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Does Step 3 Matter?

As you adapt to being an intern, it’s easy to push Step 3 out of your mind. Some residencies don’t require you to take it until your third year, which can be tempting, but not the best idea! Your upper-level residents will tell you, “Don’t worry about it. No one cares about Step 3, and you can pass with just a day of studying.”

So, does Step 3 matter?

It depends on your situation. If you already matched into residency, your score doesn’t matter, but it does matter that you pass the exam for both licensing and potentially fellowship applications. However, if you have only matched into a prelim or transitional year, Step 3 can help bolster your application for a categorical spot.

Finally, if you’re an IMG or reapplying in the Match, Step 3 can matter quite a bit. It can be your opportunity to show improvement in your Step scores if you struggled with Step 1 or Step 2. In this case, it’s important to plan out your Step 3 studying which may require a longer study timeline. 

If I just need to pass, how long do I need to study?

The first step is to reflect on what type of test taker you have been so far. Are you someone who only needed to do the UWorld questions to prepare for Step 1? Did you have to do a deep dive on content review before Step 2CK? I would not recommend that anyone try to take the test with less than one month of prep.

If you performed well on previous Steps by just reviewing UWorld, you can likely do the same thing for Step 3 with at least a month of part-time studying. If you struggled with or failed Step 1 or 2CK, you may need to plan to study for multiple months or even take a dedicated study period if possible.

What should I use as my resources if I need a few months to study?

For those who have done well with just Qbanks in the past, UWorld for Step 3 is once again the best study tool. Especially the CCS case series, which is pretty close to the actual software you will use on the test.

If you think you might need more content review, adding in a book can be a good way to brush up on areas you are weaker in. Step Up to Medicine is one of the best out there for internal medicine topics, and then you should add First Aid for Step 3 to cover other specialties (e.g., OBGYN, peds, psych). If you want to assess how prepared you are, there are NBME and UWorld self-exams that can give you an estimated score for the actual test. Finally, if you need more specialized help or support making your study schedule, review courses, or individualized tutoring can be incredibly helpful.

Now, how do I actually do this while being an intern?

Unlike your medical school experience, most people will not get a dedicated chunk of time to dedicate to Step 3 prep. Navigating being an intern while trying to study is complicated. The best approach is to make yourself a structured but forgiving study schedule. Recognize that some months will be much harder than others, and try to do 5-10 UWorld questions per day during hard rotations (e.g. ICU months) and 20-40 questions per day on lighter ones (e.g. outpatient or elective months). Lighter rotations would also be the time to plan for a more dedicated review of content if necessary. Be prepared to forgive yourself if you get a bit off schedule and allow yourself time to catch up on your days off. 

Ultimately, Step 3 is less important than your previous Steps, and most program directors will recognize that you had much less time to study. However, for some groups (e.g., IMGs, prelims), it can be a great way to bolster your application to residency. And even if you only need to pass, make sure you set yourself up for success with enough time and a flexible study schedule.

If you run into trouble, reach out to us at Blueprint to help you figure out the right study plan for you!

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