So I Failed USMLE Step 3: Now What?

One of the harshest truths about USMLE Step 3 exams is that sometimes you may do everything right and fall short. And that is life. But it shouldn’t be the end of your exams; instead, it should push you to do better.

Keeping that in mind, here are some practical steps to follow to do it.

What to do if you don’t pass

Take a deep breath and just stop. You don’t have to do anything else; just accept whatever emotion you are feeling at that particular time. But don’t wallow for long.

It’s not uncommon for students who don’t pass to feel unprepared, and they often attribute this to a set of common pitfalls. It’s important to acknowledge and tackle these challenges before making another attempt. Taking the time to address them can greatly increase your chances of success.

Knowing this, here are some common reasons people fail exams:

  • Underestimating the difficulty of the exam
  • Not properly timing the exam date.

Understanding the common reasons people failed

You might have heard the saying, “Two months for Step 1, two weeks for Step 2, and a #2 pencil for Step 3.”

Unfortunately, it’s not always that simple. Step 3 covers a broad range of material, both in breadth and depth. You will likely need to review some of the topics, especially if it’s been a while since you last encountered them.

For many people, USMLE Step 3 is taken during residency training. Balancing long hours at the hospital and avoiding burnout can make it challenging to find time and motivation to study. However, most residency programs have some rotations or services that are less demanding. These could be electives, research, or clinical work. It’s a good idea to schedule your exam date with your study schedule in mind so you can have enough time to study during a lighter workload. The amount of time required for preparation will vary from person to person. If you need more guidance, our Step 3 QBank can assist you in determining the best timeline for your study needs.

The next thing you have to do is address your weaker areas.

Addressing areas of weakness

Once we enter our residency and focus more on specialized training, some commonly tested topics may no longer receive as much attention. That’s where your score report comes in handy. It can help you identify the areas you should concentrate on when preparing for your next attempt at the exam.

In addition to the main sections of the exam, there are a couple of aspects that are often underestimated: CCS cases and statistics. Unlike Step 1 and Step 2, the previous USMLE exams, Step 3 includes CCS cases. Even if these cases seem straightforward, performing poorly in this section might be due to unfamiliarity with the format, approach, or program interface. Practicing beforehand can make you feel more at ease and ready to excel in this part of the exam.

Statistics also make up a significant portion of the Step 3 exam. Simply memorizing equations won’t be enough. You need to practice applying the fundamental concepts to different scenarios.

To find the best study materials for Step 3 preparation, you can explore some recommended resources. Like any other Step exam, Step 3 requires time and effort to prepare for. If you’re uncertain about the amount of time or resources you’ll need, seeking guidance from a test tutor can help you design an effective study plan to pass the exam. Schedule a complimentary consultation today to learn more about how an Elite Medical Prep 1-on-1 tutor can support your success!

Next steps

You have to start asking yourself questions like

  • Do I need a tutor?
  • Do I need to work on my test-taking skills?
  • Is there an extra issue with me that needs to be resolved?

Do I need a tutor?

There’s no embarrassment in needing a tutor or help. Luckily for you, our CanadaQBank exists for this particular reason. You have access to countless resources always at your disposal 24/7, no matter where you are in the world. Whether you’re an IMG or not. All you need to do is simply ask.

Do I need to work on my test-taking skills?

Did you feel excessively anxious during the exam? Did you struggle with managing time effectively? Were you faced with challenges when diagnosing or answering management-related questions? Did you find it difficult to approach the statistics questions, given their lengthy passages?

If you responded with a “yes” to multiple questions, a helpful strategy is to go through the QBank questions multiple times, ideally three, while adhering to a timed format. This practice will aid in improving your performance. If you continue to encounter difficulties, seeking the guidance of a tutor who can provide advice and engage in discussions about the questions may be a beneficial option for you.

It is disheartening to witness students doubting themselves or feeling shocked when they receive the same score on subsequent attempts, as they may attribute it to incomplete question banks or inadequate resource utilization.

To address this issue, it is crucial to shift the focus from reviewing and relearning to enhancing Test-Taking Skills. These skills enable the application of your existing medical knowledge from previous exams and training during the actual Step 3 exam.

Is there an extra issue with me that needs to be resolved?

Sometimes, the problem may not be an academic one or lack of preparation, but because of personal issues you’re faced with. Maybe you lost a loved one, or maybe you have a health issue or something of that nature. In times like this, you may need to prioritize your own well-being over the exam or at least find a way to balance both of them. It’s always best to find the issue at the root cause and care for them.

You can do this!

Understanding these key points can help address various challenges. Firstly, it is important to note that you can utilize USMLE Step 2 CK resources to prepare for USMLE Step 3. This includes resources like NBME’s Clinical Mastery Series and assessment forms 9, 10, 11, and 12. The similarity in the MCQ portion means you don’t necessarily need to purchase specific “USMLE Step 3” resources if you have recently passed Step 2 CK. Nonetheless, it’s crucial to acknowledge that the CCS portion and the frequency of biostatistics questions are significant differences between the two exams.

However, despite having passed USMLE Step 2 CK and acquiring the clinical knowledge necessary to succeed, many individuals find USMLE Step 3 more challenging. This stems from the scoring system, which typically exhibits an average drop of 20 points compared to Step 2 CK. This score difference can significantly impact the pass/fail outcome, particularly for students who scored below 220 in Step 2 CK. Students should aim for a minimum score of 220 in NBME’s 9 to 12 before attempting Step 3. Finally, always focus on your test-taking skills.


If you fail your USMLE Step 3 exams, always examine the reason you failed, try to work on your weaknesses, focus on getting better test-taking skills, and timing your exams better. Don’t forget to take advantage of CanadaQBank for better exam scores.