meds and the case ended. Maybe he died? There were at least 3 cases following that that were very bizarre. They seemed obvious based on HPI, but when you try to manage them the way you're taught to, they either worsened or nothing happened. None of my cases went through to the end (i.e., they all ended early), but not because I was managing them well, I think. I would say that only 7/13 went well, 3 were absolutely off the wall and I still can't figure them out, 1 was mismanaged and 2 I can't even remember. I also forgot to put in end orders for a few of them because I was so rattled. Probably lost easy points.
Post-exam sentiments: I couldn't sleep for the first week following the exam. I kept mentally kicking myself for guessing so much and also not figuring out all of my CCS cases. I can honestly say, though, that even if given another month, I would have done exactly the same thing on the exam. There is just so much you have to know and remember that it's not possible for many of us to feel confident leaving the exam. I am in the majority of people who think they failed. Hopefully someone heard all of my frantic prayers before, during, and after the exam.
