Step III before residency?

Discussion in 'General Residency Issues' started by SilverCat, Feb 1, 2018.

  1. SilverCat

    SilverCat The Friendly Reapp Cat

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    Hi,

    Just wondering--if you have time before residency starts, would you recommend getting Step III out of the way? Do scores matter for fellowship?
     
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  3. SamDabutcha

    SamDabutcha ASA Member

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    I hear a few schools of thought:
    1) Relax, this is your last time to do so for a while
    2) Just wait for intern year, because a) the work you do doing intern year makes the test easy, b) many programs will reimburse for it
    3) Get it out of the way (regardless of reimbursement) so that you have one less thing to worry about during intern year.

    I'm going option #3 (also thinking that it will at least give me a surface knowledge of things so I'm a tad more ready for day 1 of intern year).
     
  4. gutonc

    gutonc No Meat, No Treat
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    You're wrong in thinking that. But good luck.

    1 and 2 are absolutely correct.
     
  5. SamDabutcha

    SamDabutcha ASA Member

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    Care to say why? How does it hurt you (other than being out $800, and not all programs reimburse anyhow)?
     
  6. smq123

    smq123 John William Waterhouse
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    It doesn't hurt. But it doesn't help either. As always, the test answer is frequently different from the real world answer. It doesn't provide you with clinical training, and it certainly doesn't make you a better intern.

    Also, are you a resident yet, or did you change your status early?
     
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  7. SamDabutcha

    SamDabutcha ASA Member

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    Nope, but I've graduated, and there's no status in between medical student and resident. Definitely not an attending!

    I don't understand the philosophy that there's nothing that we can learn prior to being on the job. Do you all remember how 4th year was (and maybe it's different now). We can be months without any clinical contact whatsoever. Any kind of practice/learning/studying seems like it would be beneficial, but then, I'm just a fake resident at this point so what do I know?
     
  8. neoexile

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    All the residents I've met have advised us to take Step 3 before the residency starts. It's one thing off your shoulders and you can just focus on the residency then.
     
  9. xffan624

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    What specialty are you going into? That may affect the answer.
     
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  10. SamDabutcha

    SamDabutcha ASA Member

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    I'm curious about whether the score matters as well (for anesthesia fellowship). Thanks!
     
  11. xffan624

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    I honestly have no idea for other specialties. For me in peds I have been told it doesn't. It's just a box to check and better to get it out of the way early before I forget the adult stuff. I took it in August of intern year IIRC.

    Sent from my XT1650 using SDN mobile
     
  12. Doctor Christmas

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    I would say no. Step 3 has gotten harder for one. Also you will need some clinical training in order to pass the CS component which is needed to pass step 3.
     
  13. rokshana

    rokshana Member
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    no one cares about the score, just that you pass.
    the "2 pencil" thing doesn't work if you take Step III before actually having done the intern year...why waste the free time you have now as a 4th year or after graduating studying for something that after a year of being an intern you can just walk in and take...free time is not something you will have a lot of for at least the next 3 years..

    and a graduated med student is just that..an MD/DO/MBBS...
     
  14. SamDabutcha

    SamDabutcha ASA Member

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    Right, but unfortunately that's not a status option within SDN. I made my status blank so that I don't mislead anyone!
     
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  15. neoexile

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    My friend passed it in like 2 months after he finished his medical school.
     
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  17. xffan624

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    I would say if you have a history of doing well on board exams, it's passable with a period of dedicated study ( doesn't have to be all day but you have to put in some hours) with minimal intern experience.
     
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  18. rokshana

    rokshana Member
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    2 months that could have been used for something enjoyable vs the weekend (at most) needed after intern year...bur i guess some people would rather study.
     
  19. pandh83

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    Almost every resident in 4 different residencies I rotated through said to take it to get it out of the way. A lot of them have to take 5 days of their vacation time to prep and sit for the exam which they would have liked to use for something else. Also, 4th years who taken it said you only need a month off for it to pass and biggest plus was relearning a lot of knowledge they had lost plus the UW CCS cases were the most helpful in knowing what orders to put for the most common cases. Most programs don't reimburse it and if they do they do it from the Educational allowance which you can use for other stuff anyways(your not losing it).
     
