How come my CCS case ends at 8 minutes when it’s a 20 minute case?

CCS Cases ends early

We have been getting this question a lot lately. Users have been frequently contacting us thinking there is a bug in the program because their 20 minute case is ending at 8 minutes. No, there is no bug. This is how the real test program works as well. If you do the correct things either in diagnosis or treatment, then the case will end before the allotted 20 minutes. This typically is a good sign if you do the right time. However, if you advance the virtual time too far without doing the correct orders, the case will also end prematurely.

So, it’s okay! Take a deep breath – This is just the way it works. If you want to do an experiment and just let the case sit there without doing anything, you will notice that the case will last a full 20 minutes. This is good preparation for test day, so you don’t get surprised when this happens on test day as this is a frequent occurrence. We’ve written about this before in our blog about cases ending early, but we thought it would be a good thing to re-emphasize.

If you’d like to test out having the case end early, go to our trial page and download our trial version here, and make the diagnosis quickly and treat appropriate, and you will notice that the case ends early. It can take some getting used to, but after doing a dozen cases, you will get the hang of it.

Release of version 4.0.2

We continue to improve our product. We have released a new version: version 4.0.2. This has made some minor improvements to cases and cleaned up some things. We know that people are anxious to have our product work on more mobile devices that don’t run on OSX/Windows such as iPads/iPhones/Android phones/Chrome Books/etc. Although the display screens will not be the same as a normal computer screen, we are working on something to accommodate this. This is a difficult project as these devices don’t have the computing power needed to run the software, but we are looking into having servers do some of the heavy lifting. More announcements to come on this. It may take us awhile to come up with a solution for this.

What percent correct is considered a passing score on your program?

A common question that we receive is: “What percent correct is considered a passing score on your program?” Essentially, how will my scores on your program translate to a score on the real USMLE Step 3 exam. There is a Pass / Fail cut off for the USMLE Step 3 exam in total. That number is 196 – This includes the multiple choice part of the test. However, there is no “Pass / Fail” cut off for each individual case.

There are 13 CCS cases that you will have to complete on test day. Each case is worth between 2% -2.5% of your total grade.

You don’t pass or fail each case. There isn’t a cut off. Your scores are compiled into a total score and then combined with your multiple choice and given a final numeric value. If you get above a 196, you pass the USMLE Step 3 exam.

Your grade read out will look like this regarding the Step 3 CCS portion of the exam:

What percent correct is considered a passing score on your program?

If you would like the “xxxxxx” or range of your performance to be on the “Higher Performance,” we’d recommend to attempt to achieve a basic competence of 80% or above on each of the cases. 

Some people come to us and are very upset that they didn’t get 100% passing score on each exam. They say that our program is flawed and that in the real world the treatment they offered is top-notch and they should be allotted 100% because of their expertise in handling the case. We kindly remind them that the CCS Cases program is not real life. There are things that are graded in the program that you would likely not do in real life.  Remember, it is likely a computer that is grading your performance (just like our program), so we recommend getting used to it!

Once you are finished and have successfully passed your test, you can go back and practice the way you feel most comfortable, but our product is not designed to train you to practice on real people. Our product is designed for you to pass and do well on the USMLE Step 3 CCS Cases! Ideally, it would be one and the same, but realistically, they are two separate skills.

If you’d like to try out our program, click here to download free trial version of our software.

Release of version 4.0.0

We have been working hard and have finally released a major update: version 4.0.0.

Things may look the same on the outside and run the same, but we have essentially “replaced” the engine. Everything “under the hood” has been changed or updated. This was done to assure stability in future versions of Windows and Mac and to accommodate updating technologies. You might notice some graphic user interface (GUI) updates in the Mac version. The installation process for the Mac was also simplified. We also updated some cases to the most up-to-date treatment protocols. We will continue to improve our software. As always, updates are free to paid users.

We are working on some new features, so we will release these when completed. Enjoy.

What can you expect on test day for the CCS portion of the test?

Student studying for USMLE Step 3 CCS portion

What can you expect on test day for the CCS portion of the test?

Many people are naturally concerned and ask us the question “What can you expect on test day for the CCS portion of the test?” You will be taking your test in a testing center. Typically, each testing center is a carefully monitored room with a bunch of computers divided by cubicles. You will have to empty your pockets and store your things in a locker prior to entering the test room. You can only keep your photo ID in your pocket. You will have to have your finger-print scanned each time you enter and each time you exit the testing room.

You will be given a laminated card with a dry-erase marker and an eraser to allow you to take notes. The room is monitored at all times and there are cameras recording everyone in the room. Big Brother really is watching you during your CCS test day. People have stated that the testing room does vary in temperature and can be either too warm or too hot, so dress accordingly. Test takers have also noted that the quickness of the Internet connection does vary dramatically from testing center to testing center. This can affect your score if you are slowed down by loading delays.

There are 13 cases on the CCS portion of the test. You will be given either 20 minutes of real time or 10 minutes of real time to complete the case. We recommend that you try our software to get used to having time limits on your cases.

If you really want to answer the question of: What can you expect on test day for the CCS portion of the test?, then you should download our free trial of our product. Our program is nearly identical to what you will see on the real test-day. You can download our product here.

Happy studying!

