hi. non US grad; not in residency. step 2 score was 235 (june 2025). been trying to take step 3 since, couldn’t due to a mix of life chaos, was meant to finally take it during the 3rd week of september. wanted to share a write up because posts like thse helped motivate me so much. will try to keep it brief but i yap a lot so i’ve divided this & you can skip & read relevant stuff.

this is a tangent about adhd & accommodations, you can skip this -> there were very few posts where people had below avg step 2 scores & adhd. i mention adhd because i didn’t get accommodations, theyre generally not given to anyone diagnosed after childhood & i frankly didn’t even try because i have a suffering kink & i dont have the executive function required to jump the hoops required for the process.

resources i used & what i did with them :

-primary for multiple choice = uworld, completed 56% with an avg of 64% starting with 20q/day and titrated it up to 40 and eventually 60, over 8 weeks. with my attention span, i can only make slow increments to avoid burnout (hard lessons were learned in step 1 & step 2 prep)

-supplementary : white coat companion, during dedicated i only used for revising algorithms for day 2 of those topics i kept getting wrong in uworld blocks. before dedicated, i did light reading while watching tv for CVS, renal, pulm crit.

-self assessments :

1-uswa 1 201, 3.5 weeks before exam. weakest topics were imm/hem/onc, endo, and reproductive system. so i brushed up on those with white coat companion book.

2-uswa 2 222, and i scheduled my test the moment i saw that score; day 1 for 7 days after this, and day 2 for 10 days after.

3-new free 137, split into day 1 & day 2 portions. took the day 1 part, the day before day 1. and the day 2 part, the day before day 2. score was 65.8%

-biostats : i suck at it. always have. drug ads are a hit or miss. so i triaged and focused on the core concepts of sensitivity specificity ppv npv and type 1 & 2 errors. i was always doing biostats questions intermixed with my daily blocks. i also started reading these topics’ lessons from ccscases site since the access was free with the cases. i liked the lessons in this qbank. v easy to read to read. explicitly laid out common exam traps for relevant topic at the end of lesson and also taught why this is imp for usmle. did this every day for a week, 3 weeks before the test. got my basic concepts down. on the day before day 1, i spent 3 hours and went through the uworld biostatistics portion, the one that’s activated separate from the qbank just like the uswa. i have to study for about 6 hours and omly 6, no more, the day before these exams, or my brain refuses to work on test day.

-for cases, I WOULD NOT RECOMMEND DOING WHAT I DID, BUT IF YOU’RE IN MY SITUATION ALREADY, THIS MIGHT HELP REASSURE YOU.

(june ‘26 onwards) i used CCSworld, it’s cheap, created by a resident, it gives AI feedback and the developer zev is pretty cool (this is not a promo, he just listened to feedback and was super nice about it) i completed like 5ish cases here.

in mid-august, i bought ccscases, the og one, and kept doing some here and there. first attempt avg was 68% when i started, went up to 76% before day 2. on the day i scheduled the exam, i had completed 20 cases with an avg of 74%. i was scared, i kinda wanted to delay the exam, i was also super bored & tired of living like this and wanted to move on with my life. didn’t tell anyone i trust with usmle advice about how many cases i’d done, until after scheduling.

if you’re still reading, bravo! here’s what i did for CCS damage control : set a goal for going upto 40 cases 7 days before day 2 OR i had to reschedule it. now with adhd, you know this exact situation got the gears turning. total of 41 cases was reached over 48hrs, 16 new HY cases were done. exam not rescheduled. i only reattempted 2 cases, the rest were all first attempts throughout.

had 2 days left for day 1, focused heavily on first aid step 1, mostly rapid review pages & biostats formulas. i had already done some micro & pharm revision in the months before. nothing focused, just some light reading while watching tv, then prepared snacks & clothes for the test.

after testing on day 1, i obviously took the rest of the day off. had 2 break days before day 2. first day, was still exhausted, just chilled out and did 8-9ish cases only over 3 hrs. second break day = the day before day 2, did 3 ccs cases from free137 (total of 55ish cases was reached, which seemed somewhat reasonable) and then i did the day 2 part of free 137. and then just focused on relaxing and eating well & preparing snacks & clothes and finding a show to bingewatch after the exam was over.

