How can you prepare for Step 3 as a resident? In this article, I will give you a framework on how to study for Step 3 during your busy residency.
But wait! If you want this article in video format, you can check out my YouTube video below. If you like it, subscribe here for weekly content! And if you want to watch the old videos on the step 3 series, go ahead and check out the playlist here. We talk about resources, planning, and my own prep and reaction.
Plan Your Step 3 Test Date
So the first thing is understanding that Step 3 has two test days with a break in between.
Most people will have a few days to a week between the two days of their exam. This is for a mental break and to also make sure that they can study for the second part of the exam, which also includes the clinical cases that are unique to set three.
So once you understand that the two days usually will have some gap in between, you want to make sure that you’re taking the test during a lighter rotation.
I personally took it over Thanksgiving weekend. So I took it on a Saturday and took the second part of my exam on a Monday. So I had that Sunday and the rest of the Saturday evening off.
And you want to make sure that not only are you taking the test on a lighter rotation, but that you also study for the test on a lighter rotation.
One mistake I made was I went ahead and scheduled my test while I was finishing up an ICU rotation. So my ability to study effectively had gone down and up depending on how busy I was.
And so that is really going to affect how effective your studying is. You can look at a time throughout your calendar where you’re not on call, and when you can have your weekends off or you just have a good amount of days off. That will make up for the days that you are busy.
And as a bonus step, try to get Step 3 out of the way as quickly as possible. Doing clinical rotations in your intern year, whatever specialty you’re in, will help you out. But you also are likely to forget the things that are unrelated to the field that you’re going into.
So if you’re a medicine physician like me and you’re gonna figure out all of the OB-GYN knowledge that you learned during medical school, it’s probably more advantageous that you take it quickly in your intern year and do the studying while you’re on a line of rotation.
Your Study Approach
Once you get the Step 3 schedule out of the way, next, we’re gonna talk about your study approach.
Limit Your Resources
Now, the first thing you really want to keep in mind is you want to limit the kind of resources to those that provide questions.
You don’t have time to read and watch videos as you did back in medical school. You probably didn’t have time to do it then, and you definitely don’t have time to do it now.
So just limit your resources to the questions. And I really only recommend using UWorld plus the cases that come with it. And it just helps you to simplify. This is all you really need.
There’s not much like ancillary or support resources that you have to add on to do well on Step 3.
And in terms of how long you need to study, it just depends on how quickly you can get through the questions and the cases, as well as giving a little bit of time at the very end to review and focus on your weaknesses.
And so as the making of this article, UWorld currently has about 1600 practice questions for all of their multiple-choice sections. This doesn’t include all the cases that they have on top of it, as well as other resources and exams.
It’s definitely a lot, but I recommend that you try to get through as much if not all of it as possible.
A nice way to break this down, so you can have a manageable study schedule, is to find that time of the year when you’d like to take Step 3. And then account for how many days a week you would study.
So let’s say you want to take the test in March and you have a lighter rotation at the end of March, as well as February. So ideally, that gives you the opportunity to study five days a week. For a busier rotation, study maybe three or four days a week.
As soon as you can do that, then you can divide the 1600 practice questions by the number of days or weeks in between and get an idea of how many questions you’ll have to do per day.
Obviously, this number is just an average. This is the problem that I personally ran into.
You might think that you only have to do 40 questions a day, but there are going to be some days where you either don’t study because it was a longer day than you expected, or you had no motivation to do so.
But just keep in mind that if you do have days off on the weekends or a day off after your call day, you can do two blocks or more questions on those days to make sure you don’t get behind.
Don’t Cram Your Study In A Month
Avoid falling into the trap (many residents do) where you only give yourself about a month and then you study during a busy rotation.
Sometimes you’ll end up having to be in a situation where you have to do about 80 to 120 questions a day just to get through all of your practice questions.
Usually, residents tend to not finish all of the valuable practice questions that they paid for and could potentially help them do better on the exam.
To counteract that problem, make sure you plan your study prep and look at your calendar first before scheduling the exam. That way you can give yourself enough time to start doing the UWorld questions without it becoming overwhelming.
And as you’re answering the questions, I really recommend just answering the questions randomly. There’s no real benefit for answering them by part like you did for First Aid for Step 1, where you have cardiovascular on day one GI on day two, for example.
It’s probably more advantageous for you to have all of the questions of OB-GYN, urology, and pediatrics mix. So that way you can see the topics where you are strong or weak at.
And as you’re missing questions or as you’re getting questions correctly but for the wrong reasons, make sure you’re marking them. This is so that you can go back to those questions and make sure that you’ve reviewed those topics so you don’t miss them on the actual test day.
Use The Excel Method
Now, one of the things that I was personally doing to keep track of all of my missed or marked questions is what I call the Excel method.
And if you are more interested in how I use it for Step 3, you can check out our modules in the Med Elite Academy.
Basically, I was taking all the content that I was missing on UWorld and making sure that put them nicely into an Excel sheet so that I could look at it during my review week, the night before exam, as well as when going to the exam. This is to feel comfortable that I have now understood the topics I’m weak at, and that I should be good for test day.
Now, as you’re going through your studying, all I recommend doing is just answering the UWorld questions and getting through as many as possible, and making sure you’re not getting very far behind.
3-4 Weeks Before The Exam
But during the last few weeks, about three to four weeks away from your exam, I recommend starting to do the cases which will show up on the second day of your test.
Now you probably haven’t done anything like these cases before, because it’s a completely different interface.
