Archive for the ‘Step 3 USMLE’ Category

Step 3 Anxiety

January 23, 2011

Just back from the step 3 class in Chicago, I have deepened my understanding of anxiety. It is a near continuous state that the anxious think is only experienced by them. All we can do is prepare. When nervous, study, when upset, contend. It is better to be angry than depressed. Anger can move you, put you into action. get you to be inventive. If you do not like the method, change it. If you are sad, get mad!

All of them are variants of fear anyway, so choose the most mobile. When you are anxious say ‘I have a lot of company’.

How can we struggle to remember that what we are learning for that ‘test’ is all needed, useful and potentially life-saving? this is really the question. Why don’t we remember? Because we can’t help but forget. It is like saying’ why do I get tired?” or ‘If I do not eat why do I get hungry?” . Our calling is to be of service to a suffering humanity, and our work is to learn the skills, knowledge and judgement to take care of them, and work consistently, and regularly to keep it emotional for us.

Emotions are the ‘fixative’ that change, ferment and make permanent, more quickly what is ‘information’.

Today’s information, is tomorrow’s salvation.


Live Event at the Pasadena Kaplan Center, 6pm Thurday

September 24, 2009

Come on by!!!

Answering any Step 1,2,3  question. Showing ‘Comprehensive Cases” and…. ‘Routine Miracles”

HIV and pregnancy Question

September 24, 2009

The criteria for starting anti-retrovirals in pregnancy are

1. If the CD4 is LOW (<350) or the Viral load is elevated, then start THREE drugs IMMEDIATELY

2. If the CD4 is HIGH (>350) and the viral load is LOW, then start medications in the 2nd and 3rd trimester and stop after delivery

3. C-Section is ONLY used if the viral load is above ONE THOUSAND. this is a special cut off just for preventing perinatal transmission of HIV.

Presentiations in San Diego and Los Angeles: Test Taking and Routine Miracles

September 20, 2009

San Diego: September 20, 3-5pm

UCSD in the Liebow Auditorium

9500 Gilman Drive

La Jolla, CA 92093


Los Angeles: September 21, 6pm

Westwood Kaplan Test Prep & Admissions Center

1133 Westwood Blvd, #101

Los Angeles, CA 90024


Step 3 CCS question

September 20, 2009


have a question regarding CCS cases.
When exactly do you cancel NPO in a patient
on IV antibiotics?


You do NOT have to be NPO or to be fed when using IV antibiotics. They are not necessarily related.


How important are Step 3 scores?

September 12, 2009

QUESTION:Congratulations on your new book and i hope to meet you soon in the bay area! I was wondering important are the step 3 scores? I mean, do PDs look for a pass or is there any optimum range of scores? I have 99 in both step1 &amp; 2, and 85 on step3


When you have all three steps prior to applying, they are, more or less, averaged.

When you have a 99 on step 1 and 2 then a step 3 score of 85 may hurt you just a little.

If you have step 1 and 2 score of 79 and 79 or a failure on step 1 or 2 then a step 3 score of 85 will help you.

Conrad Fischer’s World tour begins!

September 4, 2009

I have some availability in:

San Diego California September 20/21

Los Angeles Sep 21

SanFrancisco Sep 25

Seattle Sept 29/30

Houston October 5-7

Chicago Oct 9/10  Oct 20-22

Detroit Oct 14/15

Columbus Ohio Oct 26

Toronto Oct 27

Boston Oct 29

Columbia Missouri Oct 30

All of these places have presentations scheduled, however, since this is a FIRST ever national tour I want to PACK the days to reach the maximum number of people.

The Fisch is coming to Washington DC on Sept 18

September 4, 2009

Hi All,

I do NOT just want to do a presentation at  a kaplan center, which I am doing on friday the 18th. Please send me a message directly or by email at
I will come to YOUR hospital or Medical school free of charge to present on the board review topic of your choice. I Can also do “Grand Rounds” in medical education.

I will be announcing other dates. If you are not in those cities, then send the message to your friends. As long as I am nearby, I want to be maximally useful.

Step 3 CCS: Advancing the clock

August 17, 2009

Question sent in:

“Yes, I am stressed about the CCS. Also why does the software ask if I am sure that I want to advance the clock, am I penalized for advancing the clock? ”

Do NOT be distressed by the question on CCS asking if you ‘are sure’ you want to advance the clock. they are just giving you the opportunity to double check.


It does NOT mean you did anything wrong. It is just giving you the opportunity to be sure! Sometimes people do make a mistake.

It is like being in a relationship, and looking for re-assurance. Just say “Of Course I REALLY love you!” and say “I am SURE I want to advance!”

Question on Organophosphate poisoning

August 17, 2009

“I’m confused about Organophosphate poisoning/AChE inhibitor overdose in terms of whether you give pralidoxime first to start replenishing AChE or give Atropine first to stabilize the cholinergic overactivity first.  I’m getting conflicting answers.”


Unquestionably, the MOST important thing about an acute overdose of organophosphates is to give ATROPINE. If the question has a choice of BOTH atropine and praladoxime, this would be ideal, however if there is a choice between these two, then ATROPINE in unquestionably the right answer.

Good Luck!!