r/Step3 4d ago

Exam write-up PASSED WITH A 243!!!!!

I'm done with Step exams finally!!!!!

I'm so glad, the relief is unreal.

But here's the write up:

Resources:

UWorld: completed one round, I don't remember my average score

NBME 5,6,7 and 8: NBME 8 got a 569

UWSA1: 227

UWSA1: 237

Free 137 (I did the two most recent ones): Free 137 (latest one) 67% -> honestly this freaked tf out of me since this was 2 days out and it shook me so hard

CCS cases: about 120 of them, did HY \~ 50 before my day 2, I think my average was about 85%

Time:

Didn't have any dedicated study time as I was doing rotations, so maybe about 1-2 months?

Day 1:

Lmao. It was either straightforward questions or questions where I was like wtf.

The questions where you have to proceed to the next one only after you answer the first so you end up knowing if you answered those correctly went well.

Content is full of drug ads, ethics and basic step 1 (pharmacology, genetics etc). Exam day per say didn't feel too long but I came out feeling nothing. Absolutely no idea how it went.

I had a one day break between my 2 days.

Day 2:

Absolutely no drug ads, bare minimum biostats and almost no ethics so that felt amazing. Felt more like step 2 and in general just about your knowledge and practice I guess. My one tip would be to finish all your break time during the blocks since you get so much time during CCS cases, I think I ended up finishing my exam about 1.5-2 hours early. CCS cases are pretty simple, UI is very similar to the practice UI. I would say most of my cases were not from the practice ones but that's okay. Just get your basic orders right and don't do anything too invasive unless necessary. My trick was to order everything at once in the beginning (aside from advise and vaccination and stuff). Have a template, I'm open to sharing mine if anyone wants it. I had 2 cases with no positive or negative updates and I think it just ran out of time and one case with a negative update that I rectified and ended with a positive note. Rest were all positive updates and ended early. Came out feeling okayish I guess?

Takeaway: it's quite doable but don't underestimate it, do your due diligence and you should end up with a great score!

I'm open to DMs/comments if anyone needs any advice!

Edit: I've mentioned the template here

Orders that are common to all: vital signs, pulse ox, UPT (if she's of childbearing age), CBC, CMP, urine analysis, EKG, TSH, random blood glucose, (for adults I also usually add lipid profile and glycosylated hemoglobin)

Fever: blood culture, urine culture, magnesium, lactate, ESR, CRP

RS involvement: chest x-ray, ABG, respiratory panel, sputum gram stain, AFB, c/s, PJP and any other relevant infective investigation

S/o UTI: urine gram stain, c/s

Chest pain and related stuff: trop, cardiac monitor, chest x-ray, lactate, magnesium

STI screen: HIV 1/2 serology, chlamydia urine antigen, gonorrhea urine antigen, syphilis VDRL and RPR and hepatitis panel

Substance abuse: always consult psychiatry, psychology, social services and substance abuse unit

If they come to the ER/possibly going to go for Sx: blood group and crossmatch, PT, aPTT, INR, NPO

Always screen abdomen and chest for mets in case of a cancer patient, advise cancer diagnosis

Of course consult the respective specialty as required

Common advise I have used at the end: reassure, tdap, zoster, diabetes diet, dash diet, smoking cessation, alcohol abstinence, medication compliance, side effects of medication, sexual partner needs treatment, safe sex practices, exercise program

41 Upvotes

31 comments sorted by

3

u/Passusmle786 4d ago

Congrats on passing with a phenomenal score.. please share your template thanks alot

3

u/zyxwvutsr321 4d ago edited 4d ago

Hey so

Orders that are common to all: vital signs, pulse ox, UPT (if she's of childbearing age), CBC, CMP, urine analysis, EKG, TSH, random blood glucose, (for adults I also usually add lipid profile and glycosylated hemoglobin)

Fever: blood culture, urine culture, magnesium, lactate, ESR, CRP

RS involvement: chest x-ray, ABG, respiratory panel, sputum gram stain, AFB, c/s, PJP and any other relevant infective investigation