Step 3 Format

Step 3 Format

Step 3 Format

A common question that we receive is what is the Step 3 Format? Step 3 is the final USMLE exam required to qualify for an unrestricted medical license. The exam is a two day exam:

Day 1 includes 232 multiple choice questions divided into 6 different blocks of 38 to 39 questions. You are given 60 minutes for each block of test items.

Day 1 will be approximately 7 hours which includes 45 min of break time and an optional 5 min tutorial.

Day 2 is a longer day. This lasts approximately 9 hours. There are another 180 multiple choice questions divided into 6 blocks of 30 questions. You are given 45 min for each block.

After the multiple choice questions, there are 13 case simulations which haws both 10 minute cases and 20 minute cases of “real time.” You have 45 min of break time for this day as well.  This is the Step 3 format. The CCS portion will take a significant portion of your time on the second day. Many people do not take the CCS portion seriously and focus mainly on the multiple choice questions. However, this is not recommended as the case simulations are unique in a sense that most people who have never taken Step 3 before are not familiar with the software and what is required and what is being graded.

This is what specializes in. We help students who are unfamiliar with the test and provide a simulation environment to help prepare them for test day. We give feedback after the cases to give you advice on what you did right and would you could do better to maximize your score on test day. If you would like to try out our case simulation software, please go to our download page here.


Release of 3.3.4

We have released a new version today: version 3.3.4.

We also made some minor updates to the cases. This update is only available for the PC at this time. We have a new update which is coming soon which will be available to both PC/MAC coming soon!

You can download the new version here.

Thanks for your support.

CCS Cases Team.

USMLE Step 3

Everyone knows that the USMLE Step 3 consists of two parts: the multiple choice question section and the CCS (Computer-based case simulation). The CCS test is difficult to study for because it’s essentially an open book; there is no multiple choice. You need to logically think through each case and decide which tests to order and which treatment to administer. It can especially be challenging for foreign medical graduates (FMG). The issue with our competitors is that they do not offer interactive feedback on what was done right and what was done incorrectly. Our USMLE Step 3 CCS computer simulator offers interactive feedback after each case and tells you what you should do and should not do. It will help you prepare for the USMLE Step 3 CCS portion of the exam.

Better than the other USMLE Step 3 Products

There are hundreds of other USMLE Step 3 products that state that they can help you prepare for the USMLE Step 3 CCS portion of the exam. However, our product is one of the only ones that is an interactive computer based software that provided grading and has more than just 51 cases. It has 100 cases, all with feedback and grading to help you prepare for the real test.

Try our USMLE Step 3 Product

We offer 2 free fully functional cases to try on your own. You can access these at our Try-It and Downloads page located here. We would welcome your feedback in regarding to this, but we are sure that it will be very helpful in your preparations for the CCS portion of the exam. You can contact us at any time if you have any questions or concerns regarding our products. Our contact information is located here. You can also take a look at our Frequent Asked Questions (FAQ page)

Preparing for the USMLE Step 3 CCS

How do I prepare for the USMLE Step 3 CCS?

Many students struggle with the USMLE Step 3 CCS portion of the test. Preparing for the USMLE Step 3 CCS can be challenging because this is not a multiple choice question. It is like an essay test with a question at the top of a blank piece of paper. This makes preparing for the USMLE Step 3 CCS a difficult proposition for students who are used to just doing multiple choice questions. This is quite the paradigm shift for a lot of students. The most importance piece of advice that can be given for preparing for the USMLE Step 3 CCS is to practice until you are very familiar with the software, very familiar with the format, and very familiar with how to treat the most commonly seen CCS Cases given.

Preparing for the USMLE Step 3 CCS

In order to help those who struggle with the step 3 portion, we have created This is an interactive software program for the PC or MAC which allows you to practice cases just like in the real test. Many students have found that studying for the CCS with books and written materials is not sufficient to score well on the test day. Practice with actual software that mimics the real test environment, so you can learn to perform at your best on test day. Try our product free before you purchase.

If you would like to try out our product without any strings attached, go to our download page here and download our trial version which shows exactly what you will be getting if you do decide to purchase. If you do decide that you would like to purchase to help you in your ccs studies, you can do so here.

CCS Preparation – Most Effective Tools for Success – For PC/Mac

We get a lot of questions about the most effective way of preparing for the USMLE Step 3 CCS exam. They ask us, “What is the best way of preparing for the CCS Portion?” “What do I do to prepare for the CCS portion?” “What is the secret to do well on the CCS Preparation.”

Like most things in life, the best CCS Preparation is practice, practice, practice. Don’t just read about what the best way to treat a COPD exacerbation and memorize that steps; learn from doing. The best CCS Preparation is to actually practice the most common cases that is seen on the USMLE Step 3 CCS portion of the test.

Many students make the fatal mistake of memorizing algorithms and then come to test day and get completely paralyzed when they get on the Primum Software. They get flustered; they don’t know what to do. The best way to prevent this is to become familiar with the software and become confident doing test cases using the software that you will be using on the real test day. This is the best CCS Preparation.

At, we recommend that you get familiar with our software, take the advise learned from the interactive feedback, and do as many cases as you can before the real test. This can take quite a bit of time which is why we offer an unlimited time to study. There are no monthly fees that limit your study time. You pay once, and you can study early and consistently until your exam time without incurring additional fees. If you have any questions, please click on the contact us link on our homepage and send us an email.

We recommend that you download our software and take a look at and try a couple free cases yourself to make up your mind for yourself. You can download it here.