My step 2 and 3 experience
I am old medical grad 2010 from India, accepted a prematch offer in IM this year. I studied step 1 for 14 months and got 235 in March 2022 and I wanted to apply for 2023 match.
FRED cases
orientation.nbme.org
Inka protocol
I used the mnemonic "ABCD IBU POT MRT PEDAL" in CCS
Age Gender - write it down
Brainstorming - write down every idea (what to order not D/D) while reading the initial presentation!
Consults
Diagnostic steps
Imaging
Bloodwork
Urine
Pregnancy test
Others: ECG, EEG, CSF
Treatment of pain and nausea - before knowing the diagnosis
Monitoring
Routine: CBC, CMP, PT/PTT, IVA, NSS 0.9%
Treatment - after knowing the diagnosis
Prevention: cancer screening, vaccines
Exercise
Diet
Avoid: smoking, EtOH, drugs
Location
In emergency cases I always order: ABC before PE
Air: Oxygen saturation q1h + Oxygen tx
Blood pressure q1h
Cardiac monitor q1h
for surgery prep NICE PT:
NPO, NSS
Informed consent
Cefazolin
ECG
PT/PTT
T&C
for admitted pts ADMI CON:
Activity: Bedrest
Diet: NPO, diabetic
Meds: Heparin
Intake & Output
Compression stockings
Omeprazol
Nasogastric tube
I used my break time in between the MCQ blocks to write out all my mnemonics on my scrap paper. This helped a LOT! I did not order everything for each case of course. Just checked my mnemonic at the end of each order sheet to see if I did not forget any pertinent order.
I recommend to start with the 6 FRED cases, because they are the gold standard!!! Then skim through CrushStep3CCS (pdf in files), after that start practicing either on UWccs or CCScasescom or both - following the principles learned from FRED and CrushStep3CCS. Don't follow what CCScasescom is trying to teach you! Don't get discouraged if you don't get feedback from surgeons, your pts only get partially better or your simulated time doesn't progress in UW!
Then in the last 3 days before day 2 repeat the 6 FRED cases and the entire 120 cases from CrushStep3CCS. With your gained experience you will notice more details this time.
Between day 1 and 2 also focus on practicing timing for the 10 min cases. Use a time lag of 1 second if available in your practice tool!
When reading the book CrushStep3CCS, save time by only reading the diagnosis and the sequencing. You can finish CrushCCS in 1-2 days easily this way.
The cases on the exam are different from any you encounter in the practice tools. You will have to think on your own on the exam, but CrushStep3CCS is the perfect map for that.
Practicing helps to train you to use the software efficiently. But both practice softwares have serious and very annoying errors, but you have to choose one! UW has far less mistakes when it comes to important teaching content.
Just approach all of them following the principles from the book CrushStep3CCS (pdf in files). This book is really the best secret weapon to getting a great score on CCS. I love how simple and short and logic the sequencing is. And it covers at least 90% of the content needed.
My decision not to be scared of negative feedback from the system was very helpful for my CCS. I tested and retested. I examined and reexamined. I checked interval hx obsessively. Take every pt feedback as a helpful hint to adjust your management on your exam.
