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Studying for Step III in Residency

Activity Forums USMLE Step 3 Forum Studying for Step III in Residency

This topic contains 1 reply, has 2 voices, and was last updated by Dr. David Delnegro MST USMLE Tutor Dr. David Delnegro MST USMLE Tutor 2 years ago.

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    One of the most difficult and unusual things about studying for Step III is that this is an exam taken during residency — a time when you have no “dedicated” study period, unlike you had for every other USMLE exam. This will mean you often have much less time to “study” in the traditional sense, but that you will have a lot more hands on clinical experience to rely on.

    The first day of your exam is all multiple choice – six one hour blocks, with traditional USMLE questions. There’s a significant emphasis on biostats, ethics, and the social sciences on this day, and you will definitely need to review UWorld’s biostats more than you did for the previous USMLE exams.

    The second day has six forty-five minute blocks, and then 13 “cases.” This day is much more traditional clinical medicine, more like typically what is seen on your USMLE exams from medical school. The best resource for the multiple choice is, as always, Uworld Uworld Uworld. By doing just one to two blocks a day for a month, you will be in good shape to take the exam. It’s important to find a relatively “lighter” rotation during which it would be feasible to study for a month prior to taking the exam.

    The CCSE cases are unlike anything experienced in Step I or II. These cases present a clinical vignette, with which you are to decide whether management should be inpatient or outpatient, what labs to order, what images to assess, what intervals to follow up. UWorld has over 50 case examples and simulations, and doing these are absolutely paramount to doing well on the exam. If only to get a feel for the cases and format, there is no substitute for practice on the UW software.

    Big picture – take a solid month or two of a lighter block, and carve out time for 1-2 blocks of UWorld daily. Make absolutely sure to complete the CCSE case review before the exam. And – if you have the luxury – try to split the exam by more than a day! Back to back days are (from personal experience…) exhausting!


    Some great points here! Residency invariably has harder and easier rotations. Talk to your upperclassmen and see when they found time to study and to take it.

    For example, during my emergency medicine intern year I found a bunch of time during anesthesia to knock out studying and at the end just took the exam.

    Ditto for not doing back to back. If you passed Step 1 and 2 comfortably (and I mean comfortably as in distance from 192, not “I only got a 235”) then you can do a Friday Monday or something similar to give your brain a rest. If you were borderline passing, then you may actually need to spread the days out a little further in order to study for CCS and Day 2 material.

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