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Step 3 Ccs Mac Download


USMLE Step 3 has always been the hardest part of all USMLE exams, significant portion of students who easily passed step 1 and 2, only to fail to pass step 3 just because of the CCS section. Mapping CCS is an interactive PDF program that will help you master the hardest real exam cases you can find. . Download the Step 3 tutorial and practice items, which includes practice CCS cases. Read the Primum CCS FAQs (PDF) to learn more about the Primum experience. Review the links below, which provide feedback on diagnostic and management steps for the sample Step 3 Computer-Based Case Simulations. Download Crush Step 3 CCS PDF Free – The Ultimate USMLE Step 3 CCS Review Direct Link The Computer-based Case Simulation (CCS) portion of USMLE Step 3 comprises 12 interactive cases over 4 hours designed to evaluate your approach to patient management. Primum® Computer-based Case Simulations (CCS) Frequently Asked Questions (FAQs). What are my responsibilities? You should function as a primary care physician and maintain responsibility for the patient in all management locations throughout each case. An outline and strategy for going through the Step 3 CCS cases.


Step 3 assesses whether you can apply medical knowledge and understanding of biomedical and clinical science essential for the unsupervised practice of medicine, with emphasis on patient management in ambulatory settings. It is the final examination in the USMLE sequence leading to a license to practice medicine without supervision. The examination material is prepared by examination committees broadly representing the medical profession. The committees comprise recognized experts in their fields, including both academic and non-academic practitioners, as well as members of state medical licensing boards. Step 3 content reflects a> Three stages of clinical encounters INITIAL WORKUP CONTINUING CAREURGENT INTERVENTIONPatient encounters characterized by initial assessment and management of clinical problems among patients seen principally in ambulatory settings for the first time. These encounters may also include new problems arising in patients for whom a history is available.Patient encounters characterized by continuing management of previously diagnosed clinical problems among patients known to the physician and seen principally in ambulatory settings. Encounters focused on health maintenance are located in this frame.
Also included are patient encounters characterized by acute exacerbations or complications, principally of chronic, progressive conditions among patients known to the physician. These encounters may occur in inpatient settings. Patient encounters characterized by prompt assessment and management of life-threatening and organ-threatening emergencies, usually occurring in emergency department settings.
Occasionally, these encounters may occur in the context of a hospitalized patient. Clinical problems include ill-defined signs and symptoms; behavioral-emotional; acute limited; initial manifestation and presentation of chronic illness.Clinical problems include frequently-occurring chronic diseases and behavioral-emotional problems. Periodic health evaluations of established patients are included here.Clinical problems include severe life-threatening and organ-threatening conditions and exacerbations of chronic illness.Physician tasks emphasized include data gathering and initial clinical intervention. Assessment of patients may lead to urgent intervention.Physician tasks emphasized include recognition of new problems in an existing condition, assessment of severity, establishing prognosis, monitoring therapy, and long-term management.Physician tasks emphasized include rapid assessment of complex presentations, assessment of patients' deteriorating condition, and prompt decision making.

Content Outline and Specifications

Content Description

The content description that follows is not intended as a curriculum development or study guide, but rather models the range of challenges that will be met in the actual practice of medicine. It provides a flexible structure for test construction that can readily accommodate new topics, emerging content domains, and shifts in emphasis. The categorizations and content coverage are subject to change. Successful completion of at least one year of postgraduate training in a program accredited by the Accreditation Council for Graduate Medical Education or the American Osteopathic Association should be helpful preparation for Step 3.

Content Outline

All USMLE examinations are constructed from an integrated content outline, which organizes content according to general principles and individual organ systems. Test questions are classified in one of 18 major areas, depending on whether they focus on concepts and principles that are important across organ systems or within individual organ systems. Sections focusing on individual organ systems are subdivided according to normal and abnormal processes, including principles of therapy.

Table 1: Step 3 MCQ Test Content Specifications*

SystemRange, %*
General Principles of Foundational Science**1–3
Immune System, Blood & Lymphoreticular System, and Multisystem Processes/Disorders 6–8
Behavioral Health 4–6
Nervous System & Special Senses 8–10
Skin & Subcutaneous Tissue 4–6
Musculoskeletal System 5–7
Cardiovascular System 9–11
Respiratory System 8–10
Gastrointestinal System 6–8
Renal/Urinary & Male Reproductive Systems 4–6
Pregnancy/Childbirth & Female Reproductive System & Breast 7–9
Endocrine System 5–7
Biostatistics & Epidemiology/Population Health & Interpretation of the Medical Literature 11–13
Social Sciences: Communication Skills/Ethics/Patient Safety 7–9

* Percentages are subject to change at any time.
** The general principles category for the Step 3 MCQ examination includes test items concerning normal processes not limited to specific organ systems. These test items are typically related to normal development. Categories for individual organ systems include test items concerning those normal and abnormal processes that are system-specific.

