5 Tips on Studying for Step 3

In the busy life of residency, scheduling, studying for, and taking USMLE step 3 can seem like an insurmountable obstacle. You’re already catching naps in the call-room, and now you’re expected to study for a huge exam during the time you might be able to actually sleep in a bed? Completely awful… but it doesn’t have to be. With logical preparation and studying help, you can transform USMLE step 3 from a 36 hour call shift to an optional elective in ophtho clinic (no offense meant to you ophtho bound folks).

1. Narrow your step 3 resources and study aids

As with all the USMLE tests, choosing your resources for studying for step 3 is one of the ways to set yourself up for success. Use too many, and you’ll never get through the entire resource. The UWorld step 3 Qbank is the most important resource for USMLE step 3. The step 3 Qbank includes both over 1000 multiple choice questions as well as 24 cases that simulate the format of the computer-based cases that form the second half of step 3 (more on those later). For many, UWorld alone may be enough of a resource. On tutor mode, each question has the highlights of the tested topic; all the highlights together can replace using a textbook to study. If you prefer a book to keep all the information in one place, First Aid for USMLE step 3 is an excellent choice. As you approach the exam, plan on doing the practice step 3 cases found on the USMLE website to get familiar with the software format. If you have additional questions regarding best step 3 resources, feel free to contact one of our tutors. 

2. Make the timing work for you

Fitting USMLE step 3 in with all your other responsibilities is a challenge. Most residency programs don’t care when you take it as long as you’ve passed prior to oral boards your last year in training. However, it is a good idea to take it intern year, before the information you learned in medical school has completely disappeared from your brain. Try to find a time where you have two relatively light weeks in a row. If you’re reading this thinking, I’m a surgical intern, I don’t have light weeks, that’s ok too. With good planning of your study time for step 3, you can still get a high step 3 score. For the two to three months leading up to the exam, plan to do 1-2 Qbank sets a day while taking notes from those sets or from first-aid.  Start with a short review of your strong subjects, then a longer review of your weak subjects. Close to the exam, run through the “memorization” material (antibiotics, blood cell cancers, those pesky rheum antibodies) and review your strong subjects again. Finally, the week before the test, do a lot of mixed sets of step 3 Qbank questions.

3. Know your strengths, know your weaknesses

If you’re a pediatrics resident, odds are you know a good amount of pediatrics, so you don’t need to study this subject for as long as, say, orthopedics. Figure out your strong subjects (based on how you did on past USMLE exams), write them down in a list, and limit the time you spend on them. Next, write down the subjects that you think you’ll be able to re-learn, but need some more love and care. Spend the most time on this middle group. Finally, write down the subjects that you know are going to be a challenge. Then choose the worst one on the list and throw it out. There’s too much information on the exam…

4. … and know you can’t know it all

By focusing on the “middle difficulty” subjects, you have the best change of retaining and recalling the most information. You already have a good foundation in your strengths; review them in broad strokes. You’ll likely be able to dredge up the details on the exam without explicitly reviewing all of them because you see this stuff every day in residency. For the “middle difficulty” subjects, do more step 3 Qbank sets and take more comprehensive notes, reviewing the details as you go along. When dealing with your weak subjects, use broad stroke overviews to create a foundation. Then take a mental inventory: do you have room to remember the specifics of Wallenberg syndrome or is your understanding of the brainstem limited to knowing it has 3 segments? Finally, it’s not worth focusing on your worst subject. If the surgical abdomen is your nightmare, studying it will be exchanging hours of stress for 5-6 questions out of hundreds on step 3. While the idea of straight up not studying something may be terrifying, each subject is, at most, around 6% of the total exam. A caveat is cardiovascular, central nervous system, and pulmonary; these are more heavily covered and should be reviewed.

5. The dreaded DAY 2 of step 3

The first day of step 3 is all multiple choice. The second day is 1/3 multiple choice, 2/3 computer cases. These cases are all about playing the game; sure, you need to know some medicine, but mostly you need to know the patterns the cases are looking for and the steps they require you to complete. In general, be conservative. If you have the option to transfer the patient to the emergency department or admit them to the hospital, do so. If there’s a test you think might be useful but probably wouldn’t be sent in real clinical practice, order it. If a consultant is available? Consult them. Finally, check in with your virtual patient (repeat vitals, answer questions, repeat physical exam) as often as you can. Use the step 3 Qbank cases to get a feel for how the cases are scored. Look at these the week prior to the exam. The day before you take it, do the USMLE practice cases to get used to the software.

Above all, remember that they let you bring snacks of all types to the exam!!! A bit of brain food will get you through the multiple choice marathon to obtaining the Step 3 score of your dreams. 

If you need help along the way to define a step 3 study strategy, contact or call us! Our USMLE Step 3 tutors are happy to aid in your studying process.