Saw a lot of these posts while studying, and most of them made me more worried than I should have been, so wanted to post about my experience…
Background
Step 1: 246 (May 2015, 6 week dedicated studying)
Step 2: 257 (July 2016, 10 days dedicated studying)
Step 3: 243 (Oct 2017, 6 weeks part time during intern year)
Going into non-medicine advanced program and in a relatively chill prelim year. Wanted to get the thing over with early in intern year and not worry about it. A lot of these threads talked about using a ton of sources, and many of my categorical co-interns are studying super hard for it, so made me anxious about it.
I studied part time for 6 weeks. 4 of those weeks I was busy on wards, (studied maybe 1-2 hrs a day after work, and on the phone/under the table during rounds/noon conference lol) 2 weeks I was on light outpatient rotation (2-3 hrs of studying a day plus 2 weekends part-time). Finished uworld x 1 (overall percentage 65% first pass), all uworld CCS cases x 1 (both interactive and practice cases), and UWSA. Didn’t take any notes or anything. I did maybe half incorrects but stopped as I was getting 90+% and mostly just remembering the questions. A little less than 2 weeks out I took UWSA and got a 201 (average was 204. I got slightly higher than avg on each block so not sure why my score was slightly below avg). Regardless, it made me worried as I had already finished most of uworld, but I decided to leave test date as is. I just kept reminding myself that pass rate is like 97% for US MD first takers. I thought UWSA was hard, timing was an issue for me (which has never been the case in previous tests), and just weird questions overall—I wouldn’t even recommend taking it. I crushed through the CCS cases the week and a half leading up to the test, and the night before the test reviewed first aid for step 1 stats for about an hour.
Day 1: Very heavy on stats and ethics. About 10-12 questions per block were either stats or ethics. All the stats was very doable/basic--nothing more than uworld or what is in first aid step 1 stats (relative risk, hazard ratios, confidence intervals, Sensitivity/specificity, positive/negative predictive values, drug ads/abstracts, etc). What I did is save all the stats questions til the end, which I highly recommend since they take up more time than the others. For me, the ethics were extremely challenging and not straightforward at all (definitely hardest section for me), but I also found ethics on step 1 and 2 difficult. A lot of informed consent in pt’s below 18, a lot of “how would you respond,” reporting other physician’s behaviors, and end of life stuff. I could always narrow it down to 2 but way harder than Uworld ethics questions in my opinion. Other questions I thought were on par with uworld. Didn’t have a problem finishing blocks in time but sometimes wouldn’t have much time to review my flagged ones. There were about 2-3 basic science throwbacks every block from Step 1 days that annoyed me (types of receptors, mechanism of random drugs, histology of tumors, etc), but not enough to make it worth reviewing any basic science stuff.
Day 2:
No stats or ethics. Questions more clinical, a lot of risk factors/ complications/ prognosis/ treatment. Still a good amount of annoying ones though since they ask things like biggest risk factor for CAD and then list a bunch of risk factors for CAD (dm, htn, obestity, hld, smoking, age, etc). But overall seemed more straightforward than day one, and no basic science questions. Was finishing every block 10-15 mins early, with plenty of time to review flagged ones. Question length felt shorter than uworld. CCS cases for the most part ended early for me. About 9-10 of them were straight forward and very similar to uworld ccs. 3-4 of them were harder and didn’t figure out diagnosis til late, one was childhood cancer (I think it was ALL) but heme/onc had no recs and didn’t know how to treat so I just gave steroids and scheduled bone marrow transplant and case ended lol… I’m sure I got a bunch of points off for that. Overall just be methodical about cases and at least get the basic orders in which you learn from doing uworld ccs.
Overall
Get it over with earlier on in the year. It's not the type of test where waiting til later in the year (even when I’m doing an internal medicine prelim year) would help. Know stats, be aware ethics may be hard (although don’t really see how you’d study for it), and don’t let the few basic science qs on day 1 demoralize you. I think uworld x 1 and doing all the CCS cases is more than ample preparation for anyone who didn’t have issues with step 1 or 2. And don’t worry about UWSA (and don’t read into it if you took it and didn’t do well). After the test I felt like I probably got around average (I would have guessed I prob scored around 220-225), but the curve must be very generous. Ended up with 243- in regards to breakdown Ethics/behavioral and ccs were lowest and went a bit into the borderline area, everything else was relatively high end. Goodbye USMLE!