Table 2: Step 3 CCS Test Content Specifications
Categories in bold are covered in CCS cases; categories not in bold are not covered.

General Principles of Foundational Science
Immune System
Blood & Lymphoreticular System
Behavioral Health
Nervous System & Special Senses
Skin & Subcutaneous Tissue
Musculoskeletal System
Cardiovascular System
Respiratory System
Gastrointestinal System
Renal & Urinary System
Pregnancy, Childbirth, & the Puerperium
Female Reproductive & Breast
Male Reproductive
Endocrine System
Multisystem Processes & Disorders
Biostatistics & Epidemiology/Population Health, & Interpretation of the Medical Literature
Social Sciences

Physician Tasks/Competencies

An additional organizing construct for Step 3 design is physician tasks and competencies. More information about the physician task and competencies outline is available. Items are constructed to focus on assessing one of the following competencies:

  • Medical knowledge/scientific concepts: Applying foundational science concepts
  • Patient care: Diagnosis
  • Patient care: Management
  • Communication and interpersonal skills
  • Professionalism, including legal and ethical issues
  • Systems-based practice, including patient safety
  • Practice-based learning, including biostatistics and epidemiology

Table 3: Step 3 MCQ Physician Tasks/Competencies Specifications

CompetencyRange, %Step 3 Foundations of Independent Practice (Day 1)Step 3 Advanced Clinical Medicine (Day 2)
Medical Knowledge: Applying Foundational Science Concepts 11–12
Patient Care: Diagnosis 33-36
History/Physical Exam 5-9
Laboratory/Diagnostic Studies 9-12
Diagnosis 6-10
Prognosis/Outcome 8-11
Patient Care: Management 32-35
Health Maintenance/Disease Prevention 6-11
Pharmacotherapy 9-13
Clinical Interventions 5-9
Mixed Management 6-11
Practice-based Learning & Improvement 11-13
Communication/Professionalism/Systems-based Practice & Patient Safety 7-9

Table 4: Step 3 CCS Physician Tasks/Competencies Specifications
Categories in bold are covered in CCS cases; categories not in bold are not covered.

Step 3 Ccs Mac Download

Medical Knowledge/Scientific Concepts
Patient Care: Diagnosis
  • History/Physical Exam
  • Laboratory/Diagnostic Studies
  • Diagnosis
  • Prognosis/Outcome
Patient Care: Management
  • Health Maintenance/Disease Prevention
  • Pharmacotherapy
  • Clinical Interventions
  • Mixed Management
  • Surveillance for Disease Recurrence
Communication and Professionalism
Systems-based Practice/Patient Safety and Practice-based Learning


  • Read each question carefully. It is important to understand what is being asked.
  • Try to generate an answer and then look for it in the option list.
  • Alternatively, read each option carefully, eliminating those that are clearly incorrect. Of the remaining options, select the one that is most correct.
  • If unsure about an answer, it is better to guess since unanswered questions are automatically counted as wrong answers.

Patient Scenario Formats

Patient scenarios for any Single Item or Sequential Item Set may be provided in either Vignette (paragraph) format, or in Chart/Tabular format. Test items using the chart/tabular format are designed to resemble patient charts but are not intended to be an exact representation of a patient chart. Questions written in chart/tabular format will contain relevant patient information in list form, organized in clearly marked sections for ease of review. Familiar medical abbreviations may be used within chart/tabular format questions.

Single-Item Questions

A single patient-centered vignette is associated with one question followed by four or more response options. The response options are lettered (ie, A, B, C, D, E). A portion of the questions involves interpretation of graphic or pictorial materials. You are required to select the best answer to the question. Other options may be partially correct, but there is only ONE BEST answer. This is the traditional, most frequently used multiple-choice question format on the examination.

Example Question 1

1. A 30-year-old man comes to the emergency department because of an acute episode of renal colic. Medical history is remarkable for episodes of painful urination and passing of what he calls 'gravel in my urine.' Urinalysis demonstrates microscopic hematuria with some crystalluria and no casts. Supine x-ray of the abdomen shows no abnormalities. A 4-mm renal calculus is detected in the distal right ureter on ultrasonography. There is no evidence of dilation of the collecting system. The patient's pain is responsive to narcotic medication. In addition to administering intravenous fluids, which of the following is the most appropriate next step? Traktor pro 2 crack mac kickass torrents torrent.

