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  #1  
Old 09-16-2016
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Default Long time lurker, first time failer

Hey guys,

Need help!!!

Stats:
US-IMG
Graduated December 2015
ECFMG certified
Step 1: 210
Step 2: 220 (August, 2015)

Applied this year for IM and FM. About 210 programs (150 FM, rest IM) everywhere.

So took step 3 on august 20th. Received my scores on 9/14/16. And scored 185. Very surprised. Actually surreal. I couldn't hide this from my USMLE transcript, i tried though!

Prep:

4 months of dedicated time. About 12 hours a day. Lets make it 7 hours a day of solid studying for 4 months.

UW: First pass: 57% correct. Timed, random. Then incorrect questions. 2nd pass: Reset the qbank. Timed, random 85% correct. Then incorrect questions. Then marked about 600 questions on topic i sucked at. Made blocks out of these. Then marked another 250 questions that i was still struggling with. Then marked another 100qs to make sure i was focusing on weak concepts.

Notes: Made flashcards out of UW and reviewed them on regular basis. Was trying to avoid passive learning. Looked up material from Step up to medicine and or MTB step 2/step 3.


Videos: Used medquest (conrad fischer's) Step 3 HY course. Watched these videos about twice becasue most of the content was still fresh from step 2.

Audio: My daily commute was 90 minute one way. So converted step 3 HY videos to audio for listening.


Exams: NBME: scored 400 raw score since they don't give you conversion. NBME was done about 9 weeks before test date. UWSA: Took about 7 weeks before my test and scored 208. From the time i took UWSA to my actual exam: Primarily stuck on uw, and uw flash cards.

CCS: UW 51 cases about 4 times.
Official Usmle CCS: Went through couple of times.

Biostat: Did UW step 1, step 2, step 3 + UW biostat course.

Wk areas: Early on i sucked at acute coronary syndrome, pna, gallstones, cholecystitis, elec trolytes, and some endo. Worked at these. Opened up MTB, wiki, step up to med to make sure i learned it.

Past: I was guilty of using too many sources and i tried to learn from my mistakes and just stick to one source which was UW. Sure, watched video's (step 3 HY course) but didn't prioritize anything over UW.

I am crushed. Felt/feel incompetent, not good enough and just like a loser who did nothing but study. Tried to improve my application by being done with all the USMLE's and applying on time with everything in hand. But seems like no matter what, no matter how hard i try, it doesn't work. Now, $4700 down the drain, another year wasted and just 8 more months of positive self talk, constantly trying to quiet self doubt, trying to stay positive, avoiding friends and everyone (because i feel so F***** incompetent despite preparing.

Plan:

Just paid to retake step 3. Aiming for early November so probably in 6 weeks.
Def have to attack weak areas by looking at my score breakdown profile. So will start with Pediatrics. What should i use? UW for questions? Another qbank? content review by using what?

Just read or do questions?

Only last 2, short cases, CCS cases ended early for me on the real test. Even though interval history always said, "feels better."

Options:

Kaplan 2013 CK notes
Step up to med
MTB Step 3 HY videos'
UW question bank? Or kaplan/first aid?
Clinical Mastery Series NBME form 3 and 4 for peds, pysch, obgyn, IM, neuro, surgery? Did forms 1 and 2 for step 2 prep.
Onlinemeded videos
and how should i go about it? Spot reivew? or review everything?
Review UW flash cards?
Read content review multiple times?
I dont know...

I dont know how to go about this. Any suggestions/guidance will be highly appreciated. Thank you.
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  #2  
Old 09-16-2016
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The MCQ looks pretty good even with Pediatrics. I think higher CCS could have helped this be a passing score. However, by how much Im not sure, all the way one star to right, or just all xs over the borderline to the right? Anyway im having trouble passing too so im no expert. However Archer CCS review in some form or fashion might be enough...can you tell a little bit in general about your exam day experience? what did you think was cause of lowered CCS score?