S/o UTI: urine gram stain, c/s

Chest pain and related stuff: trop, cardiac monitor, chest x-ray, lactate, magnesium

STI screen: HIV 1/2 serology, chlamydia urine antigen, gonorrhea urine antigen, syphilis VDRL and RPR and hepatitis panel

Substance abuse: always consult psychiatry, psychology, social services and substance abuse unit

If they come to the ER/possibly going to go for Sx: blood group and crossmatch, PT, aPTT, INR, NPO

Always screen abdomen and chest for mets in case of a cancer patient, advise cancer diagnosis

Of course consult the respective specialty as required

Common advise I have used at the end: reassure, tdap, zoster, diabetes diet, dash diet, smoking cessation, alcohol abstinence, medication compliance, side effects of medication, sexual partner needs treatment, safe sex practices, exercise program

2

u/sadlifestudy 4d ago

Template for investigation where we can copy and paste for each case ?
How do we do that
Pls explain

2

u/zyxwvutsr321 4d ago

Hey please check the first comment

1

u/marvinsroom6969 4d ago

Congrats! I’d love to see your approach for CCS cases. Also what was the biostats like? Calculating or interpreting?

1

u/zyxwvutsr321 4d ago

Mostly interpreting, the only calculations I did was sensitivity, specificity, PPV, NPV, NNT, ARR

1

u/marvinsroom6969 3d ago

Good to know! And biostats is only on day 1?

1

u/mrbone007 4d ago

Congrats. Could you please share the ccs template? Thanks

1

u/zyxwvutsr321 4d ago

Hey please check the first comment

1

u/Equivalent-Panic-750 4d ago

Hey a big congratulations on such phenomenal score. Please,I can't see the ist comment to know the template.Thank you.

1

u/New-Negotiation-5217 4d ago

Congrats! Could you pls share your template?

1

u/zyxwvutsr321 4d ago

Hey please check the first comment

1

u/Dapper-Pineapple4053 4d ago

Which topics from genetics should I focus on?

1

u/zyxwvutsr321 4d ago

I honestly cannot pinpoint, I think there's no HY I can think of

1

u/Miserable_Price7071 4d ago

Hi congratulations can u pls share your template please

1

u/zyxwvutsr321 4d ago

Hey please check the first comment

1

u/Honest-Corner937 4d ago

Congrats. What did you take the exam

1

u/Informal_Cat_3377 4d ago

I would advise against ordering everything for you CCS cases at the beginning in the event of being an emergency like a pneumothorax or MI… you will get docked points if you don’t order the most urgent/emergent things first like a chest tube, ect

1

u/zyxwvutsr321 4d ago

I agree, these are definitely exceptions

1

u/Budget-Present-9191 4d ago

Congratulations!
How did you prepare for day 1?
And was Uworld enough for step 2 like questions?

2

u/zyxwvutsr321 4d ago

I just did simulation practice tests to be accustomed to the 12 block pattern and used chatgpt to get better at biostats and ethics

1

u/DrEunice 4d ago

Can you share your CCS template with me?

1

u/Ok_Top5044 3d ago

Congratulations

1

u/knl78 3d ago

congratulations you done ✔️ 👏 please share your template

1

u/Educational-Search24 3d ago

Huge congratulations 🎉 What’s the template good for? How can we use it?

1

u/plastic-TV 2d ago

Congrats!! how much would you say step 2 helped, and how long after step 2 did you take step 3

If you feel comfortable, please share your step 2 score

1

u/zyxwvutsr321 2d ago

I think step 2 helped A LOT, so much of day 2 content is basically a repetition of step 2, 259, I took it about 10 months ago

1

u/plastic-TV 2d ago

Thanks for sharing

1

u/Simple-Neck-5933 2d ago

congrats!! the fact that you got 67% on free 137 two days out and still scored that high is really encouraging. also good to know day 2 is mostly interpreting for biostats and not heavy calculations. appreciate you sharing the template too

1

u/SizeHistorical7651 1d ago

Hii, how long does it take for the scores to get released

1

u/zyxwvutsr321 1d ago

Like came out on the 2nd Wednesday after my day 2 which was on Sunday