Release of version 4.8.1

We have released Version 4.8.1! What’s new:

  • We have updated the internal “engine” of the program.
  • We have made some bug fixes and made the program compliant with the new security requirements of OS X Catalina.
  • We took out the trash and mowed the lawn. 

This version is not as exciting as our last one as we have been making more internal improvements rather than features. We will continue to made improvements as time goes on.  As usual, updates are free to paid users. You can download the update here. Enjoy! We are actively working on the program and will continue to offer updates and improve the program. 

What happened to the final diagnosis window in your program?

What happened to the final diagnosis window

We have posted about this before, but we continue to receive e-mails about this question: What happened to the final diagnosis window? The official USMLE Step 3 CCS Cases program has removed this window. It was never graded, and it created a lot of angst with students about whether they got the right diagnosis or not, thinking that this would be the majority of their grade. In actuality, it was never graded at all. This was never a secret as they stated this from the beginning, but many students felt that it was a very important part of the program and put a lot of emphasis on this. 

In order to avoid confusion about what is and isn’t graded, the official test has removed this window. That means that you will not free-hand text the diagnosis into a pop-up window anymore. When you click “Exit case” or the allotted time runs out, then the case will end. We feel that this is a good thing to avoid confusion. To be consistent, we have also removed the final diagnosis input window, so if you are using our newer versions, you will see that this has been removed.  If you are using an older version, you will still see this pop-up, but if you don’t want to bother to upgrade, you can just leave it blank, and it still will not affect your grade as this was never graded at all.

Other things that we predict that will change in the future is the consult pop-up “reasons for consultations” which are also not graded. This is likely to be eliminated in the future as well. We will keep you posted if this does eventually get eliminated.

If you would like to try our program or upgrade your current program, you can go to our download page located here.

Thanks for reading.

You will be graded on timing as well as diagnosis/treatment


A common comment that we receive (sometimes more of an accusation) goes something like this: “Hey! I moved the patient to the ER, and I got marked off that I didn’t move the patient to the ER, so your program isn’t working right, and this is outrageous! You have offended me, my family, and my ancestors!”

What we have to explain is that on the test and our program, you will be graded on the timing of your orders. By timing, we mean that you order the correct diagnosis tests and treatments within a reasonable time. If you wait too long, you will be marked off. It’s kind of like “too little too late.” For example, lets say someone has a raging bacterial infection. You wait until the patient is on the brink of death, and THEN you start the correct antibiotic. Obviously, this isn’t good medication care, and you would be marked off for this.

In our program (and the real test), if you move a patient to the correct location (ICU, inpatient unit, ER, etc), but your timing was too slow (meaning that the patient has worsened before you moved the patient to the correct location), you will get marked off for providing slow care. Usually, the penalty isn’t a harsh one for being too slow unless the case is an emergency situation in which time is of the essence. If you are slow in these cases, you will likely not pass the case.

So, it’s okay! The entire program is designed to help you intervene with the correct diagnostic tests and procedures in the appropriate amount of time so that you will perform well on the test. Just learn from the feedback and improve your performance on the next case practices.

Happy practicing! You can practice 2 free cases located here. If you like what you see, you can purchase the full program that includes 101 cases.

Thanks for reading.

What is the overall passing rate of those who take the USMLE Step 3?

What is the overall passing rate of those who take the USMLE Step 3?

The USMLE publishes annual data about the passing rate of each test per year. Those who go to US/Canadian School and are taking the test for the first time have a 97% average pass rate. US/Canadian School candidates who are repeating the USMLE Step 3 test have a 73% pass rate overall.

Those who go to non-US/Canadian Schools have a 88-90% pass rate for 1st time takers. Those who are taking the test again have a 59-60% pass rate.

From these overall pass rates, you can see that it is important to pass the USMLE Step 3 on the first try. It’s true that you may say that the repeat pass rate is so poor because it is measuring those who are poor performers and will continue to struggle with standardized tests. While this is true, we feel that the psychological impact of failing a test for the first time can decrease future performance.

We recommend that students take the USMLE Step 3 seriously and study to avoid having to retake the test which can lead to further issues. A big part of the USMLE Step 3 is the CCS Portion of the test. The best way to prepare for the USMLE is to actually practice simulated cases which will be similar to what you will see on test day.

We recommend that you try our free 2 cases located here, so you can see how the step 3 CCS cases will be presented on test day and what you will be required to know and how your performance will be measured.

How long do I have to complete all the Step 3 CCS Cases on test day?

CCS Cases ends early

The CCS Portion is on day 2 of the 2 day test. The second day will consist of:

Step 3 Section  
Max Time allotted
Multiple Choice Tutorial   5 minutes (Optional)
Block 1 – Multiple Choice   45 minutes (30 MCQ)
Block 2 – Multiple Choice   45 minutes (30 MCQ)
Block 3 – Multiple Choice   45 minutes (30 MCQ)
Block 4 – Multiple Choice   45 minutes (30 MCQ)
Block 5 – Multiple Choice   45 minutes (30 MCQ)
Block 6 – Multiple Choice   45 minutes (30 MCQ)
CCS Tutorial   7 minutes (Optional)
5 x 10 min cases*   50 minutes
8 x 20 min cases*   160 minutes
Break time   45 min
Total Time   537 min (approx 9 hrs)


*Note that the 10 min and 20 min cases are mixed together. You will not have 5 x 10 min cases and 8 x 20 min cases. There is a total of 13 total cases that you will see. It is also possible depending on the day to have a different mix of 10 min and 20 min cases, but the above breakdown is a possible scenario. The 45 min break time will be interspersed throughout the entire 9 hour day. You of course can finish early if you do not utilize all the available time given.

For those looking just for a short answer, you have 3 hours 30 min total time allotted just to complete the CCS Cases. You may not use the entire time (some cases will finish earlier than the allotted time if you have completed them successfully).

Our program has a good mix of 10 min and 20 min cases to practice from. You can try two cases for free here. Check us out.