Last edited by 300usmle2016; 09-16-2016 at 12:53 PM.
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  #3  
Old 09-16-2016
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Quote:
Originally Posted by 300usmle2016 View Post
The MCQ looks pretty good even with Pediatrics. I think higher CCS could have helped this be a passing score. However, by how much Im not sure, all the way one star to right, or just all xs over the borderline to the right? Anyway im having trouble passing too so im no expert. However Archer CCS review in some form or fashion might be enough...can you tell a little bit in general about your exam day experience? what did you think was cause of lowered CCS score?
Hey,

MCQs look okay? Not being sarcastic but i don't know how to really read this darn thing. I mean MCQs are borderline/low borderline. But i am not sure.

Pediatrics is the only one that has an asterisk and all the way to the left indicating i sucked major B*lls in this topic and generally speaking i do relatively decent in peds. Perhaps didn't review it thoroughly enough and UW step 3 didn't have too many peds questions.

Day1: It was okay. Definitely difficult. About 5 biostat questions per block and most of them were simple. Only couple of calculation questions and rest were testing same basic concepts like sensitivity, specificity, PPV by asking if you really understand the meaning behind these instead of just knowing the formula. Had about 2-3 abstract passages which i left for the very end. I tried to answer these but i wasn't getting anywhere.

Day2: Felt little easier and more familiar type of questions. CCS - I was just really nervous. Despite the fact, i had practiced beforehand. Perhaps, due to lack of familiarity? Not sure. Without revealing the content of CCS, last 2 CCS cases were short cases and these are the only TWO which ended early for me. Rest of the cases didn't end early and i kinda started to "think" about it more because everyone said that your real cases should end right away. I know atleast one case that i bombed. But rest of them, felt okay and patient did get better.
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Thanks for the info further added. Your exam experience doesn't seem unusual, only I can add theres got to be some test takers that probably know for sure of several "easy" MC questions missed, that being as a result of stress, anxiety, fatigue, frustration, timing, etc....but again, in CCS there seems to be something lacking on your performance. Maybe sequence, correct tests or studies ordered to rule in/out, monitoring of patient, etc..Archer is good at covering these and with practice could improve CCS score. No I don't work for Archer but it teaches simple elements that may be overlooked studying CCS by yourself. Ive read on forums that Crush CCS is good also but I havent tried it. By the way,something I can think of is that the patient has or could have multiple pathologies that the case wants you to investigate, which is why the case won't end early. Or some criteria isn't met where all the orders you need haven't been entered, etc...anyway good luck and wish me the same
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  #5  
Old 09-16-2016
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Quote:
Originally Posted by Bazinga1983 View Post
Hey,

MCQs look okay? Not being sarcastic but i don't know how to really read this darn thing. I mean MCQs are borderline/low borderline. But i am not sure.

Pediatrics is the only one that has an asterisk and all the way to the left indicating i sucked major B*lls in this topic and generally speaking i do relatively decent in peds. Perhaps didn't review it thoroughly enough and UW step 3 didn't have too many peds questions.

Day1: It was okay. Definitely difficult. About 5 biostat questions per block and most of them were simple. Only couple of calculation questions and rest were testing same basic concepts like sensitivity, specificity, PPV by asking if you really understand the meaning behind these instead of just knowing the formula. Had about 2-3 abstract passages which i left for the very end. I tried to answer these but i wasn't getting anywhere.

Day2: Felt little easier and more familiar type of questions. CCS - I was just really nervous. Despite the fact, i had practiced beforehand. Perhaps, due to lack of familiarity? Not sure. Without revealing the content of CCS, last 2 CCS cases were short cases and these are the only TWO which ended early for me. Rest of the cases didn't end early and i kinda started to "think" about it more because everyone said that your real cases should end right away. I know atleast one case that i bombed. But rest of them, felt okay and patient did get better.
Was your CCS on the higher side?
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  #6  
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Originally Posted by faith255 View Post
Was your CCS on the higher side?
If im not mistaken he attached his reakdown from score report, with 3x's past borderline into higher. Maybe all xs over borderline would have been a passing score for this examinee?
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  #7  
Old 09-17-2016
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Quote:
Originally Posted by 300usmle2016 View Post

If im not mistaken he attached his reakdown from score report, with 3x's past borderline into higher. Maybe all xs over borderline would have been a passing score for this examinee?
Well, I'm not sure. I don't know if these x's are meant to represent number of cases? I scored 185 so it's just few qs here n there? Regardless, wasn't trying to just pass. Aim was to kick as*.

