All About the USMLE® Step 3 Exam

Everything you need to know about Step 3

USMLE Step 3 at a glance

The USMLE Step 3 exam is the final examination in the series of licensing exams required to practice medicine without supervision in the United States. This two-day exam focuses primarily on patient management. It tests your understanding of biomedical and clinical science, and assesses whether or not you are able to apply this knowledge with patients. This includes the ability to collect patient history, perform physical exams, order diagnostic tests, select the initial therapies, and overall manage a patient from start to finish.  

Who can take the USMLE Step 3?

To be eligible to take USMLE Step 3, you must have already taken and passed Step 1, Step 2 CK, and Step 2 CS, and meet other eligibility requirements, including your continued ability to complete all steps of the USMLE® exam within seven years. Scheduling is first-come, first-serve. Similar to previous Step exams, when you apply for Step 3 you will be able to select a 3-month eligibility period.

When and where can I take the USMLE Step 3? 

USMLE Step 3 can be taken at any Prometric test center in the United States or its territories, and can be scheduled either on two consecutive or on two non-consecutive days. You must complete Step 3 Day 1 before taking Step 3 Day 2.

It is recommended that you take Step 3 after completing (or when you are close to completing) at least one year of postgraduate training at a US-accredited graduate medical program. 

What is the format of USMLE Step 3?

Day 1

The first day of the USMLE Step 3 exam, also called Foundations of Independent Practices (FIP), focuses on testing your knowledge of basic medical and scientific principles. This testing session includes six 60-minute blocks of 38-39 multiple choice questions, similar in style to what you experienced with Step 1 and Step 2 CK. The first day takes about 7 hours, including 45 minutes of break time and an optional 5-minute tutorial. 

Day 2

The second day of the USMLE Step 3 exam, also called Advanced Clinical Medicine (ACM), focuses on your ability to apply comprehensive health and disease knowledge to patient management and the evolution of disease over time. This testing session includes six 45-minute blocks of 30 questions, and 13 case simulations, for each 10 or 20 minutes are allotted. There is a 5-minute optional tutorial for the multiple choice section, a 7-minute clinical case simulation tutorial, and 45 minutes of break time. 

What topics are on the USMLE Step 3? 

The USMLE Step 3 exam tests your medical knowledge and ability to apply it in patient-centered contexts. In addition to your medical and basic science foundations, your communication and professionalism will also be tested as part of this two-day examination.

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

Step 3 CCS Test Content Specifications

  • 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

What is the minimum passing score for USMLE Step 3?

The current minimum passing score for USMLE Step 3 is 198. (Last updated Jan. 2020) 

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