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  20. metallica81788

    metallica81788 Keeper of the Llamaworm
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    Depending on your residency and schedule, you could work it into an elective month or ER month when you're not working every day. I took mine during ER month in December of intern year without taking vacation. Don't waste your precious remaining free time it won't ever come back.
     
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  21. Oso

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    I've heard both sides of the argument from people in peds since intern year doesn't really help much for step III and you forget so much of adult medicine...

    Also, the thought of doing u world questions during residency sounds sad. Questions in general are fine, but u world ... again...
     
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  22. eteshoe

    eteshoe .......

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    At least my thinking is not too nuts since I was planning on taking step 3 before intern year
     
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  23. clutch21

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    +1 for taking it as soon as you can. I took it in the first few months of internship. Kinda sucks to go home and study after working a 10-12 hour shift. Would rather put a few hours of studying in each day when I have nothing else going on. Do whatever feels most comfortable for you.
     
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  24. AdmiralChz

    AdmiralChz ASA Member

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    I’m not sure where all this advice is coming from to take the test before starting intern year. ALL of my intern class of 12 took it in November, and our program reimbursed and allowed time off. I honestly don’t believe I know a single person who took it before residency, unless it’s an IMG with different circumstances. Certainly none of my friends or acquaintes from medical school took it early, we all went to the beach in May instead and enjoyed life before it got crazy.

    Translating passing Step 3 into solid preparation for intern year is a stretch at best. That being said, since clinical responsibilities as a medical student tends to be pretty low, so intern year will help acclimate you to what is important in your patients day-to-day.

    In anesthesiology no one gives a crap about Step 3, just need a pass. I imagine most fellowships are the same (MUCH more important - in training scores).
     
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  25. FutureInternist

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    There are a lot of “not your reseidency specific” questions on the exam (although IM may have an advantage) and getting it out of the way earlier is best before your mind gets all blurried up by what your attending says, what insurance says, what case manager says etc.

    The “real world” answers work in the real world only and do not help on exam.

    I had to postpone my exam from Dec of intern year to Dec of 2nd year (this was before the rule about having passed Step 3 to advance to 2nd year) and it SUCKED having to re-learn fetal heart tones, vaginal discharges, where the appendix is etc ;)

    “Using up” what little free time you have left before residency is worth it to have it over and done with and then you can use the downtime in elective to relax during intern year when you actually need a break. Most of my 4th year rotations (after the Match) were easy so I don’t buy the “you need time off” argument.

    Also, if you haven’t started doing this then you should try it with Step 3 UW questions.... read the answer choices first. It really helps focus your thoughts on the disease, body part, syndrome etc.
     
    #23 FutureInternist, Feb 2, 2018
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  26. Doctor Christmas

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    Our program does not reimburse us and only gives us the 2 days off for the actual test but no other time off. None of my colleagues took it prior to residency either.
     
  27. GoSpursGo

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    Personally, I think this is worth an email to the chiefs or program coordinators at wherever you match to find out if you would get reimbursed if you wait, and what most people at your program do. I took it in August on intern year on a light (non-elective) month without taking any time off for it, and got reimbursed. If you're doing a surgical intern year where you're getting killed on a daily basis on every rotation, that might not be a great idea.

    As far as I know, I have not heard of anyone anywhere suggesting that step 3 score matters at all for fellowship.
     
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  28. anonperson

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    Taking it before residency or during intern year are both reasonable approaches.

    There is no tangible benefit other than not having to worry about it during intern year.

    I did an OB GYN residency and took the test intern year so it was a bit painful to review IM, Neuro, etc but I was able to pass without any issues.

    I did dedicate study time for it and did do USMLEWorld practice questions. This is annoying as you are busy intern year just trying to get a handle on things so studying for Step 3 when you get home is a bit of a bummer.

