DeltaF508
Forum Junior
Topics: 15
Posts: 70
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Exam was pretty tough; having clinical experience will definitely help you pass this exam. It seemed that this exam has a lot of 'ethical' type questions as well, and interestingly there were a lot of Step 1-type questions (including slides). I only had one media question (think it was a kid with TOF but I really didn't bother wasting too much time on it since it was VERY long). Some of the questions were very very long. I felt rushed for time in some long questions but then there were also some questions which could be answered in as little as 2 seconds (eg. what drug to prevent recurrence of varices).
The first day felt very long; the 2nd day felt shorter (yes, I know they are the same length). The CCS cases I had are listed below:
Cystic ovarian torsion-ED (ended with pt going to surgery)
DM2-Office
Polymyalgia rheumatica-Office (ended in 2mths simulated time)
Gallstone pancreatitis-ED
HUS(kid with bloody diarrhea)-Office which went to ED and ICU
Fe-def anemia in kid-office
Anaphylactic reaction-ED (ended with me giving Epi within 2hrs of simulated time)
Acute pulmonary edema
I forgot the last one; but in almost all of these cases, the diagnosis was very apparent.
Somethings to note for future testtakers:
When you get the initial history, STOP and create a differential list; don't hurry into reading the entire history or ordering a physical. This helped me immensely; since I was using an ordered approach. After creating a list of 7-8 differentials (some very far-fetched), I then clicked through to the rest of the history. Before ordering the physical, I checked to see if there needed to be any emergency orders; these included mostly monitoring and/or Oxygen; but I never gave any concrete treatment before doing the physical.
Target your physicals; I don't know how much this hurts your grade but I'm sure it will help. As far as office physicals go, I think you will be fine in doing complete physicals as long as it doesn't look like an emergency case.
I was very scared about advancing the clock; this gave me the most stress on the cases. I would initially advance to 'next result' but I realized that isn't a very good way because sometimes the next result would be 2 hrs away; and in an emergency case, 2 hrs is a lifetime. So I made myself a rule; I would do a follow-up History every 15minutes in an emergency case (eg. check pulse ox, lungs, breathing q15min in anaphylactic reaction); check ABG q2h, etc. Decide whatever rule works for you. I would actually spend upto 10 minutes deciding the initial tests to rule in/out diagnoses and starting any symptomatic treatment; Entering these orders only took about 1min; advancing the clock took another minute to get the results of these tests (of which I already knew the answers since the diagnosis is so apparent). Based on the initial results, I had the diagnosis confirmed (or almost confirmed); now order the confirmatory test and start complete treatment.
I learnt that asking for followup-history on a patient is basically useless; the CCS is setup so that the patient himself provides an update when he starts to get better; but I kept doing followups because I'm paranoid.
Remember to give diet orders and bedrest orders.
In all of my cases, the patients got better except for HUS where I forgot to give dialysis and instead gave plasmapheresis and prednisone (pts platelets kept getting lower and lower); case ended in 1.5days simulated time; right diagnosis, wrong treatment!
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Studied 1.5mths
Used Kaplan Step 2 CK notes, UW questions and Shaher's CD. UW questions were great but they didn't quite cover the breadth of material tested on the Step 3. So if you get a chance to read some other sources, that's great.
Shaher's CD I can't praise enough -- granted it's basically just walking you through the cases in a powerpoint presentation, but it provided me confidence and a stable framework to work through the cases. If you have issues with how to run the cases or advance the clock, I recommend this CD. Keep in mind though, some of the material on the CD is out of date (especially when it comes to treatment regimen), but that's not why I bought the CD anyway.
So that's it, I hope I pass and can be rid of this USMLE monster. Good luck to you all; I feel your pain.
p.s.: Any idea how soon the score will be available?
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| hottie99
Forum Guru
Topics: 33
Posts: 766
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hey best of luck, i plan to take in summer time, just wondering what is shaer's cd??? just ccs cases, and where do u get that?? also, so no step 3 books, our ck books are just fine?? and u did uworld but do u suggest kaplan at any point?? thx and good luck with u scores!
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| arlete
Lucky woman!
Topics: 49
Posts: 3,465
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Congrats, good luck with your results and match!
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Now it's on God's hands. I've done my best!
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| doc1981
Forum Senior
Topics: 12
Posts: 239
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Thanks for sharing your experience! I guess you should get your result in three weeks - good luck! I'm sure you've aced it.
Did you do NBME prior to the exam?
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Rome wasn't built in a day!
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| Iceburg
Forum Newbie
Topics: 1
Posts: 35
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good luck ! and congrats, u r finally done with USMLE monster 
i have the exam in 2 days
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99/99/79/cs 2004/ 3 US LORs /3mo US Obsv /need visa
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| beiwen
Forum Elite
Topics: 27
Posts: 247
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Congratulations! Good Luck with the score
Thanks for sharing your experience.
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BW
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| drshvetasm
Forum Elite
Topics: 30
Posts: 305
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Thanks so much for sharing your experience...results are available for most peoplewithin 3-4 weeks a tues night/wed mornin
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| doc_clotaire
Forum Guru
Topics: 159
Posts: 1,298
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Congrats and best of luck for a great score 
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The elevator to succes is broke ,you must take the stairs
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| DeltaF508
Forum Junior
Topics: 15
Posts: 70
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Thank you for the kinds words everybody; i'm getting nervous for the results now. It's funny how you can seem to remember every single wrong answer on the exam, but I can't remember even one I got right.
Shaher's CD is just CCS cases; got it from ebay for around $40. It's a great guide and helps you get the hang of the CCS cases. Total of 76 cases; Did 6-7 everyday (each case about 15min). On ebay, search for 'shaher'.
Didn't use Kaplan; I don't have anything else Kaplan but I know for sure that USMLEWorld will test my knowledge more than Kaplan will. Kaplan would have provided me with a false sense of security going into the Step 3; that's not something I want. USMLEWorld made me think very hard about the topics; I feel I learned a lot by being wrong so many times on the USMLE World tests.
I used CK books mostly; but I did watch the Step 3 videos for Kaplan to see if I missed anything. It's about 70+hrs; took me about 8days at the beginning of my preparation.
Did NBME; got 450. Hopefully that's enough to pass. Only score that matters arrives in a few weeks.
Edited by DeltaF508 on 05/22/08 - 01:34 PM
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| DeltaF508
Forum Junior
Topics: 15
Posts: 70
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Got my score; a surprising 92/219 (was just hoping to pass)
finally done with the USMLE monster!!
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| arlete
Lucky woman!
Topics: 49
Posts: 3,465
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YAY, Delta, GOOD FOR YOU!!!!!
Good luck with the match!
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Now it's on God's hands. I've done my best!
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| doc1981
Forum Senior
Topics: 12
Posts: 239
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Wow! Congratulations - great score. Your prep and experience serve as an inspiration to all of us.
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Rome wasn't built in a day!
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| hottie99
Forum Guru
Topics: 33
Posts: 766
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hey congrats!!! that's awesome, did u get my pm??
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ask me if u wanna know, thanks!
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| Pulmonary
Forum Senior
Topics: 9
Posts: 217
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Congratulations , you are My Man...............
By the way What was your USMLE WORLD SCORE during your preparation???
I finished half of the studies, and I just started UW..i got 62%.....So wat do u say????
Thanks................enjoy.its time for Party
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In God I trust .....
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