u/Key-Improvement-9729

Got my score back. Posting the full breakdown - one data point only, but figured it might help someone planning their prep.

Background:

• IMG, PGY-1
• Step 1: pass
• Step 2: 248
• Roughly 5 weeks of real prep, 1-2 hours weekday, 4-6 hours weekend

Scores:

• Real deal: 232
• UWSA 1: 218
• UWSA 2: 229
• NBME 6: 67%
• NBME 7: 71%
• Free 137: 73% (taken 1 week out)

What I used:

• UWorld: ~60% completed, 64% correct. Did not finish - for me, time-to-test mattered more than completion.
• CCS cases: ~50 cases. Shotgun orders by chief complaint plus prophylaxis/counseling reminders.
• Randy Neil biostats videos
• Divine Intervention rapid review podcasts on commute.
• Light Step 1 micro/pharm refresher: 2 evenings.

What helped me most:

• Front-loading biostats. For me it felt like the most predictable points per hour, but I know plenty of people scored well without spending much time on it.
• Repping CCS cases until the interface felt automatic. The medical knowledge is the easy part - clicking around fast is the hard part.
• Free 137 in the last week as a final calibration check.

What I personally found low-yield (your mileage may vary, this is just what I noticed):

• Drug ads. Spent way too long here early on. Pattern recognition came faster than I expected once I just did them in UWorld.
• Pushing past ~60% of UWorld. Diminishing returns for me - but if you have time, more is more.
• Doing CCS cases without a written framework first. Felt scattered until I built a shotgun list.

Sharing what I used for CCS prep in case it helps. These are not gospel, just the defaults I built up over ~50 practice cases so I was not thinking from scratch in the first 60 seconds. Drop your additions/corrections in the comments and I will edit them in.

Universal first-minute orders (most cases):

• IV access, pulse ox, continuous cardiac monitoring
• CBC, CMP/BMP, UA
• ECG if any chest, syncope, dyspnea, or age > 50
• Pregnancy test for any female of reproductive age

Chest pain:

• High-sensitivity troponin (serial), CXR, ECG (within 10 min)
• ASA 325 chewed, sublingual nitro, heparin if ACS
• Statin (atorva 80), beta-blocker if no contraindication
• Cardiology consult once trop comes back
• (Morphine is no longer first-line in NSTEMI per recent guidelines - only if refractory pain on nitro)

Shortness of breath:

• CXR, ABG, BNP, D-dimer if PE suspected (CT-PA if positive)
• Supplemental O2 to keep sat > 92
• Nebs + steroids if wheezing

Abdominal pain:

• Lipase, LFTs, lactate
• Upright + supine abdominal x-ray
• US (RUQ) or CT abd/pelvis depending on age and exam
• NPO, IV fluids, antiemetic, analgesic

Altered mental status:

• Glucose first, always
• CBC, CMP, urine tox, blood alcohol
• CT head non-contrast
• LP if febrile or meningismus
• (Ammonia, B12, TSH only if the history actually points there)

GI bleed:

• Type and screen, coags, lactate
• 2 large bore IVs, IV fluids, PPI drip
• GI consult for endoscopy

Sepsis-looking:

• 2 sets blood cultures BEFORE antibiotics
• Lactate (repeat at 2-4h if elevated)
• Broad spectrum within 1 hour
• 30 mL/kg crystalloid bolus

Things I personally kept forgetting on practice cases: prophylaxis (DVT, GI), counseling/education, smoking cessation, and follow-up labs. Setting those as end of case defaults helped me a lot.

Scores just dropped! Big congrats to everyone who took the leap, whether you're celebrating or regrouping, you made it through one of the toughest exams in medicine.

If you got your score back, drop your stats below. Your prep details help the next round of test takers more than you know 👇

• US MD / US DO / IMG:
• Real deal:
• Day 1 & 2 (test dates):
• Step 1:
• Step 2:
• UWorld completed %:
• UWorld % Score:
• Number of CCS cases done:
• CCS cases average:
• NBME 6/7:
• UWSA 1:
• UWSA 2:
• Free 137:
• Any other assessment:
• Any other advice:

To everyone still grinding, keep going. You're closer than you think. 💪

Step 3 prep can be brutal, and I think a lot of people in this sub are silently grinding through it right now wondering if they're the only ones losing motivation. The hours blur, the question banks feel endless, and some nights feels really lonely.

I wanted to start a thread where we can share whatever's been carrying us through, for the people who really need it right now.

Could be a YouTuber you put on in the background, a podcast that makes long blocks feel shorter, a study with me creator that helps you actually sit down, a playlist, a coffee shop, a snack, a study buddy, or even a piece of advice that randomly stuck with you.

Drop your favorites below, the more this thread grows, the more it becomes a small comfort kit for anyone, wondering how to keep going. 🙏

We talk a lot here about UWorld percentages, NBME forms, what to focus on, what to skip. We don't talk much about the other ledger, the one with everything Step 3 quietly takes from you while you're preparing for it.

The dinners you skipped. The friend's wedding you watched on Instagram because you had a block scheduled. The phone call home where your mom asked how you were and you said "fine, just studying," for the eighth Sunday in a row. The relationship you've been holding together with one hand while the other clutches a flashcard. The savings that disappeared into resources, fees, travel, retake fees, prep courses. The version of yourself that used to read books, work out, cook, sleep eight hours, gone for a season you don't get back.

The exam is hard. The studying is real. The cost is real too, and that part never shows up on a score report.

Whatever happens on your test day, I hope you remember that the work you've done off the test matters too. You stayed up. You showed up. You sacrificed things the people around you will never fully see. That counts, regardless of the number you get back.

We're all in different chapters of the same long story. Be kind to yourselves out there. 🫡

The only thing harder than Step 3 is the version of it that's been living rent-free in your head for the last six months.

I delayed for over a year. Rewrote my study plan four times. Bought resources I never opened. Took one practice test, hated the score, and then avoided practice tests entirely. I spent more hours catastrophizing about this exam than I ever spent actually studying for it.

The actual exam? Two long days. Some questions felt like riddles, some felt like gifts. I walked out of Day 2 already drafting the "I have to retake it" text to my program.

I passed.

Here's what nobody on this sub says out loud: the exam is hard, but it's not the boss fight you've built it into. The curve is forgiving. The questions are more pattern recognition than recall. The CCS cases are honestly almost fun once you stop being afraid of them.

What's actually wrecking you isn't the content. It's the months of almost studying. The dread. The reschedule. The I'll be more ready in three weeks, lie you've been telling yourself for a year.

Stop negotiating with yourself. Pick a date. Show up underprepared if you have to. The curve will catch you, it catches almost everyone.

You can spend another six months being scared of this exam, or you can spend two days inside it. Only one of those options ends.