  1. Acidification of urine by drinking cranberry juice
  2. Cystoscopic removal of the calculus
  3. Cystoscopic ureteral lavage
  4. Shock wave lithotripsy
  5. Straining of the urine

(Answer: E)

Example Question 2

StepStep 3 ccs faq

Patient Information
Age: 62 years
Gender: M, self-identified
Ethnicity: unspecified
Site of Care: office

Reason for Visit/Chief Concern: 'My legs hurt when I walk, and it's getting worse.'

History of Present Illness:
• 3-month history of worsening leg pain
• pain exacerbated by walking; peak intensity after 1 block
• pain resolves completely with rest
• pain rated 4/10 at worst

Past Medical History:
• hypertension
• mild angina
• type 2 diabetes mellitus

• lisinopril
• metoprolol
• furosemide
• glyburide
• lovastatin

• no known drug allergies

Psychosocial History:
• has smoked one-half pack of cigarettes daily for 44 years

Physical Examination

TempPulseRespBPO2 SatHtWtBMI
72/min14/min140/90 mm Hg164 cm
5 ft 5 in
90 kg
198 lb
33 kg/m2

• Appearance: no acute distress
• HEENT: funduscopic shows grade 2/4 arteriovenous nicking
• Neck: no jugular venous distention
• Pulmonary: clear to auscultation; mildly diminished lung sounds
• Cardiac: no bruits; distant heart sounds
• Abdominal: obese; no tenderness, guarding, masses, bruits, or hepatosplenomegaly
• Extremities: no joint erythema, edema, or warmth; no hair on toes; no femoral bruits; dorsalis pedis, radial, and femoral pulses intact
• Neurologic: sensation to vibration intact

Question: Which of the following is the most appropriate diagnostic study?

  1. Ankle brachial index
  2. Arteriography
  3. ECG
  4. Echocardiography
  5. MUGA scan

(Answer: A)

Multiple Item Sets

A single patient-centered vignette may be associated with two or three consecutive questions about the information presented. Each question within these sets is associated with the patient vignette and is independent of the other question(s) in the set. The items within this type of format are designed to be answered in any order. You are required to select the ONE BEST answer to each question.

Example Questions 3 to 4

A 52-year-old man returns to the office for reevaluation of an ulcer on his right great toe. The patient has a 15-year history of diabetes mellitus and takes glipizide and rosiglitazone. He first noticed the ulcer 2 months ago. One month ago, a 14-day course of oral amoxicillin-clavulanate therapy was prescribed. He has smoked one pack of cigarettes daily for the past 37 years. He is 178 cm (5 ft 10 in) tall and weighs 102 kg (225 lb); BMI is 32 kg/m2. Today, vital signs are temperature 38.8°C (101.8°F), pulse 96/min, respirations 12/min, and blood pressure 130/85 mm Hg. Physical examination of the right great toe discloses a 1.5-cm nontender ulcer with a depth of 0.5 cm, a moist base, yellow exudate, and surrounding erythema to the level of the malleoli. Vibration sense and sensation to monofilament examination are absent. Pulses are diminished in both feet. Capillary refill time is 2 seconds in the right great toe. Urinalysis discloses 3+ protein.

3. Which of the following historical factors or physical examination findings is most strongly associated with development of this patient's foot ulcer?

  1. Diminished pedal pulses
  2. Neurologic findings
  3. The patient's weight
  4. Proteinuria
  5. Tobacco use

(Answer: B)

4. Which of the following is the most appropriate action at this time?

  1. Begin aggressive debridement in the office
  2. Begin intravenous antibiotic therapy
  3. Refer the patient for transmetatarsal amputation
  4. Schedule the patient for a third-degree skin graft
  5. Switch the amoxicillin-clavulanate to oral ciprofloxacin

(Answer: B)

Sequential Item Sets

A single patient-centered vignette may be associated with two or three consecutive questions about the information presented. Each question is associated with the initial patient vignette but is testing a different point. You are required to select the ONE BEST answer to each question. Questions are designed to be answered in sequential order. You must click 'Proceed to Next Item' to view the next item in the set; once you click on this button, you will not be able to add or change an answer to the displayed (previous) item.