    The score should not matter for fellowship. Each specialty is different though. If you read through some of the different specialty threads, it seems some fellowships care about Step 1 score etc. For myself, in service exams played a larger role. (Took in service exam in January and then Step 3 in March/April).
     
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  29. Doctor Christmas

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    for some competitive fellowships it does - for example in interventional pain scores matter. I'm sure for competitive medicine fellowships including GI, cards, they also matter.
     
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  30. rokshana

    rokshana Member
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    Step III unlikely , though step I scored may still be a filter
     
  31. SilverCat

    SilverCat The Friendly Reapp Cat

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    I'm going into IM, and was thinking of doing it just to get out of the way. If the score isn't important, I'm just concerned with passing it; I just don't want to find out that if I don't get a certain score I won't have a shot at more competitive fellowships.
     
  32. 24blue8

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    I would definitely take it before. It's a waste of energy, vacation and sleep if you are trying to take it during intern year in my opinion. Our program requires you to use vacation to take it and you have to pass it before being promoted to pgy-II.

    I honestly don't see how you could go through intern year and then just waltz in and pass the test without any review. You will still have to study for it at some point and when you're working nights you are really going to have that thought of OMG wtf is all this material there's no way I will learn this all! Followed by existential crisis panic, asthma inhaler, attempting to postpone the test 2x. Basically your prior step exam reactions. The breadth of material is large, all the stats nonsense and research articles they have on it now... I think perhaps the old heads are still in the "2 pencils" mindset. Or we are all just a lot dumber now. I slept well during intern year knowing that all those USMLE beasts were behind me. Other colleagues postponed, postponed some more and then looked silly having to tell our PD they'd chickened out and hadn't studied enough to take it yet.

    I will also add that yes you do learn while studying for the test. I scorched the crap out of categoricals on rounds bc I'd just finished 1000 questions of UWorld lol. Built up the fake reputation of being the "really smart" off service intern. Little did they know back at home...*asthma inhaler when opening score report*
     
    #30 24blue8, Feb 2, 2018
    Last edited: Feb 2, 2018
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  33. FutureInternist

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    Dudes and dudettes,

    Reimbursement for the exam should be the LAST reason to delay it till intern year.

    Get a loan, drive an Uber, put a want ad on Craigslist offering to dress up as a French maid.

    Take it ASAP
     
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  34. Doctor Christmas

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    I don't think the vast majority of programs reimburse you for step 3. A few might but they will take it out of the yearly allowance you get.
     
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  35. aProgDirector

    aProgDirector Pastafarians Unite!
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    Anyone who says that S3 score "doesn't matter for an IM fellowship" is being somewhat simplistic. Everything matters. It might be lower on the scale than other things, but it's not ignored.
     
  36. Raryn

    Raryn Infernal Internist / Enigmatic Endocrinologist
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    My residency had a few hundred dollars we could use as an educational budget each year and that covered like 1/2 of Step 3. I haven't heard of any programs just straight out paying for it before this thread, but I suppose they may exist.

    Regardless, Step 3 is more or less the same material as Step 2. If allowed, m people could have taken the tests on back to back days and done perfectly fine on Step 3 (if not better than they eventually did due to being UTD with the minutia not in their own specialty). But you can't take Step 3 before you have your med school diploma in hand, so then it would require doing it during your vacation between graduation and residency.

    Taking it early is fine if you don't value that vacation, but if you're in EM, FM, or IM, you'd also be just fine (if not better off) waiting. Your intern year will be directly applicable to all (EM/FM) or most (IM is 2/3 of the exam) of the exam, and you'll almost certainly have an easier block at some point in the year you can just take it. I had an EM block in February of my intern year, studied off and on for a few weeks and took it near the end of the month. Most IM/FM residencies have at least one elective or easy outpatient block during the intern year, EM residencies have EM months with fairly light schedules at baseline. I certainly would never waste my residency vacation time to study for the test (I knew one person who did that, I was baffled by it), and every program I'm aware of will give you the 2 days off for the test itself.
     
