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Excellent performance on CCS can get you to pass Step 3!

CCS – the computer-based simulations on step3 exam constitute only about 25% of your step 3 exam. When I started teaching residents for Step3 three years ago, I was of the same opinion – CCS constituted only 25% hence, required less attention and time as opposed to MCQs. However, remember that it is easy to score 90 to 100% correct on the CCS as opposed to answering 2 extra questions per block on step3 MCQs. My teaching sessions included CCS online practice as well as discussion of several high yield concepts for MCQs.

We are a group of physicians that have been in to USMLE tutoring for past three years. Most of our students had prior multiple attempts on step3. . Over the last three years we had 95% pass rate – remember, most of our students had an average of two prior failed attempts on step3. Our retrospective analysis suggested that most of our students that passed had one of the following characteristics.

- 75% had an excellent performance on the CCS with only a borderline level performance on the MCQs
- 25% did moderately well on CCS and also moderately well on MCQs
- Those who had borderline to poor performance on the CCS have failed irrespective of their performance on the MCQs

For some students with prior attempts, score reports (performance bars) did not change much anywhere else except CCS. Yet, all of them passed!! This was especially true for people who previously failed with 70 percentile scores and above. If you are below 70 percentile in your previous attempts, you need to brush your internal medicine and Pediatrics concepts too.

In fact, doing extremely well on CCS with only a borderline performance on MCQs is sufficient to pass Step3! And this is achievable and much easier than achieving an above average performance on the MCQs. Let us consider few logical points here to prove this fact again.

1. We always insist that our student take NBME simulation test before the real step3 exam to see where they stand on MCQ portion of the test. NBME simulation test does not have CCS portion. If you go by NBME simulation score (compare Step2), about 400 and above three digit score correlates with passing performance on Step3. However, since NBME does not take in to account CCS performance on this simulation test – we have had a wide range of NBME scores that correlated with a PASS on step3 – this could be anywhere between 200 to 500 (3 digit score). One of our students had a 210 – 3 digit score on NBME one week prior to his real test. Yet, he passed with a 77% - his score report showed an extreme rightward bar (excellent) on CCS. (His MCQ performance correlated with that on NBME)
2. Recognize that even though, CCS constitutes only 25% where as MCQs 75% - that is 9 CCS cases and 480 MCQs. Each CCS constitutes 3% of your total score. Most examinees cannot answer more than 60% MCQs correctly. If you lose, one CCS you lose 3% of your total score where in you need compensate this by correctly answering at least 15 MCQs ( i.e; 480 x 3% =14 MCQs) – this translates in to, roughly 2MCQs extra on each block. If you lose 2 to 3 CCS, the passing chances are dismal ( losing 2 CCS or borderline performance on CCS will require you to answer extra 4 to 6 MCQs correctly on each block i.e; for an examinee who scored 60% on his practice tests like Usmleworld losing 2 CCS cases means in order to pass, he needs to compensate by answering 4 qs extra per block which is an average of 70% performance on MCQs) à this is where it gets extremely difficult. This is why most people fail despite studying the theory time and again. This is why most people who score around 70 to 75% on practice Q banks like Kaplan and USMLEWORLD may still fail the exam!!!

- Do not neglect CCS. Doing extremely well on CCS is achievable and rewarding. Extreme rightward performance on CCS on your score report has always led to passing scores.
- Poor/ borderline performance on CCS requires excellent/ very good performance on MCQs in order to pass the test – this is very difficult to achieve!!
- Many of our students lacked simple strategies on CCS tasks – follow ups, interval history (Saying “Hello” does not hurt – but in fact, scored on the test), moving patients, essential initial orders, efficient use of simulated case time
- Implementing these strategies accurately and practicing various CCS cases using USMLE practice software has led to higher success rates – remember, you are not done with those 5 practice cases that USMLE sends you. Practice more – at least 20 to 30 CCS cases using the same software. In this way, you will get familiarized with the software and will not wonder why the software is not recognizing your orders.
- If you wish to you can register with us for a 2 hr CCS interactive, online demonstration and practice sessions for a very nominal price of $79. These time-tested strategies and tips as well as practice sessions have worked out wonders for our previous students. They might work for you too! Our practice sessions are held only once per week for two hours and we use USMLE software and online net meetings to organize these meetings. You get the live lecture on the strategies with live demonstration of these tips on the software, which you can access on your computer sitting at your home. After the lecture and demonstration from our side we will let you do the practice. You will be given controls on the screen by this conference technology and you will be asked to practice one case under our supervision. We will then analyze you and give you feedback on what you should have done or what actually you did right or wrong. Each web meeting is confined to 10 students only and slots fill up very quick. We need advance registration at least two days prior the planned session.

Sessions Includes :

CCS Strategies
Live demonstration of CCS cases
Common mistakes committed by the examinees and preventing them
Tips to score extremely high on CCS
Follow-ups of office and ER cases
Efficient use of time, doing more stuff without advancing the clock
Avoiding invasive tests
Basic set of orders for emergency cases
The 5-minute screen - adding/ disconinuing the orders that can matter
Obtaing consults and their appropriateness
Differential diagnosis for common ER and office presentations and easy tips to get the most out of few orders.
Working on efficiency
Supervised practice of one surprise case and prompt feedback on your weaknesses and strengths!!!

- After these group sessions, if you think you still need more attention and practice on the CCS, we also offer individual one-on-one CCS sessions. You an also request complete 40 hour Step3 online review (comprising CCS + MCQs) – this is recommended for people with < 250 on NBME simulated exam or < 70 percentile on their prior step3 attempt!!

Please e-mail [email protected] with any questions and to register. Payments are accepted via. Paypal only.

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