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How To Triage Reviewing for ABSITE and USMLE Step 3

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How to Complete your ABSITE Review and USMLE Step 3 Studying Simultaneously


You’ve just started your busy general surgery intern year and you’re trying to decide how best to use your free time for studying: ABSITE versus USMLE Step 3. WHAT FREE TIME?! You barely have enough discretionary time to eat, sleep, and perform other necessary bodily functions – you can’t imagine how you’ll find any time to complete a thorough ABSITE review AND study for USMLE Step 3. Unfortunately, the truth is that both tests are important, and your residency program is likely expecting you to put forth good efforts on both. Not to worry! We will cover how to best split your limited free time.


1) Take Step 3 as Early (or as Late) as Possible

All recent graduates with an MD or DO degree from an LCME- or AOA-accredited medical school are eligible to sit for USMLE Step 3. The reality is that much of the content for Step 3 overlaps with that tested for Step 2 – and it’s only going to get pushed further back in your mind the longer you wait! While some fundamental general surgery principles and pathologies are covered by the exam, many of the intricacies of managing general surgery patients and their surgical diseases are not, creating an inherent conflict; learn the details of general surgery at the potential expense of your Step 3-relevatnt knowledge or risk being under-prepared as a general surgery intern. Neither option is appealing. Instead, formulate a realistic plan for yourself. If you think you will be able to commit to some gentle, regular studying time at the end of your 4th year of medical school and beginning of your intern year, plan to take Step 3 as early as you can in your intern year and be done with it. Just remember to notify your residency as soon as you schedule it so that they can prepare for your absence for the two days required to take the exam. If you would rather enjoy the end of medical school and would like to avoid added stress in the already-overwhelming first months of intern year, plan to take your exam at least 2 months after the ABSITE, which is always the last week of January and/or first week of February. This window will allow you to fully commit to ABSITE preparation prior to the exam, before “switching gears” into Step 3 mode beginning in February. Just realize that you do not want to delay Step 3 too far or it will postpone you receiving your license, which most programs will expect you will have obtained by the early months of your second year.


2) Use Study Material for One Exam to Help You Study for the Other

If you are electing to take Step 3 before the ABSITE, help preserve your time down the road by saving your Step 3 surgery study material for your ABSITE review. Yes, there are different emphases and degrees of complexity for these two exams, but fundamental principles of caring for surgical patients are tested on both. If you use flashcard systems, such as Anki for ABSITE or Step 3, mark those surgery cards you use for Step 3 so that you can include them in your deck for the ABSITE. That being said, pay particular attention to the point that follows…


3) Remember Exam-Specific Study Material is Designed for THAT Exam

Yes, the Anki deck you created to cover surgery concepts on Step 3 may be helpful for your ABSITE review, but remember that review books designed for the ABSITE (or for Step 3) are designed with that specific exam in mind. Don’t use an ABSITE prep book to study for Step 3, aside from looking up confusing or relevant concepts, and vice versa. It may cost you a little extra $$ but it is worthwhile to purchase study aids for both and optimize your Anki deck for ABSITE or Step 3 when you get to it. As much material as may be tested on both exams, there is far more content that is tested by only one of the exams. Don’t let attempts to be efficient and/or frugal cost you the opportunity to do well on both exams. If you are concerned based on practice test performances, remember that EMP has tutors available for both exams!


4) Resist Trying to Do your ABSITE Review and USMLE Step 3 Studying At the Same Time

Space out your exam dates so that you have enough time to prepare for one exam and then the other. Preparing for both at the same time is an unrealistic goal and will only lead to inefficient studying for both. To maximize your chances for success for your first ABSITE attempt, you will need at least 2 to 3 months to adequately complete your ABSITE review (see our other blog on creating a study schedule for the ABSITE). This means marking off November, December, and January for ABSITE prep only. Schedule Step 3 before November, or in March or beyond – the amount of time you will need to prepare for Step 3 may be greater the later you postpone the exam, as you replace knowledge of other specialties with surgery-specific content. 


5) Triage Your ABSITE Review and Step 3 Prep

This final point is a reminder that these exams may carry different weight for you depending on your professional goals and status. If you have just matched into a categorical general surgery position, your score on Step 3 is likely not as important as your performance on the ABSITE (which is used by your residency and your potential future fellowship programs to gauge your likelihood of passing your written general surgery boards). If you are completing a preliminary general surgery year as part of a specialty residency like dermatology, ophthalmology, or interventional radiology, the ABSITE may be an exam you only take once in your career and may have little to no bearing on your future. If you did not match into a categorical surgery position and are reapplying after a preliminary year, these exams may be fantastic opportunities to demonstrate your fund of knowledge, in which case they both may carry extra weight. Whatever your circumstance, remember to create a plan that maximizes your chance of success.


When priorities are in doubt, ask a mentor and/or someone more senior to you in whom you trust. And remember that EMP has resources available for both exams!

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