“Insanity is doing the same thing over and over again and expecting different results.” – Albert Einstein
Failing USMLE Step 3 can feel devastating. Repeated failures can be even more crushing, making the dream of becoming a licensed doctor in the United States seem further out of reach with each attempt. The Federation of State Medical Boards (FSMB) and the United States Medical Licensing Examination (USMLE) program have made it even more challenging by reducing the attempt limit for USMLE Step 3 from six to four in 2021.
If you’ve never struggled with a USMLE exam, you might wonder, “Who needs four attempts to pass?” Well, let me tell you a story …
Once upon a time, there was a dedicated international medical graduate (IMG) from the Middle East who always aspired to become a psychiatrist. However, she was never a great test taker, which became a major obstacle on her journey. Her struggles with standardized exams began early.
- USMLE Step 1 and USMLE Step 2 CK: She passed Step 1 with a score of 199 and Step 2 CK with a score of 214.
- USMLE Step 3 | Attempt 1: Hoping to boost her chances of matching, she sat for Step 3 after completing UWorld (UW) once or twice. She failed. Devastated, she worried her chances of matching were slipping away.
- Residency Match: After two unsuccessful attempts to match, she refused to give up, and her persistence paid off. Through strategic networking, valuable research experience, and a strong letter of recommendation from a reputable professor, she successfully matched into psychiatry.
- USMLE Step 3 | Attempt 2: During her internship year, she tried again after completing UW and MTB 3. She failed once more. This time, her confidence took a major hit.
- USMLE Step 3 | Attempt 3: Pregnant during her PGY-3 year, she gave it another try with similar preparation but failed again. She began to believe she might never pass the exam.
- USMLE Step 3 | Attempt 4: After giving birth, she decided to give Step 3 one final effort during her maternity leave. Leaning on her previous preparation and adding new resources, including MedQuest videos, the Crush USMLE Step 3 CCS book, and multiple rounds of UW, she attempted again—but failed. She was shattered.
- Desperate for Answers: After her fourth failed attempt, she realized that she couldn’t keep repeating the same approach and expect different results. Determined to find a solution, she turned to Reddit to share her struggles and seek advice. In her post, she asked for advice on how to improve her score and finally pass the exam. You can read her post here: Ideas on How to Improve My USMLE Score. One of the commenters suggested working with a tutor, which led her to me.
- Tutoring: Over the next three months, we worked together weekly, focusing on a customized approach to address her unique challenges. We honed in on the following strategies:
- Identifying Core Issues: Her main struggle was not a lack of knowledge but difficulty in applying it effectively to exam questions.
- Mastering Question Stems: I taught her a step-by-step method to break down question stems, prioritize key information, and avoid second-guessing herself.
- Strategic Knowledge Application: She shifted from memorization to a focus on clinical reasoning and logical application of medical knowledge.
- Building Confidence: Regular practice assessments and personalized feedback helped her regain confidence and develop a calm, methodical approach to tackling exam questions.
- Optimized Study Plan: We developed a tailored study plan that built on her prior preparation and focused on targeted practice to ensure comprehensive coverage of all exam components.
- USMLE Step 3 | Attempt 5: Her scores on practice exams started to improve steadily. For the first time, she scored above 210 on an assessment exam, eventually reaching 229. Armed with this new confidence and strategy, she sat for Step 3 again, and this time, she PASSED!!!!
- The rise of the USMLE TACTICS Course: Her determination not only changed her life but also inspired me to develop the USMLE TACTICS Course, aimed at helping others overcome similar challenges.
You can read her full story on Reddit: Her Success Story
Here’s a copy of her USMLE certified transcript of scores showing that she passed on her fifth attempt:
Final Thoughts
Failing USMLE Step 3 doesn’t have to mean the end of your journey. With the right approach and support, it’s possible to overcome even the most challenging setbacks. If you’re feeling stuck, take heart—success is within reach.
If you’re ready to turn things around, explore my USMLE TACTICS Course to discover strategies that work. Let’s make your success story the next one.