I do recommend that during the start of your prep, or even before these last three to four weeks, to do the first four or five cases in UWorld so you can see what these cases look like. Whether you choose to do these cases towards the end of your prep or kind of intermixed is up to you.
I found it to be a little bit harder doing them intermixed because I found my focus was just alternating, but I do recommend doing the first four to five cases.
You can get an idea of what the cases are like and what type of things you have to consider. And then just keep that in the back of your mind during the last three to four weeks of doing a few cases a day.
Now, they aren’t very long cases. Honestly, you learn more by just doing the cases as quickly as possible and then reading the explanations on what type of things you should have done that you probably didn’t, and things that you did that you probably didn’t need to.
And using your study approach, whether it’s through an Excel method like what I used or something else, you can have some type of collection system. For example, you can say: I have a patient for DK on my cases, these are the things I’m going to do.
Do the cases a little bit early on to get familiar with the format and then just go through them as quickly as possible.
Anything can show up on test day. That includes pediatrics, OB-GYN, general hospital medicine, as well as general outpatient medicine. Do as many of the interactive cases where you’re actually the one who is putting in the orders, as well as the practice cases where they just walk you through the approaches.
1-2 Weeks Before The Exam
Now, once you’re getting closer about a week or two before your exam day, I recommend doing at least one self-assessment.
Make sure that you’re doing okay on your practice questions, especially if you’re going through the practice questions on UWorld quickly. You may not get the highest percentage of correct answers and that may give you a little bit of anxiety. But I do recommend putting yourself in a test environment and doing about four question banks back to back using UWorld.
Now, one thing to keep in mind is that the self-assessment is a little bit more strict and harder in terms of grading. Probably not a real thing, but that’s because the self-assessment doesn’t include any practice cases.
Just keep that in mind. Don’t pay much attention to the score, but more on your stamina and your ability to work through those problems that have the same difficulty as the actual thing.
And another thing I do recommend doing within the last two weeks of your exam is to start the biostats section of the exam prep.
Now it may seem like a lot of stuff is going on: residency, doing the cases, as well as the practice questions.
And so what you need to do as you are going into the last week of your exam is to back away from the cases. Ideally, you do a little bit more of them towards the last three to four weeks. On the last week, you can lessen the time for the cases so you can do more of the biostats questions.
There are about four to five questions per section of the exam, and maybe sometimes even two or three. So it’s not a lot of questions but they do quiz you on the ability to understand some nuances.
So a lot of things you may be asked are things like sensitivity, specificity, things that we all hate. Other things like positive, predictive value and likelihood ratios, and other things that sound pretty familiar, may be confusing and may give you a little bit of anxiety on test day.
You want to make sure you do those practice questions first on UWorld. That way, when it comes test day, you’ll probably end up getting those right.
In addition to going through your biostats questions, have some systems. So when you’re done with your UWorld questions, you can then review your weak points. One thing that I intended to do was doing all of my missed questions again, but I simply didn’t have enough time.
So I had a system where I was able to review my weak points through the Excel method.
But you can create any system you want that helps you go back to the topics that you missed. I would do that during the last week or two.
So again, through the last week or two before the exam, do one self-assessment and try to go through the biostats questions.
Ideally, you’ve done enough of the cases by now. If not, you can quickly get through them so you can back away and practice your weak points.
During the first day of your exam where there are no cases, I would probably not do any more cases. I would just focus on the practice questions and the weak points. And then maybe during the gap in between test number one and test number two is where I would do the cases.
So if you have a week in between two of the exams, that’s awesome. Just do the clinical cases. Now, if you only have a day like I did, then obviously, you’re going to have to do some cases during that last week.
But keep in mind that if you do want to have a good bit of a break in between both of them, then try to split day one and day two by a week.
But if you just want to get the test over with as I did, then you’re just going to have to fail to get enough of the cases done during your initial prep. And so during that last week, you’re not overwhelmed by doing cases and practice questions.
I know that was a lot so here’s a little bit of an overview.
Look at your calendar and find a lighter rotation for both your test day as well as the prep. One to two months is more than enough to be a very relaxing prep. A one-month prep may get a little stressful, especially the last few weeks, but it’s totally up to you.
Work backward on how many weeks or how many days in a week you want to commit to for UWorld. And that includes how many questions you plan on doing. You may miss a day but make sure that on your days off you do a little bit more to catch up.
Have some type of review system, whether it’s the Excel method or something else to keep track of the things you miss. And then during the last few weeks, whether it’s the last three to four weeks, start doing some of the practice cases and try to get through as many of them as early as possible.
So on your last week, you can just do the self-assessment, the biostat section, and then the last few cases and reminders on your weak points. That makes you ready for testing.
That is how I personally approached step 3 and my recommendations so it would not get too overwhelming.
If you want full access to the Step 3 rapid mastery guide as well as other models and courses, check out the Med Elite Academy!
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But with that being said, guys, thank you so much for reading this article to the end. Hopefully, it’s been a little helpful.
If you enjoyed this article, then check out the following articles as well:
- How To Study For Step 3 (Comprehensive Guide + Study Plans)
- What It’s Like Being A New Doctor In Residency
- What Are Clinical Rotations Like? [Detailed Breakdown]
- How To Study In Medical School [Ultimate Guide]
You can also watch my other Step 3 videos here.
Thank you for being a part of my journey. Hopefully, I’ve been a little help to you on yours.
Until the next one my friend…