Do wonder if I'm mentally challenged challenged,
Impaired or just flat out retarded with an IQ of 45?
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  #8  
Old 09-17-2016
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Quote:
Originally Posted by 300usmle2016 View Post

If im not mistaken he attached his reakdown from score report, with 3x's past borderline into higher. Maybe all xs over borderline would have been a passing score for this examinee?
but there is no CCS result attached..

CCS can make you or break you in this exam
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  #9  
Old 09-17-2016
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Quote:
Originally Posted by faith255 View Post
but there is no CCS result attached..

CCS can make you or break you in this exam
It is attached. If you look at the report, it's under day 2. It's titles advance clinical medicine(CCS). Unless this isn't the CCS we are talking about?
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  #10  
Old 09-17-2016
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Originally Posted by Bazinga1983 View Post
It is attached. If you look at the report, it's under day 2. It's titles advance clinical medicine(CCS). Unless this isn't the CCS we are talking about?
OH. I see it now. I apologize, I thought CCS result is given at the bottom..

So yes CCS is what caused your score to drop..

Did most of your cases improve and did you follow the protocol of Dx, Location, Timing, Monitoring and Sequence?

I think you should work on CCS more than any other thing.
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  #11  
Old 09-17-2016
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Quote:
Originally Posted by faith255 View Post
OH. I see it now. I apologize, I thought CCS result is given at the bottom..

So yes CCS is what caused your score to drop..

Did most of your cases improve and did you follow the protocol of Dx, Location, Timing, Monitoring and Sequence?

I think you should work on CCS more than any other thing.
Well, only last 2 CCS cases ended early and they were short cases. Other cases didn't end early. However, every patient improved. So perhaps, i didn't Fu*ck any case completely but rather all cases were managed decently by me?

I got first aid step 3. It has 100 cases, and i know secrets step 3 has about 100 cases. So gonna go thru these and then crush ccs followed by UW CCS again. Not sure if first aid ccs cases and secrets is needed because they are mini cases.

Not sure how to go about it. Re-do UW Step 3? Doesn't seem like a good idea. So perhaps, just use my flashcards that i created from UW step 3. And for weak areas either do UW step 2, Kaplan or firstaid question banks for step 3.

Perhaps UW step 2 is superior to Kaplan step 3/first aid step 3 question bank?

I am planning to do Clinical Mastery Series NBME form 3 and 4 for IM, surg, obgyn, peds etc since already form 1 and 2 for step 2.
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  #12  
Old 09-17-2016
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I have a lot of experience retaking USMLE. Theoretically you can change nothing in MCQ test prep and just by randomness of test day questions you could maybe score higher on say Pediatrics and lower on some other section you scored higher the first attempt. Im starting to think when case says pt is improving is overrated. On one of my cases because my thinking was bad im almost positive I invented a 50th line treatment I gave to the pt and if i remember correctly I did have the message from the nurse note saying the pt is felling better. Seriously doubt I earned credit for management if that's how it is scored even though I think in general my overall workup was not that bad. Not saying all your treatments or measures were wrong, but maybe there's more to scoring well on CCS than just getting message that pt is feeling better.
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Old 09-17-2016
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Quote:
Originally Posted by 300usmle2016 View Post
I have a lot of experience retaking USMLE. Theoretically you can change nothing in MCQ test prep and just by randomness of test day questions you could maybe score higher on say Pediatrics and lower on some other section you scored higher the first attempt. Im starting to think when case says pt is improving is overrated. On one of my cases because my thinking was bad im almost positive I invented a 50th line treatment I gave to the pt and if i remember correctly I did have the message from the nurse note saying the pt is felling better. Seriously doubt I earned credit for management if that's how it is scored even though I think in general my overall workup was not that bad. Not saying all your treatments or measures were wrong, but maybe there's more to scoring well on CCS than just getting message that pt is feeling better.
Yea, i mean i didn't underestimate it but i guess still not enough. It's just horrible situation. Just surreal.
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Old 09-18-2016
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I am using archer videos now. i will let you know how how it helps when I get my result in about a month.