thank you for reading, happy to answer follow up questions. p.s please try not to pull the ccs stunt i did. im a match reapplicant and i needed step 3 score report on my app before october started, so it was a needs must situation, and i went in with the hopes of just passing with a 201, immensely grateful for the actual score.

spoiler : suicidal ideation -> mention of plan and method.

context/backstory : i (28) got diagnosed with; pmdd when i was 23, and adhd when i was 24. im possibly also on the spectrum. i diligently track my menstrual cycle, i got off yaz and have a hormonal IUD which has somewhat helped. i see a psychiatrist & am treated for adhd, anxiety, depression, pmdd, the works.

now the events that led to this post :

yesterday was one of the worst days i’ve ever had to live through in terms of keeping myself safe before my period. it was so bad like i just wanted to jump off a bridge. this specific thought loop was triggered by the age old “when are you having babies whats the plan” and i was like “well if i have a baby i would wanna jump off a bridge.” after that conversation i was sitting by myself & i thought huh i wanna jump off a bridge anyway…like right now. there was this voice in my head (im sorry for describing it the somewhat offensive way im gonna) almost like…. a neurodivergent child having a meltdown saying “i wanna jump off a bridge” repeatedly over & over again, and i couldn’t make it stop & i wanted to do the thing just to make the noise stop.

//how do you guys make these thought loops stop?//

what i did : notified my therapist so she can tell me if/when i need to call crisis services, ordered some food & considered myself glued to the couch and told myself as long as im on the couch im safe there are no bridges inside my apartment, and if this continues after halfway through my period then this is a serious mental health issue until then its pmdd. i also took a third of a thc gummy to calm down a little. like this was so scary, i genuinely wanted to hurt & get rid of myself, while knowing i may not actually really want this. almost like being hypnotized & being partially conscious of whats happening.

i’m really interested to know how others get through days like this to see if there are things i can add to my coping skill arsenal. this does not happen all the time, only in the last 7 days before my period. i’m so tired. i’m just so tired of this. im gonna try famotidine today since the new data coming in seems intriguing.

I wish we had considered/asked all of these things when we were moving to the US and renting our first apartment for my spouse’s residency. So I decided to share this list with you guys, it may help someone.

I’ve divided it into 2 categories.

1-Property Features/Specs :

•Trash (valet available or not/how far is the dumpster gonna be from your apartment)

•Utilities (what's included in base rent, how common are power&water outages for the area)

•Pests, mold (who takes care of this, and how?)

•Parking (street/dedicated/free)

•Security (fence,gate,camera,street lights,proximity to housing shelters)

•Air conditioning (available? Is it Central? Do we have to put up our own window AC?)

•Heat (gas/electric; ~bill in winter for rental size, baseboard/central)

•Laundry (in unit washer & dryer/in unit connections/in building shared laundry)

•Stove (gas/electric glass/electric coils)

•Maintenance (On-site/Call 24/7/ business days or via work orders only)

•Rent Special/ Preferred Employer
Discount availability

•Window Direction (west facing windows = $$$ summer electricity bill)

•Ceiling Lights (are they present in all rooms? believe me, this one sounds stupid but 1 room in an apartment of mine DID NOT have a light lol)

•Proximity to work

•Est. Total $$$/mo (ask specific questions : base rent + any utilities + other fees that property management charges)

•appliances (see/ask if there’s any that are missing and you’ll need to buy, believe it or not some places dont have microwaves)

2.Additional stuff that affects quality of life :

-sunlight (for those of you in NE & NW, this is going to matter in winter)

-blinds/curtains (how many are you gonna need, imp for those night shifts, adds to upfront move in cost)

-dishwasher (the convenience or lack thereof is impactful longterm, unless you’re fine eating out of dixie’s plates after 12hr+ shifts with no energy to do dishes by hand)

-closet space, extra storage space in building

-neighborhood & vibes (seriously listen to your gut if it tells you its creepy, search the city’s reddit sub to get a snapshot of the neighborhood)

-windows (if in a busy area, are they double paned? if not, this will impact sleep quality.)

-pets allowed or not (may not have one now, may change your mind, may get targeted by the universal cat distribution system)

If i’m missing something, feel free to add in the comments. If you need to ask followup questions, please do so. Those of you who may find this “too much”, you can take it up with my AuDHD, or just keep scrolling. Next up I will try to do a list of things you need to do after moving here during the first month.