How to get the highest score on the USMLE step 3. Strategy.

: alex_babak — LiveJournal 2/14/20, 12(06 AM

How to get the highest score Alexey_MD_PhD

alex_babak
on the USMLE step 3. https://alex-babak.livejournal.com/
2018-12-12 10:08:00
Strategy.
How I scored “250-“ on the USMLE step 3

It was quite difficult for me to find the systematic answers to my questions regarding this exam, so I dig
through many forums, feedback, and opinions. Here I share my recent experience of USMLE step 3
preparation and taking. I would be glad if it helps somebody to excel in this topic.

In a nutshell: UWSA 1 – 231 (93rd), NBME 4 – 680 (high), UWSA 2 – 227 (89th), NBME 8 – 570 (good),
USMLE step 3 – 249 (94th).

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Timeline: in my case preparation was scattered within one year, but the net time I would estimate as about
2 mo of dedicated studying.

Background: old grad, 240-250 on steps (step 2 was taken 2 years ago), worked as an internist in Russia.

General rules: Q-banks always did in “timed random” mode. If I have done Q-bank once, the second pass
just focused on the wrong questions.

Study resources:

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How to get the highest score on the USMLE step 3. Strategy.: alex_babak — LiveJournal 2/14/20, 12(06 AM

1. Started with MTB 3, did just selected topics (weaknesses according to 2CK report), totally 50 % of this
book.

2. Kaplan step 3 Q-bank, one pass, made notes of wrong concepts. Didn’t like it as found some questions
outdated and low-yield. Didn’t remember the average, and I think it is irrelevant as I have finished it one
year before the test.

3. UW step 3 Q-bank, one pass with notes. Liked it. 70% correct, 81st percentile (picture attached), then did
behavior questions from UW. Finished UW 1 mo before the test

4. The first pass of CCS cases from UW (both written and interactive) – relaxed mode with the random
notes.

5. 100 CCS cases (https://www.ccscases.com/ (https://www.ccscases.com/) ) – did 50 %, don’t like it,

because I felt that they are too exaggerating the indications for the routine low-yield tests (like always made
me feel bad that I haven’t cultured the blood or urine in any mildly febrile patient or another minute
mistakes).

6. The second pass of the UW interactive CCS cases, quickly, checking the mistakes and noting them. Did
around 15 cases a day, to adjust me to the exam mode.

7. “Crash step 3 CCS cases” – quickly skimmed nearly 50 % of cases, just those which I felt uncomfortable
with, then skimmed CCS cases from FA step 3 – it took several hours.

8. Read my notes from the Q-banks, listened to CCS cases from Archer workshop, skimmed pharm and
biostat from FA 1.

9. Last month I did the MOCK exams every week, so was tracking my performance, and noticed that it was
decreasing (pictures attached). Maybe I was a bit tired. So I decided to take another Q-bank – checked
several free samples (MedChallenger, BoardVitals and Amboss). Liked Amboss the most (first for the huge

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How to get the highest score on the USMLE step 3. Strategy.: alex_babak — LiveJournal 2/14/20, 12(06 AM

free sample, then for quality) – did all questions for step 3 (900) and selected topics from steps 1 and 2,
averaging around 60 % I guess. Was quite surprised with this Q-bank as a very good tool for my
preparation. You can download an unlimited free sample for 14 days from my link or look for it elsewhere.

https://www.amboss.com/us/friend/naa5VGRbGyotUKpX
(https://www.amboss.com/us/friend/naa5VGRbGyotUKpX)

The exam was taken with 3-day pause, I did UW CCS during this break at the exam pace – as many as I
could, and read my notes for the CCS.

https://usmlegunner.com/usmle-percentile-rank-calculator/ (https://usmlegunner.com/usmle-percentile-rank-
calculator/)

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First mock

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second mock

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third mock

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3 days before the exam, last Mock

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How to get the highest score on the USMLE step 3. Strategy.: alex_babak — LiveJournal 2/14/20, 12(06 AM

Below is the information from forums, which I found useful.

NBME CCMSA approx 1 week out and got 680 on that. is probably the most similar to actual exam content
so I would imagine it is the best way to gauge where you stand.

UWorld-78%
UWSA 1-236
UWSA 2-239
NBME 4-510
NBME 5-510 (a new test)
Resources used-mostly UWorld, recalling a ton of the material from Step 2CK, some DIT and Kaplan Step 3
material, a smattering of MKSAP material for IM residents. Took the test 2 months after graduation (AMG).
Step 3 (07-30/31)-240s. To the right for most sections, borderline CCS.

Relatively: the first day had 30-40 questions biostats, 30 questions ethics, 40 questions (basics, mechanism
of actions and underlying pathological process ), 15 questions for drug ads. Those combined almost consist
half of the questions of the first day.

It had a lot more basic science/step 1 type stuff then I expected.

questions stems were long. There were times I had to hurry though, which could have lead to some misses.
I never have issues with time on practice sets, so this was different.

Overall, I felt it was harder on average than UW though

Ccs Nearly every other case was similar to one in UW, so if you do all the practice cases, you should be
fine. One thing I don't see people mention is how many 10 v. 20 minute cases there are. I can't remember
the exact number but it was roughly half and half.

Overall, I would say the test was slightly harder than expected with regards to MCQ and easier with regards
to CCS.

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A decent number of repeats from the NBMEs so may not hurt to take those. For CCS, enter the HY orders
and don't worry about the tons of minutiae UWorld cites.

Reviewed biostats from my old First Aid for step 1 book. Took notes as I did UW and reviewed them the last
couple days before the exam.

I was surprised at how much biostats and ethics were on the exam. Make sure you have a solid grasp on
biostats basics. My main advice is that for the 1-2 days before the test, go through all the biostat questions
instead of being overwhelmed by reviewing all the other much broader subjects. I repeated all the the u-
world biostat questions the two days before Day 1 and it helped me feel confident with biostat on the actual
test. Over the next few days I reviewed pharmacology just using the pharmacology section from Step 1 with
drug mechanisms (not interactions or pharmacokinetics) as well as the drug tables from each section. This
was MONEY on day 1. "

Some general advice: Try and avoid looking up answers or googling percentage correct to pass. I did, but
the curve must be generous. If possible, I would also avoid scheduling your test when there will be a score
delay as the wait gnaws at you.

Study basic science pharm, micro and pathophys for Day 1 out of First aid.

Def work hard on the CCS though. That is a must

I don’t recall much histology. The anatomy was present in a clinical fashion. UW x2 is a good plan!

Thank you for reading,

good luck!

So-called "Trick" to figure out if you have passed step 3 earlier before they release the score (usually
around Saturday of the week before the score reporting).

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2 comments

wtraveller
December 13 2018, 17:12:21 UTC

Great job! I'm so so so happy for you!

alex_babak
December 16 2018, 02:02:49 UTC

Thank you so much, my friend!

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