- Joined
- Jul 25, 2001
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- 9,319
- Reaction score
- 121
I took it recently. Here's my impression:
Preparation: Sat down with First Aid for about 1-2hrs/night x1wk, and then studied 10+ hrs/day x2d prior to the test. Also read Boards and Wards again, and did a minimal number of questions out of NMS. Didn't buy USMLEWorld or any of that stuff, as I didn't think it was helpful for the prior Steps and I'm poor. Total amount of studying was probably 25% of what I did for Step II.
Day One: The test was more difficult than I expected, although probably a little easier than Step II. I thought roughly half the questions were quite easy, and many of the others could quickly be narrowed down to two choices. (Many of the questions could be answered without reading the text, so I recommend reading the question first, although if you're like me you won't be able to resist going back to read the text anyway.) It was roughly 50% IM-type questions, maybe 20% woman's health, maybe 10% pediatrics, and then a hodgepodge of everything else. A lot of rashes were shown, with typical USMLE picture quality (these are always lit so poorly that all you see is a bright shine). The radiographic images were even worse... invariably horrible. If I ever actually got an abdominal plain film that looked like the ones shown to me, I would go check and see if the tech was drunk.
There were a fair number of questions of the "what would you do next?" variety where all the answers are correct and would, in real life, be performed concurrently. Presumably they are asking "if you could only do ONE of these, which would you do?" Irritating.
There was one question with a very dramatic typo.
There was one stats question which, I am 110% sure, could not be answered with the information given, but that wasn't an answer choice.
I was also surprised and incredibly irritated by the number of very very specific specialty questions. I don't remember jack-sh1t about the finer points of neonatal pathophysiology, and >95% of the people taking this exam don't need or want to remember anything about it. At some point during the day I wasted several minutes pondering why the fu(k dermatologists, urologists, plastic surgeons, or whatever should have to take this ridiculous test. I don't feel like studying more would have helped much, unless I had decided to study a whole lot more.
An interesting note: as with prior Steps, I didn't take any breaks during the day, just powered through. The guy at the testing facility, when I checked out, was totally flabbergasted. He said that in the three years he has worked there, he was never seen anybody complete a day of Step testing without taking a break.
Day Two: The morning is pretty much the same. If there is any significant difference in the question types or difficulty, I could not detect it. I was, however, more in the swing of things by the second day and felt more confident.
The CCS cases didn't seem too bad, but they are a little mysterious in how they work. In at least 6 of the cases the diagnosis was evident after the H&P and was quickly confirmed with routine tests. In the other cases, the differential was quite narrow and the diagnosis was made easily after a couple diagnostics. So in those terms, it's almost a no-brainer... everything I had was classic, and I wouldn't worry much about zebra diagnoses or complicated, unusual presentations. Most of the cases ended about ten minutes in, and that was with me taking down lots of notes and being extremely careful with my ordering. One of the cases didn't seem to want to end, and I couldn't think of anything else to do. Finally I thought of one very tiny intervention, which immediately prompted the end of the case. I left the testing center 2.5 hours early.
After leaving Steps I & II, I had felt a fairly acute sense of doom, and both scores turned out good. Leaving Step III, I felt only mild discomfort. If I didn't have the prior experiences to guide me, I would probably be slightly worried at this point. It's definitely not an easy test, but it must be scored fairly generously since most people pass it. I'll let you know how it turned out when I get my score.
Preparation: Sat down with First Aid for about 1-2hrs/night x1wk, and then studied 10+ hrs/day x2d prior to the test. Also read Boards and Wards again, and did a minimal number of questions out of NMS. Didn't buy USMLEWorld or any of that stuff, as I didn't think it was helpful for the prior Steps and I'm poor. Total amount of studying was probably 25% of what I did for Step II.
Day One: The test was more difficult than I expected, although probably a little easier than Step II. I thought roughly half the questions were quite easy, and many of the others could quickly be narrowed down to two choices. (Many of the questions could be answered without reading the text, so I recommend reading the question first, although if you're like me you won't be able to resist going back to read the text anyway.) It was roughly 50% IM-type questions, maybe 20% woman's health, maybe 10% pediatrics, and then a hodgepodge of everything else. A lot of rashes were shown, with typical USMLE picture quality (these are always lit so poorly that all you see is a bright shine). The radiographic images were even worse... invariably horrible. If I ever actually got an abdominal plain film that looked like the ones shown to me, I would go check and see if the tech was drunk.
There were a fair number of questions of the "what would you do next?" variety where all the answers are correct and would, in real life, be performed concurrently. Presumably they are asking "if you could only do ONE of these, which would you do?" Irritating.
There was one question with a very dramatic typo.
There was one stats question which, I am 110% sure, could not be answered with the information given, but that wasn't an answer choice.
I was also surprised and incredibly irritated by the number of very very specific specialty questions. I don't remember jack-sh1t about the finer points of neonatal pathophysiology, and >95% of the people taking this exam don't need or want to remember anything about it. At some point during the day I wasted several minutes pondering why the fu(k dermatologists, urologists, plastic surgeons, or whatever should have to take this ridiculous test. I don't feel like studying more would have helped much, unless I had decided to study a whole lot more.
An interesting note: as with prior Steps, I didn't take any breaks during the day, just powered through. The guy at the testing facility, when I checked out, was totally flabbergasted. He said that in the three years he has worked there, he was never seen anybody complete a day of Step testing without taking a break.
Day Two: The morning is pretty much the same. If there is any significant difference in the question types or difficulty, I could not detect it. I was, however, more in the swing of things by the second day and felt more confident.
The CCS cases didn't seem too bad, but they are a little mysterious in how they work. In at least 6 of the cases the diagnosis was evident after the H&P and was quickly confirmed with routine tests. In the other cases, the differential was quite narrow and the diagnosis was made easily after a couple diagnostics. So in those terms, it's almost a no-brainer... everything I had was classic, and I wouldn't worry much about zebra diagnoses or complicated, unusual presentations. Most of the cases ended about ten minutes in, and that was with me taking down lots of notes and being extremely careful with my ordering. One of the cases didn't seem to want to end, and I couldn't think of anything else to do. Finally I thought of one very tiny intervention, which immediately prompted the end of the case. I left the testing center 2.5 hours early.
After leaving Steps I & II, I had felt a fairly acute sense of doom, and both scores turned out good. Leaving Step III, I felt only mild discomfort. If I didn't have the prior experiences to guide me, I would probably be slightly worried at this point. It's definitely not an easy test, but it must be scored fairly generously since most people pass it. I'll let you know how it turned out when I get my score.
