When to take step 3?

[Katia482]

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I was wondering if anyone had any advice on when is a good time during intern year to take step 3. The information that is circulating around my program is that our ambulatory month is best as you have the most free time. I have this next month, and so I am wondering if this is too early to take it. On one hand it would be great to get it over with early, but I also dont want to screw myself by taking it before I've had time to absorb more knowledge.

I've gotten mixed reports on how hard this test really is, and how much time is needed to study for it. Any advice on this would be greatly appreciated. I am considering possibly going into cards so my score on Step 3 might actually conceivably matter.

 

[jdh71]

Honestly, IMHO, pretty much just showing up and paying attention during your first year of IM residency is plenty to pass step 3 . . . although I do think going over the likely cases you will see during the 2nd part of the test is helpful because you can see what the testers want and/or are looking for.

I'd pick your least busy month, study for about two weeks - nothing "hardcore" - like maybe an hour in the evenings, a couple hours on the weekends during those two weeks going over questions or the cases, and then take it.

I honestly didn't study that much and did better than step one or two . . . much of that was luck I'm sure, but it wasn't a big deal . . .

 

[Katia482]

Thanks jdh! The only thing is, I am a brand new intern right now, so if I take it next month then I will have ~6 weeks of IM residency under my belt - is this enough?

 

[jdh71]

Thanks jdh! The only thing is, I am a brand new intern right now, so if I take it next month then I will have ~6 weeks of IM residency under my belt - is this enough?

I think if you spend time studying with a question bank, definitely. I do assume you do well on stnardized multiple choice tests.

 

[gutonc]

The only real reasons to delay are:

1. You're a crappy standardized test taker and generally need lots of time to prep. If you've scored 220+ on either/both Steps 1/2 without taking a year off to study, this doesn't apply.
2. You're applying to a competitive sub-specialty fellowship (Cards/GI for sure, Hem-Onc/PCCM slightly less so) and need to dramatically improve on prior poor Step scores or some other red flag in your file.

I used Crush Step 3, the USMLEasy Lite question bank (available through my hospital's library website for free...check to see if you have similar resources) and the CD of Sample interactive cases. I studied about an hour a night for a couple of weeks and, like jdh71, improved on my prior Step scores and left both exam days 2+ hours ahead of time.

Taking it later (do you have an elective or cushy consult/ambulatory rotation later in the year?) or first thing next year may be helpful, but only if one of the 2 situations above applies.

 

[ResidentMD]

The only real reasons to delay are:

1. You're a crappy standardized test taker and generally need lots of time to prep. If you've scored 220+ on either/both Steps 1/2 without taking a year off to study, this doesn't apply.
2. You're applying to a competitive sub-specialty fellowship (Cards/GI for sure, Hem-Onc/PCCM slightly less so) and need to dramatically improve on prior poor Step scores or some other red flag in your file.

I used Crush Step 3, the USMLEasy Lite question bank (available through my hospital's library website for free...check to see if you have similar resources) and the CD of Sample interactive cases. I studied about an hour a night for a couple of weeks and, like jdh71, improved on my prior Step scores and left both exam days 2+ hours ahead of time.

Taking it later (do you have an elective or cushy consult/ambulatory rotation later in the year?) or first thing next year may be helpful, but only if one of the 2 situations above applies.

👍

To add, I used Master the Boards.

 

[PartyPants]

The consensus I heard from people in my program was the following:
Take about 2 weeks to study, 1-2 hours per day. Focus on peds / OB-Gyn, and get familiar with the CCS software.

I just took Step 3 a couple of weeks ago, and I regret not signing up for it earlier in the year when I had elective / ambulatory time (I was not aware until later in the year that my program wanted us to take it by the end of intern year ... must have dozed off during that part of intern orientation). I ended up having to study for it during a call month, and I could not keep my eyes open for longer than 20 minutes sitting in front of UW. I don't have my results yet, but I would not recommend delaying Step 3 if you don't have any nice easy months left for the year.

Good luck, I'm sure it'll work out well.

 

[KRichards62]

I was under the impression that Step 3 had no influence on fellowship applications whatsoever (other than making sure you've taken and passed).
With cardiology in particular, I've heard that many programs don't even require you to submit Step scores, and if so they only want to see Step 1 and 2.

Could somebody with more experience on this subject comment?

 

[gutonc]

I was under the impression that Step 3 had no influence on fellowship applications whatsoever (other than making sure you've taken and passed).
With cardiology in particular, I've heard that many programs don't even require you to submit Step scores, and if so they only want to see Step 1 and 2.

Could somebody with more experience on this subject comment?

Everything has influence on everything. As the fellowship scene gets more competitive, programs have to use whatever tools they have to choose who to interview and then who they're going to rank.

So while your actual Step 3 score won't be as important in getting a Cards fellowship as your Step 1 score was in getting an IM residency, a 40 point drop from Step 2-->3 will be noticed and will impact negatively on your application, no matter the absolute value of those two scores.

 

[ResidentMD]

Everything has influence on everything. As the fellowship scene gets more competitive, programs have to use whatever tools they have to choose who to interview and then who they're going to rank.

So while your actual Step 3 score won't be as important in getting a Cards fellowship as your Step 1 score was in getting an IM residency, a 40 point drop from Step 2-->3 will be noticed and will impact negatively on your application, no matter the absolute value of those two scores.

I am still a resident so take what I say with a pinch of salt, but would not a couple of stellar publications, and letters from faculty well-known in cardiology cancel that out? [P.S. I am talking about a Step 2 score of around/over 240]