Keep your head up and keep working! The destination is right there.
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Old 09-27-2016
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can u tell me what study material are u using? and would u use the UWSA again to assess?
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Old 09-27-2016
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Quote:
Originally Posted by STEMI View Post
can u tell me what study material are u using? and would u use the UWSA again to assess?

Well,

Currently, I am doing this:

Daily Schedule:

1) 2-3 hours review a weak Topic (MTB 3 for non IM) and for IM (Step up to med +/- MTB)- Anxiety about that though.
2) One Kaplan block on weak topic
3) One Kaplan block random, mixed
4) 2-3 hours CCS



Right now, i am going through Archer CCS then First aid strep 3 CCS mini cases, then Crush CCS and then UW CCS.

30% finished with Kaplan Qbank and after that i might add first aid qbank or just skip to UW qbank. Probably will skip first aid qbank because i would rather have a little bit more time with UW to make sure to work on weak areas rather than adding first aid qbank.

UWSA: I bought it so probably should take it.

Clinical Mastery Series NBME for step 2: Will do form 3 and 4 for everything or whatever is available.


Trying not to compensate for failing by adding every resource available to me. So just sticking to same resources as first attempt but rather more focusing on reason for poor performance (Weak areas such as Peds, Neuro, resp) and def CCS.



But i am not too confident and often wonder is this the right way? FML
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Old 09-27-2016
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And if someone has any suggestions, advice or anything to make this better then please, I'm all ears!
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Old 10-09-2016
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@Bazinga sorry, i still dont have enough posts to pm. Yes, I took it. It was soo hard. Crazy hard. Just waiting and biting my nails. smh.

How are the archer videos?
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Old 10-09-2016
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Quote:
Originally Posted by step2csbuddy View Post
@Bazinga sorry, i still dont have enough posts to pm. Yes, I took it. It was soo hard. Crazy hard. Just waiting and biting my nails. smh.

How are the archer videos?
Yea, I think first day is the hardest but then again, i am not sure. Archer video's are good. Made me realize a lot of stupid, small mistakes i made which i overlooked during my prep. Such as: ordering Chem 14 (more comprehensive but takes 1 hour ) instead of BMP ( takes 20 minutes), and ordering PA/Lateral chest X-ray (1 hr) vs portable X-ray (20 min)...these are tiny mistakes but can add up especially if it's an ER case.
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Quote:
Originally Posted by step2csbuddy View Post
@Bazinga sorry, i still dont have enough posts to pm. Yes, I took it. It was soo hard. Crazy hard. Just waiting and biting my nails. smh.

How are the archer videos?
I have seen the strategy video and now almost done with the very first video that appears on the page. I think it's titled Archer CCS Workshop - February 2012 - 6 hrs, 17 mins, 17 secs, ending on 2016-10-25 15:04....and then watch the rest. But it seems like the very last video on that page is the most recent one. I beleive its from March 2015. So i am not sure if i should just skip the test and watch the march 2015 along with strategy videos..
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Quote:
Originally Posted by Bazinga1983 View Post
Yea, I think first day is the hardest but then again, i am not sure. Archer video's are good. Made me realize a lot of stupid, small mistakes i made which i overlooked during my prep. Such as: ordering Chem 14 (more comprehensive but takes 1 hour ) instead of BMP ( takes 20 minutes), and ordering PA/Lateral chest X-ray (1 hr) vs portable X-ray (20 min)...these are tiny mistakes but can add up especially if it's an ER case.
Glad its helping. Take your time and finish all the videos in order, ie. if you have time before your test.
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Glad its helping. Take your time and finish all the videos in order, ie. if you have time before your test.
Yea, I am watching them in 2x so that helps. But not sure if i am gonna watch every single one.
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Glad its helping. Take your time and finish all the videos in order, ie. if you have time before your test.
I mean i am furious/disappointed at myself for not picking this up earlier. And not exploring the difference between BMP and CHem 14 orders. Like pay attention return time etc. I mean these aren't big mistakes, i think, but these small mistakes added up. And if that's how i really managed during the real test on every case then i performed/scored average on every case which led to poor overall performance. Like all the work, but just failed to pick on common sense items. And this leading to not passing step 3 and hurting my application even if it was on time. Its just disappointing more than anything else.
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