About USMLE Step 3

About USMLE Step 3

USMLE Step 3 is the last in the series of USMLE exams. USMLE Step 3 is a required exam for all medical graduates in order to obtain license as a practicing physician in the United States.

Most of the following information is adopted from www.usmle.org. For complete information, please visit the official site.

Examination Content

USMLE Step 3 examination tests on general topics that are required to understand and practice concepts of general medicine/ family medicine. USMLE Step 3 includes multiple choice questions as well as Clinical case simulations ( CCS) . Approximately 75% of the total exam time is devoted to Multiple Choice Questions and 25% of the time to Step 3 CCS.

The following components are tested:

  • Normal conditions and disease categories (normal growth and development, basic concepts, and general principles)
  • Clinical encounter frame (initial work up, continuing care, urgent intervention)
  • Physician task (applying scientific concepts, formulating a diagnosis based on history, physical exam, and lab findings, and managing the patient).

Clinical encounter frames are common clinical scenarios physicians may encounter. They range from nonemergency problems, to the continuity of care, to life-threatening emergency situations encountered in emergency departments, clinics, offices, care facilities, inpatient settings, and on the telephone. Each test item, in an encounter frame, represents one of the six physician tasks. For example, initial care encounters emphasize taking a history and performing a physical examination. In contrast, continued care encounters emphasize decisions regarding prognosis and management.

Eligibility for USMLE Step 3:

To be eligible for Step 3, prior to submitting your application, you must:

  • obtain the MD degree (or its equivalent) or the DO degree,
  • pass Step 1, Step 2 CK, and, if required based upon the rules referenced below, Step 2 CS,
  • obtain certification by the ECFMG or successfully complete a “Fifth Pathway” program if you are a graduate of a medical school outside the United States and Canada (information on Fifth Pathway programs is available in ECFMG’s Information Booklet, and
  • meet the Step 3 requirements set by the medical licensing authority to which you are applying.

Exam Layout

Step 3 is a two-day examination. You must complete each day of testing within 8 hours. The first day of testing includes 336 multiple-choice items divided into 7 blocks of 48 items each. There will be 60 minutes of time allowed for completion of each block of test items. There is a maximum of 7 hours of testing on the first day. There is also a minimum of 45 minutes of break time and a 15-minute optional tutorial. Note that the amount of time available for breaks may be increased by finishing a block of test items or the optional tutorial before the allotted time expires.

The second day of testing includes 144 multiple-choice items, divided into 4 blocks of 36 items. These blocks will take 45 minutes. The total time allotted for these blocks is 3 hours. The second day also includes a Primum® Tutorial and instructions for which approximately 15 minutes are allowed. This is followed by 9 case simulations, for which 4 hours are allotted ( From February 2012, there will be 12 Case simulations instead of nine) . A minimum of 45 minutes is available for break time. There is an optional survey at the end of the second day, which can be completed if time allows. The timing and structure of the Step 3 testing days may change without notice.

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