How To Prepare for USMLE Step 3
What is the STEP 3 examination?
The USMLE STEP 3 is the final examination of the USMLE series. It tests your understanding of both basic biomedical and clinical sciences.
What are the USMLE Step 3 requirements?
The requirements for the USMLE STEP 3 are to be a medical graduate and have completed both STEP 1 and STEP 2CK. For international medical graduates, they should also be ECFMG certified.
What is the pass rate for USMLE STEP 3?
The current USMLE STEP 3 passing score is 198.
What is the average score for USMLE STEP 3?
The average (mean) score of STEP 3 is 228 with a standard deviation of 15. Your USMLE STEP 3 score report will have your performance by systems, by Physician task, and by CCS cases.
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What are the STEP 3 CCS cases?
CCS stands for Computer-based Case Simulations and they are interactive cases in which you get presented with a history and vital signs, then you start ordering physical examinations, diagnostic testing, imaging, treatment options, monitoring, and counseling. I have made a detailed video on the CCS cases that you can check
What are the STEP 3 Study Materials?
There are books and question banks available to prepare for the STEP 3 exam.
Available books include Master the boards Step3, First Aid STEP 3, Kaplan books STEP 3, and others. You can also review the materials you studied for STEP 1 and STEP 2CK.
Master the Boards USMLE Step 3: by Conrad Fischer
This book is 608 pages and is sold by Kaplan Education Publishing. It is structured in a system wise manner going over the main concepts tested in the exam. It has a rating of 4.5/5 on amazon.
An Amazon link for the latest (2020) 6th edition of Master the Boards USMLE Step 3: https://amzn.to/3n468Hy
First Aid STEP 3
This book is part of the First Aid series, and similar to other First Aid books, it is a review book going over the high yield concepts tested in the exam. The book
is 512 pages and has a rating of 4.6/5 on amazon.
An Amazon link for the latest (2018) 5th edition of First Aid STEP 3 : https://amzn.to/32xsIz1
The Kaplan books (USMLE Step 3 Lecture Notes)
More detailed study material from the Kaplan company divided into two books (932 pages). It has a rating of 4.4/5 on amazon.
An Amazon link for the latest (2021-2021) 3rd edition: https://amzn.to/3n5w5Xm
U World STEP 3 and Amboss STEP 3 are among the common question banks.
USMLE STEP 3 U World
U World STEP 3 has around 1600 questions similar to the exam style divided into Foundations of Independent Practice (FIP) and Advanced Clinical Medicine (ACM) and is also divided into different systems. However, you can choose the way you would like to solve the questions in, randomly or by systems.
The U World STEP 3 subscriptions is currently 399$ for 90 days, 449$ for 180 days, 549$ for 360 days. This subscription also includes 2 self-assessments and the CCS cases which I will cover in the next paragraph.
AMBOSS STEP 3
AMBOSS STEP 3 has around 800 questions similar to the exam style. To have access to AMBOSS STEP 3, you need to pay the membership ($89/year) in addition
to the subscription for the question bank which is 79$ for 30 days, 149$ for 90 days, 229$ for 180 days, 299$ for 360 days. This however, will give you access to all they USMLE question banks (including STEP 1 and STEP 2CK).
So to compare the price with U World STEP 3 for the 3 months’ subscription, it would be 399$ for U World STEP 3 and for 238$ AMBOSS STEP 3. So AMBOSS STEP 3 is cheaper but has only half of the questions available in U World STEP 3.
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| U World STEP 3 | AMBOSS STEP 3 | |
| Number of questions | ≈1600 | ≈800 |
| CCS cases | Yes | No |
| 3-months subscription | 399$ | 179$ |
| 6-months subscription | 449$ | 289$ |
| Full year subscription | 549$ | 388$ |
What study materials and resources are available for the STEP 3 CCS cases?
For the CCS cases, you can use the CCS cases included in the U World STEP 3 question bank subscription or CCScases.com. You can also use the STEP3 CCS course that I created
U World STEP 3 CCS
U World STEP 3 CCS bank has 41 practice cases and 51 interactive cases. The practice cases give you information about a case and what type of orders you should put in. However, they are not interactive (not similar to how you get tested on the exam). The 51 interactive cases are similar to the exam and you solve them using a platform similar to the exam platform. No scoring is available when solving the interactive cases but the right management is provided in addition to information about the presented disease. They also don’t show you how the cases are solved in real life.
CCScases.com
CCScases.com has 105 cases (2 are free). Although they provide you with a score, the score validity (if it correlates with the actual exam) is not confirmed and you should not base your assessment on that score. They also don’t show you how the cases are solved in real life (just written feedback is provided).
STEP 3 CCS course
This is a course I created since just READING how to solve different interactive cases might not be enough. In this course, I show you how you approach each case using the exam platform explaining each step of the process and available options in the software. The course goes over the details of 6 cases in addition to a final lesson discussing different high-yield concepts. The course price is $59.99 for 90 days’ subscription with 100% refund if you are not satisfied within 24 hours of order.
