Well, that was not fun. For future reference:
May 14: graduate, apply online
May 15-17: all supporting forms in to fsmb
wait, wait, wait ...
June 2: medical school finally certifies me
June 7: email saying I've been approved (through Connecticut)
June 9: permit is mailed from Texas
June 14: permit arrives in Boston, exam scheduled
June 21&22: Step 3 (could have taken it June 17&19 but didn't want a Saturday)
So for people wondering how long it takes for the permit to come ... it might have come within a couple of weeks of application but for the hang-up waiting for my school to certify me. This should only be a problem for people who just graduated. Also, my original scheduled test was for a week later than I wanted and an hour's drive away -- but fortunately there were cancellations, so I ended up getting the exact dates and location that I wanted. Just keep calling to check on cancellations. The permit tells you to go to the website to book, but you actually can't book Step 3 that way, you have to talk to them on the phone at 1-800-MED-EXAM. Cute.
My prep: First Aid and Kaplan QBank. The knowledge database from First Aid for this step isn't worth the paper it's printed on, unfortunately -- not nearly as useful as First Aid for the first two steps. The 100 cases in the back were useful though, so at least read through those or some similar source. QBank was also not as directly applicable for this step as it was for Step 2, but it was somewhat helpful. I couldn't use USMLEWorld because I have a Mac and didn't want to risk trying to outsmart them but failing.
Content of exam:
*Very heavy on outpatient stuff
*Lots of medication side effects (the big ones - know one major side effect for the most common psych drugs, a couple for the major cardiovascular drugs)
*Lots of questions in the format of: complaint or problem, big question stem with many possible causes for the problem, then you have to choose which one was most likely to have caused the complaint
*Multiple questions asking you to say which of the patient's risk factors for a particular disease is the most significant
*Good amount of OB questions -- really helps to have been pregnant for these
*Peds also showed up, especially neonatal problems and common ailments of the small child -- same thing, if you can arrange to have had your own small children by the time you take the test, these will seem much easier!
*Rashes -- I stink at these -- I guess my kids haven't had too many rashes (though there was a yeast diaper rash question -- regular diaper rash is solid red, yeast rash has red bumps)
*As mentioned previously, not very much cardiology, compared to how much it was emphasized in med school
The cases went by in a flash. Mostly they just cut off and I still wanted to do a bit more to manage the patient. I'm pretty sure I never managed to transfer them to the next appropriate setting before it told me I had five minutes left (the program can cut you off, even though you haven't nearly used your whole twenty minutes yet), and I couldn't figure out how to get back to the "change location" tab at the last five minutes if you're supposed to be able to do that. If it ended up being a surgical case, the case would pretty much end once you'd ordered the surgical consult and they said the patient would be scheduled for surgery. Definitely go through the cases on the sample CD to become familiar with the format.
Probably the people best prepared for this test are family practice residents. I found myself thinking back to my family practice, medicine sub-I, and ob/gyn rotations the most. So, for pathology residents, sooner is better! I'm not sure my studying really helped much this time. The questions seemed to get harder throughout the test, which I attributed to mental fatigue and to a rapidly deteriorating attitude, as as far as I've heard it's not adaptive. I could be wrong. I really hope I passed, because I certainly don't want to repeat the last couple of days. I did get out pretty early both days, which was nice, but still.