  37. smq123

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    My main concern would be that you'd be trying to take Step 3 AND moving right before orientation. If your program starts fairly late and/or you're not moving very far, it might be ok. But some of my med school classmates were asked to show up for orientation the first or second week of June, right after we had graduated in late May. To me, that feels like it's pushing it.

    And yes, I absolutely just waltzed in and passed the test with minimal review. But I'm FM, and the test basically reviewed everything that I had done during intern year. So it all depends.
     
  38. Mehd School

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    Every program I'm ranking pays for it. And I'm burnt crispy from all the tests I took 4th year. Going to wait.
     
  39. nlax30

    nlax30 Fellow
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    I may be confusing the question.... though you can’t take Step 3 until after med school graduation correct? Without looking at the requirements that’s what I recall from 7-8 yrs ago.
     
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  40. Doctor Christmas

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    That's correct
     
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  41. nlax30

    nlax30 Fellow
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    So then what’s the OP’s question?
     
  42. Doctor Christmas

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    Well for many students/grads there is a timeframe between graduating from med school at which time they are eligible to take step 3, prior to starting internship. i dont think they are suggesting that they would take it prior to graduation, simply prior to starting internship.
     
  43. parcus

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    If you have the time, I think taking it before the internship helps if you have the time. 1) it might help marginally with the interneship. 2) content is very similar to step 2, you won't have too much trouble studying for it.
     
  44. ThoracicGuy

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    Step 3 won't help any for actual training.
     
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  45. Oso

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    So I know you need to have graduated in order to take the test, but do you need the diploma in order to just register for/schedule the exam?
     
  46. Raryn

    Raryn Infernal Internist / Enigmatic Endocrinologist
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    If only there was a website listing requirements.

    You have to be past the date on your diploma itself to even register for the exam.
     
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  47. AdmiralChz

    AdmiralChz ASA Member

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    Interesting, considering most schools graduate mid-May to early-June I'd be surprised if USMLE could turn it around quickly enough for one to even take it before a July 1 internship start date. I seem to remember scheduling my exams months if not weeks in advance, but I'm largely trying to forget those times.
     
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  48. Raryn

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    The only people I know who took step 3 prior to residency were people who didn't match or IMGs who graduated 1-2 years prior. That's another reason why this thread made no sense to me.
     
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  49. Doctor Christmas

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    Even if they could turn around and process things (I think they verify with your med school that you've graduated) typically you have to book the actual test a few weeks in advance. Sure you perhaps may luck out and grab a spot for someone who cancelled but given that it's a 2 day test it'd be hard. So say someone graduates 6/15 or so - you could apply for it, verified maybe 5 days later, then you'd have to find 2 days either back to back or in different weeks in a matter of 2 weeks or less and take it. Even if someone graduated mid to late May, same thing, you'b ebe looking at likely late May or early June before you could take it. Hardly seems worth the effort and stress to take it before July 1. And most people have some sort of orientation of various lengths - some programs a few days, some programs go close to a week - so hae to consider that too. Again not worth the stress. I don't know anyone who took it before residency - and most of my classmates actually took it PGY2.
     
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  50. parcus

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    It depends heavily on location. I scheduled mine about 1 month in advance in the SE. In the NE the dates were all taken for 2-3 months.
     
  51. nlax30

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    Glad i wasn’t the only one.
     
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  52. DocDoItAll

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    I finished school last July (I'm an IMG) and finished a job at the end of February and would have had a few months with nothing to do before residency starts. I did have fun and did things I enjoy but I'm also a little restless and get bored easily so I needed something to stay busy. I just got my scores back last week after taking it in early/mid-May and studying for a solid 2 months and did well on it. I took it for that reason and because I'm going into peds and didn't want to forget everything else after already being a year out from step 2, and also because I know myself and there's no way I'd be motivated to study after working all day. I'd rather use my time after work to work out, play guitar, cook, or generally relax. Whether or not to take it depends on a lot of factors but based on what residents in peds told me, if you're motivated to do it sooner I'd say just get it out of the way early.
     
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