246/99 passed step 3

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Posted by jsylvia from IP 165.155.108.58 on September 01, 2010 at 12:37:34:

I am so grateful to GOD for blessing me with this score. Sorry about this long post but I want this post it to be as useful to as many people as possible. I am a foreign medical graduate, born in to a financially poor background and came to the USA with few pennies in my hand. I completed Step 1 and Step 2 with high scores of 96 and 97 but did not match last year. I do not know what the criteria for residency is because my scores are decent. I was shocked and hurt but a friend told me that I did not match because I did not have ECFMG certification and Step 3 in hand at that time. Now I have both . I was very anxious about step 3 and pleasantly surprised to get this very high score.

I scored a 246 / 99, and maybe this info will help others to do better, taking what's good and avoiding the mistakes:

What is this exam about?
This exam is all about primary care doctor's most seen cases in the office and what he will see as a hospitalist in the inpatient wards. There are no advanced questions. Every question is on simple problems but it is difficult for an FMG to know these if he did not work in US clinical setting. This exam is big on preventive medicine, screening, ethics and general medicine. Another lion's share goes to pediatrics but only handful questions came from ob, psychiatry and surgery. If we know general medicine and pediatrics good enough, this is a easy exam. The exam has CCS which is only for 1/4th of the total time of the exam but from my experience I noticed, it plays a BIG role in getting high scores. I got a highest star performance on the CCS. I got some high stars in the multiple choice areas but fell weak in pediatrics. My pediatrics is in borderline but my high star in general medicine likely helped to get the 99. I would say anywhere b/w 60 to 70 % questions were from general medicine.

Preparation:
1.) The total time I spent on step 3 is 2 and half months. I did not start my preparation soon after match result because it took me two months to recover from the depression and to gain confidence. It is difficult in this country when you have no money in the bank.

2.) First let me say that I did not really do any Kaplan reviews, despite following them for step 2ck and step 1 because of most people on this forum did not recommend Kaplan for step 3. I do not know if kaplan step 3 is good because i did not touch it. But I was able to get this very high score with out it so may be you should all take the advise of the people from this forum.

3) Because my step 2 score was good, I started with UW question bank first to test myself. I was not scoring well averaging only 45 to 50%. The questions were too difficult I thought. But people recommend UW for step 3 questions so, i decided to stick with it. Due to low average, i decided to continue the qbank after improving my theory.

4) Some people here recommended swanson and i started that book. The book is good but it covers only few conditions. Then I saw many people recommending Archer's review course. I never heard of this course but i decided to try because the price was ok. I took their samples first, liked the lecture and signed up for the whole course. It was a good decision for me and thanks to all people here who share their experiences. It showed me light to choose this course. I paid close attention to the archer review course, took notes, and read the notes that came with the lectures. This lectures felt very different that what I knew from my Step 2. Many people say if you scored highly on step 2, you can easily manage step 3 but my experience is different. There is no way we will know step 3 level management decisions with out being in residency or with out reading a dedicated step 3 material. Archer did not recommend doing questions with out the review course, as they contend that doing questions without a firm grasp on the subject material is a poor use of time. Archer recommends that after their review course, you should study each subject again on your own, and start doing questions from qbanks, so I did that. Later I nearly panicked because I felt I forgot most of what was said in archer lectures, but it sticks with you subconsciously, thanks to the repetition. I realized it when I restarted UW and amazingly, my scores were in 60 to 65% average. I was happy but did not want to take a chance. I repeated UW once again for the next one month. I felt another queston bank or a course would have been redundant.

5.) CCS of step 3 is a whole different case. It may have scared me in the beginning with complex buttons but it is the most fun part of step 3. CCS is the best of step 3 and i think this is a great thing not only for step 3 but it is also a program that makes us a better clinician also. I only started CCS in the last 4 weeks of my preparation. By then, I was already scoring 60+ on UW qbank. Having been impressed with archer course, i attended their ccs workshop in the end of june and then worked on UW. I did not do uw software but i did all the uw cases which a friend printed for me. I listened to archer recorded workshops 1 week before the exam. CCS needs knack, a clever understanding of how the patient's condition progresses and special capacity to quickly exclude the differential diagnosis starting from your first orders. Archer course is an expert in this and UW reinforced my understanding. The result is a high CCS star on my exam.

This integration is the key to doing well on Step 3, more than anything else except maybe doing just the review courses. Integrating CCS and theory questions, attempting question banks only after getting adequate knowledge in theory and continuous practice are very important to do well. Also, I can't stress enough how important it is to stick to one set of review books and only use others whenever you need quick reference to some detail. If you are jumping from one course to another, you get confused. In my experience, archer and uworld are enough to get high scores. But if you are doing kaplan, you should just stick with it but do not switch between courses because it causes confusion. Each course has it's own style and jumping from one to another defeats the whole purpose.

I did not do NBME because I felt it would hurt my confidence if I did poorly on the NBME tests, which do not tell you the answers to questions you miss.


I did all the questions and CCS on the USMLE practice software on their website www.usmle.org I ended up scoring around 80% on these blocks.

Have confidence because it plays a huge role in how well one performs on this test. You have to trust yourself and believe that all the repetition of the material is embedded somewhere in your brain and will come back to you at the right time, and it will if you worked hard.

If you have any questions about anything that I may have neglected to mention, I will be happy to answer (except for the materials, of course).

I am hoping to pre-match this time and put an end to this financial strugle. I just do not have enough money to fly to different interviews. I will use greyhound and probably take the first prematch I get. I am very interested in GI fellowship and I hope if i have enough urge and confidence, I will be able to reach it even if i end up in a anonymous program.

best of luck. Wish me luck for residency

- sylvia

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