Studying for COMLEX Level 3 with TrueLearn
You finally made it to your last medical school board exam! Congratulations!!! This is the last one so let's make it count and I’m going to help prepare you well. It won't require countless study hours like the prior 2 exams. Remember, this is the third time taking an exam you are already very familiar with in terms of the format, timing, and content.
Do I need to ace this exam?
This question is dependent on your prior board scores, your decision to pursue fellowship, competitiveness of fellowship, and other extracurricular activities during your residency.
If you are planning on completing residency with no further formal education like fellowship, your Step 3/Comlex 3 does not matter. You just have to pass.
A lot of people online say, if you did poorly on your Step/Comlex 1 and 2, you need to ace your Step/Comlex 3 to be considered for fellowship. Although this may be true in the past, my personal opinion is networking and connections are much more coveted and will take you further than a high board score. Developing good relationships with mentors in your interested field and showing them how great you are as a clinician will be important when you are applying and need recommendations. Your board scores cannot outshine your accomplishments in research, interactions with patients, and how highly viewed you are as a resident. I would focus my energy on these skills instead of being frustrated and hyper-fixated on standardized testing.
This exam is not even testing material you will need to know on your actual licensing board exam for your speciality. It is a formality to complete as part of graduate medical education graduation requirements. Get it out of the way so you can focus on your preparing for your licensing exam.
If I am a DO, do I need to take both?
Absolutely not. It is absolutely pointless and a waste of money. Take COMLEX and be done. Utilize all that extra time to work on research, network, and excel clinically.
Changes from COMLEX Level 2 to 3
The biggest change is a new section called Clinical Decision Making (CDM cases). It will overtake 2 sections of your Level 3 exam (essentially one half day). In Level 1, you were tested about how to make diagnoses and understand the molecular foundation. With Level 2, you were expected to figure out best management and treatment of any condition. Now for Level 3, they want to test your ability to do a work up on an undifferentiated patient and the most common presentations. Most of these problems are high yield medical conditions and pattern recognition.
For example, a patient might present with symptoms indicative of a pulmonary embolism, and you’ll have a question asking what are some risk factors for this disease with fill in the blank spaces. For this question, you have to recognize that this is a pulmonary embolism then free type the answer.
CDM also includes multi select answers based on questions like “What initial tests would you order?”
The test is also 2 days so I suggest finding 2 back to back days that work well with your schedule. You should start thinking about scheduling towards the beginning of your intern year because these test centers are usually booked 6 months out.
What question bank should I choose?
For most of us DOs who have been taking Step/COMLEX, we’ve always used UWorld to get us through for both exams. But, the third board exam is different because Step and Level 3 deviate in terms of the structure for their clinical reasoning section. If you use UWorld, you will not be familiar with the types of questions and format of Level 3 CDM cases.
Therefore, you have to use a specific COMLEX Level 3 question bank and I recommend no other than TrueLearn.
TrueLearn was first introduced to me through my medical school and I have been using it for my COMLEX Level 1-3. TrueLearn is such a comprehensive question bank targeting all the high yield topics on Level 3 such as OMT, statistics, and the CDM cases.
How did I use TrueLearn?
As a busy resident, you will only have 1-2 hours each day to study. Some days, it is completely normal for you to spend that time decompressing after a long day. At max, you’ll usually get around 3-5 hours of studying in a week. On my days off, I tried to spend half the day studying but used the rest of the time to do errands and things I enjoyed. It is imperative you keep this balance because if not, you’ll be too exhausted from work to be motivated to study.
I gave myself a 4-month time frame to study - the first 3 months to review content and CDM cases, and then the last month was just statistics and OMT. I suggest starting the CDM cases within the first month because they’re foreign and you don’t want to stress about them if you save them till the end. TrueLearn allows you to divide questions by topics very easily (Figure 1) so I was able to see how many questions I needed to do.
Figure 1.
The TrueLearn’s CDM cases were stylistically very similar to the actual Level 3 examination. I’ve always loved TrueLearn's explanation in prior exams because they tend to supplement the text with videos and images so you understand the wrong answers just as well as the correct ones. I think they do an exceptional job with their CDM explanation as well (Figure 2).
Figure 2.
You should have a sense of your test taking style at this point. For me, I never had an issue with timing so I did most of the blocks in tutor or untimed mode. If you have timing issues or test anxiety, I would do timed mode to stimulate the testing environment as much as possible.
TrueLearn also compiles statistics which as people in medicine, we love our data (Figure 3). You can track how you do against the national average. As with any marker, don’t be discouraged if you are consistently scoring at a lower percentile. The pass rate for Level 3 is 350, that is the bottom 3% on the bell curve. The knowledge you’ve learned the past 4 years is cumulative and you will pass if you study. With that being said, you can hide your performance on TrueLearn if this is too much of a distraction.
Figure 3.
Content resources I use
Dirtyusmle Youtube for OMM videos
Step up to Step 2 book for relearning topics
Randy Neil and Usmle Step 1 First Aid for statistics
On test day
Remember you can look at study material on test day so if you want to check topics or review some questions, do it.
All you need is a form of ID and confirmation email.
Bring snacks, caffeine pills, lunch, and water.
If you are interested, use my referral https://truelearn.referralrock.com/l/shanonology/
(Code: shanonology) to get a $25 discount for USMLE, COMLEX, and residency 90-day or longer banks
I hope this helps, and good luck everyone!! Happy studying!!
Lub dub, Shanon