The STEP 3 CCS course ($49 USD)
The STEP 3 CCS course is designed to help you navigate the CCS part of the USMLE STEP3 exam, Check out our STEP 3 CCS Course
| CCS Cases | U World STEP 3 | CCScases.com | STEP 3 CCS course |
| Number of CCS cases | 51 interactive cases and 41 practice cases | 105 | 6 |
| Shows you how the CCS cases are done | No | No | Yes |
| 3-months subscription | Included in the UW question bank subscription (399$) | 75$ | 59.99$ |
| 6-months subscription | Included in the UW question bank subscription (449$) | 85$ | Not available |
There is also a YouTube video I made on how to approach the CCS cases of STEP 3 in addition to a demonstration of a practice case using the exam platform.
What study materials and resources did I use to study for STEP3?
The main STEP3 study material I used to prepare for STEP 3 was the U World STEP 3 question bank. I feel U World STEP 3 was more than enough given the limited time we have to prepare for STEP 3 as long as you carefully review all explanations. So to answer the question of whether UWorld is enough for Step 3? U World STEP 3 is more than enough to get a great score. If you are having difficulty with the CCS cases or you would like to make the preparation easier and more interactive, check out my STEP3 CCS course as well which is only 3 hours.
What assessment tools did I use?
The main assessment tools I used were the U World STEP 3 self-assessment 1 and 2 which were close to my final score. Each of these self-assessments is four blocks.
- There are also four blocks as a sample from the USMLE website.
These self-assessments are only for the MCQs part of the exam. For the CCS cases, there is currently no self-assessment tool. There are six CCS cases available for practice on the USMLE website with some written feedback on the case but they do not have assessment of your performance or show you how they are solved.
- You can download the exam program from this page.
How long does it take to prepare for STEP 3 USMLE?
Generally, students take between 2 to 8 weeks to prepare for Step 3. However, the time to prepare for USMLE STEP 3 varies based on your prior knowledge but. For me, I had a good foundation from my STEP 1 and STEP 2CK; therefore, it took me around four weeks to prepare for this exam.
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Do I need STEP 3 for residency?
STEP 3 is not required to apply and start residency in the US. However, some applicants choose to take STEP 3 if they did not get a high score on STEP 1 and STEP 2 CK to show program directors that they got a better score on STEP 3.
Does USMLE STEP 3 score matter? How important is the score of STEP 3?
I don’t feel that the STEP 3 score matters too much for fellowship applications as long as you are around the average. Therefore, don’t spend too much time trying to get a very high score. However, for those who scored low on STEP 1 and/or STEP 2CK, they might consider taking STEP 3 before applying to the match to compensate for the low scores on STEP 1 and/or STEP 2CK. This might increase their chances of matching. But generally speaking, STEP 3 scores are not that important. Make sure to pass STEP 3 from the first time.
Is USMLE STEP 3 hard?
USMLE STEP 3 is not as hard as USMLE STEP 1 and STEP 2 CK. However, you still have to prepare for it and familiarize yourself with the CCS cases which are unique to this exam.
My final advice for students studying for STEP 3
Use U World as your main studying material. Practice CCS cases as much as possible as they are the unique aspect of this exam. You can also watch videos about the CCS and attend my CCS course. For IMGs, try to take the exam before residency to save yourselves time during residency.
What does STEP 3 consist of? How is the exam structured?
The STEP 3 exam is a two-day exam:
- The first day tests Foundations of Independent Practice (FIP) and comprises 232 multiple-choice questions (MCQs) divided in six blocks. You will encounter a good portion of biostatistics questions. Each block is for one hour and has 38 to 39 questions. So, the first day in total is six hours plus additional 45 minutes break. There is an additional five minutes that can be added to the break if you skip the tutorial.
- The second day focuses on assessment of Advanced Clinical Medicine (ACM) and has questions both in MCQs and Computer-based Case Simulations (CCS) style. The first portion of the second day is divided into six blocks. Each block is 45 minutes and includes 30 MCQs. After you finish the six blocks, you will have 13 CCSs, each is 10 or 20 minutes of real time. There is a minimum of 45 minutes of break time for the second day (plus 10 minutes if you skip the tutorial). In most cases, the CCS cases end before the allocated time which increases your break time. So generally, the second day my run between 8 to 9 hours.
You can schedule the second day of STEP 3 within 14 days of the first day. I had my second exam day week a week after the first day because this was the closest available date. I recommend having at least a one-day break between the two exam days if possible.
What is the USMLE STEP 3 cost?
The Step 3 fee is $895
USMLE STEP 3 registration is detailed in our other post about this topic:
USMLE STEP 3 registration and scheduling
Good Luck Everyone!
By Firas Bahdi and Malke Asaad
The STEP 3 CCS course ($49 USD)
The STEP 3 CCS course is designed to help you navigate the CCS part of the USMLE STEP3 exam, Check out our STEP 3 CCS Course
It is designed to help you navigate the CCS part of the USMLE STEP3 exam. Throughout the course, I show you how the CCS cases are solved exactly like you would solve them on the real exam using the exam platform. I also share with you all the tips and tricks that you need to master the CCS case of the STEP 3 exam
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Summary The USMLE STEP 3 is the final examination of the USMLE series. It tests your understanding of both basic biomedical and clinical sciences. Choosing the right STEP 3 study materials can be challenging! In this post, I will discuss how to study for STEP 3 based on my 267 experience on the USMLE STEP 3 exam. The requirements for the USMLE STEP 3 are to be a medical graduate and have completed both STEP 1 and STEP 2CK. For international medical graduates, they should also be ECFMG certified.
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