Example Questions 5 to 6

A 2-year-old girl is brought to the office by her mother for evaluation of fever. You have been the girl's physician since birth. While in the office, the girl stiffens and then has bilateral, symmetrical shaking of her upper and lower extremities; she becomes mildly cyanotic. The episode lasts for approximately 45 seconds, after which she becomes relaxed and appears to fall asleep. Vital signs at this time are temperature 40.0°C (104.0°F), pulse 120/min, and respirations 40/min. On physical examination she has a generally pink complexion and flushed cheeks. She is limp and somnolent and responds with a cry to noxious stimulus. Tympanic membranes are inflamed bilaterally, nose has a scant, clear discharge, and throat is mildly erythematous. Lungs are clear to auscultation except for transmitted upper airway sounds. Heart has rapid rate with a grade 1/6 systolic murmur at the left sternal border. Complete blood count, blood culture, lumbar puncture, and catheterized urine specimen are obtained and sent for stat analysis. Acetaminophen is administered by rectal suppository. Thirty minutes later the patient awakens and is smiling. She is afebrile. Additional history discloses that she was born at term, she had an uneventful neonatal course, she has normal growth and development, and vaccinations are up-to-date. She has never had an episode similar to this. Initial laboratory results are shown:

Neutrophils, segmented
Neutrophils, bands
Cerebrospinal fluid

Other laboratory studies are pending.

5. In addition to ampicillin for otitis media and acetaminophen, this child also should receive which of the following?

  1. Oral ethosuximide
  2. Oral phenobarbital
  3. Oral phenytoin
  4. Rectal diazepam
  5. No additional medications

(Answer: E)

Step 3 Ccs Practice

6. Two weeks later the patient is brought to the office for a follow-up visit. Her mother says that she is doing well and she has had no recurrence of her symptoms. Examination of the ears shows resolution of the otitis media. Which of the following is the most important diagnostic step at this time?

  1. Audiology testing
  2. Cognitive testing
  3. CT scan of the head
  4. EEG
  5. No additional testing

(Answer: E)

Pharmaceutical Advertisement (Drug Ad) Format

The drug ad item format includes a rich stimulus presented in a manner commonly encountered by a physician, eg, as a printed advertisement in a medical journal. Examinees must interpret the presented material in order to answer questions on various topics, including

  • Decisions about care of an individual patient
  • Biostatistics/epidemiology
  • Pharmacology/therapeutics
  • Development and approval of drugs and dietary supplements
  • Medical ethics

Step 3 Ccs Cases

Abstract Format

The abstract item format includes a summary of an experiment or clinical investigation presented in a manner commonly encountered by a physician, eg, as an abstract that accompanies a research report in a medical journal. Examinees must interpret the abstract in order to answer questions on various topics, including

  • Decisions about care of an individual patient
  • Biostatistics/epidemiology
  • Pharmacology/therapeutics
  • Use of diagnostic studies

Primum Computer-based Case Simulations (CCS)

You will manage one case at a time. Free-text entry of patient orders is the primary means for interacting with the format. Buttons and check boxes are used for ordering a physical examination, advancing the clock, changing the patient's location, reviewing previously displayed information, and obtaining updates on the patient. At the beginning of each case, you will see the clinical setting, simulated case time, and introductory patient information. Photographs and sounds will not be provided. Normal or reference laboratory values will be provided with each report; some tests will be accompanied by a clinical interpretation. To manage patients using the Primum CCS software, it is essential that you complete the Primum tutorial and sample cases provided. A brief description of the interface is provided in the Primum Tutorial.

We have a Step 3 CCS product that will meet your highest expectations for studying for the USMLE Step 3 CCS portion of the test. It has all the features that you would be looking for including a fully interactive software, 20,000 orders (just like in the real test), interactive grading based on your orders/responses, a reasonable fee, with over 105 Step 3 CCS cases. We would ask that you take a look at our Step 3 CCS cases and download the trial version our our Step 3 CCS cases here.

Here is a screen shot of our Step 3 CCS Product:

Study for the Step 3 CCS with over 100 Step 3 CCS Cases with interactive grading/feedback for the MAC/PC.

Notice that our Step 3 Product looks nearly identical to the real test. This is to get you familiar with the format so that on test day you will be comfortable and perform well on the Step 3 CCS portion of the exam. You will learn when to perform a physical exam, what diagnostic tests to run, what treatment options to perform, and appropriate preventative orders at the end of the case. This is a comprehensive Step 3 CCS test preparation software that will fully prepare you for the real Step 3 test.

Go ahead and check out our Step 3 test preparation material by going to our “Try It” page and downloading the Step 3 test preparation trial version which contain 2 free and fully functional cases. You can purchase the full version to have access all of our 100 Step 3 Cases to study and master the Step 3 portion of the exam, so you can do well on test day. We are sure that you will find that our product is more more thorough and complete and is a better value than our competition in particular UWorld which does not offer grading and interactive feedback.

Step 3 Ccs Reddit

Many people have tried and loved our CCS software simulator. The great thing about our software is that you can try a full version of the product with 2 cases prior to purchasing our product. We feel that you will know exactly what you will be getting before you decide to buy. In order to do this, simply click here and you can download the CCS software simulator for the PC or MAC