Step 3: Managing Anxiety if Day 1 Didn’t Go as Planned

Whether you spent a lot of time preparing for Step 3 or not, the first day for most test takers feels like absolute defeat. But, there is still another day of test taking. To manage Step 3 post day 1 anxiety, it is important to understand how it is different from day 2. 

The first day of Step 3, otherwise referred to as Foundations of Independent Practice, is geared to be more like Step 1. You are tested on the material that you have likely not seen for a while, such as drug mechanisms, the details of pathogenesis, etc. As a new intern, it is already difficult to make time to study for Step 3, and you certainly do not have the time to review pharmacology and microbiology in utmost detail as you did for Step 1. Many test takers report marking a significant amount of questions and feeling a sense of failure after the first day of Step 3. But given that Step 1 material is years away, it is normal to feel this way. After a nerve-wracking day 1, focus on easing your anxiety and set yourself up for success on day 2.

The second day of Step 3 is referred to as Advanced Clinical Medicine,  and it is much more clinically oriented. It somewhat resembles Step 2. Furthermore, the questions on this day are similar to the UWorld questions. CCS cases are engaging and often remind you of patient cases you have seen on clinical rotations. Most test takers feel better about the second test day.

Now that you understand the differences between the two days, you have likely concluded that you are better equipped to handle day 2. This should help ease your anxiety, and as should these tips.

Remind yourself of your past successes. You are likely a resident now, which means that you have successfully completed Step 1, Step 2, and graduated medical school. You made it this far and Step 3 is just another test. Considering your prior accomplishments, you are more than capable of passing it.

Relax before day 2. Though you may be driven to spend the time in between the two days studying non-stop, it is important to dedicate some time relaxing and practicing mindfulness. If your next day is tomorrow, spend the evening in good company and watch a movie, go on a walk, meditate, or do anything else that brings you peace. Do not spend more than an hour on studying. If you have more time in between two days, consider going on a hike or the beach. Spending time in nature has been shown to reduce anxiety. It is unlikely that you will alter your score in these few hours or days, so this time is better spent preparing yourself mentally. 

Now that you are relaxed and reminded of your capabilities, set your mind to taking on day 2 of Step 3. You got this!