The sole purpose of USMLE Step 3 is to assess your abilities to apply medical knowledge and understanding of biomedical and clinical sciences that are necessary for practicing medicine in the United States without any supervision. The material of this examination I made by the examination committee itself that represents the profession of medicine and associates of Sate medical licensing board. The content of the USMLE Step 3 reflect the general medical practices of a doctor in the United States. The test items and cases portray the clinical situations that are confronted by a physician within the context of a specific setting. Consider the USMLE Step 3 as a final evaluation of physicians while presuming independent responsibility of giving general medical care.

The USMLE Step 3 puts a spotlight to the importance of evaluating the knowledge and skills of physicians while they assume sole authority of giving medical care to the standardized patients. The USMLE Step 3 is taken for 2 days. The first day deals with what you can refer as a Foundation of Independent Practices (FIP) & the second day is referred to as Advance Clinical Medicine (ACM).


After successfully completing the step 1 and step 2 exams, you shouldn’t be unduly concerned of the final curtain. The USMLE Step 3 is the final stage of the USMLE (United States Medical licensing Examination) which ultimately leads you to acquiring a license to practice medicine. It is a 2-day long exam which is taken on computer and has 500 multiple choice questions for now. . And all you need to put forward is again a chunk of the hard work and preparations that you did during the previous exams. You’re also supposed to take standardized patient encounters in a digitalized format. Here, you will examine their history and gather information regarding physical examination, perform other diagnostic tests and perform therapies. Such questions are called CCS (Computer-based Case Simulations).

Now let’s break this 2 days exam and look at the USMLE Step 3 structure carefully. The first day would probably bring you memories of the step 1 and step 2 CK. Just like these previous ones, it will consist of 233 Multiple-Choice Questions that will be covered in 6 blocks of 38-40 questions each. You will be allotted 60 minutes to answer each block. The first day of USMLE Step 3 Exam lasts for around 7 hours including a break time of total 45 minutes and a 5 minute optional tutorial.

Day 2 is where you will get your hands on new modules that come into the picture. The day 2 is a 9 hours journey and is again sub-divided into two test formats. The first phase will bring in 180 multiple-choice questions. These questions are further covered into 6 blocks each with a prescribed time of 45 minutes to complete each block. The second phase of day 2 is packed with CSC which would be of standardized format. The total number of CSCs you would be asked to solve is 13 and each of them can have duration of 10 or 20 minutes. The allotted break time for the second time would be as minimal as 45 minutes. However, if you want to extend your break time, then you can skip both the tutorials and stretch the time by 12 minutes (5+7). After the lengthy 16 hours journey, you will be finally done with your USMLE. You are now released of all these steps and are ready to step into the clinical and research work. And prior to that, relish the life!


One good thing about USMLE Step 3 is that you needn’t have to take this 2 day long exam consecutively. Rather, you can reserve the dates as per your schedule. Also, make sure you have taken the prior steps (USMLE Step 1, Step 2) and passed the same. The next thing that comes into the discussion is that when is the right time to take USMLE Step 3 registration during the year? Generally, the Step 3 should be taken while you are in the intern year of your residency. By doing so, you complete the license applications at the end of the year and obtain the license in the next year.The peak time for USMLE Step3 is the period from May to July and November to December. Do not forget to schedule your dates in advance so that in case you face any trouble with the dates in the future, you can easily reschedule it.


Day 1 is concerned with FIP (Foundation of independent Practices) that emphasizes on assessment of knowledge of basic medical and scientific principles required for effective health care. The contents of FIP include the following topic.

  • Application of basic sciences
  • Understanding of biostatistics and epidemiology/population health
  • Interpretation of the medical literature
  • Application of social sciences
  • Communication and interpersonal skills
  • Medical ethics
  • Systems-based practice
  • Patient safety

Day 2 is concerned with ACM (Advanced Clinical Medicine). This test day deals with your assessment of the ability of application of comprehensive knowledge of health and disease in the context of patient management and the evolving manifestation of disease over time. Content areas covered include the following topics.

  • Evaluation of knowledge of diagnosis and management
  • Health maintenance and screening
  • Therapeutics
  • Medical decision making
  • Knowledge of history and physical examination
  • Application of diagnostic study


The USMLE Step 1 and Step 2 (CK&CS) requires your registration with ECFMG (Educational Commission for Foreign Medical Graduate) in order to register for these exams. However, the USMLE Step 3 registration doesn’t follow the same procedure. Since the USMLE Step 3 is taken By US Medical Graduates once they have completed their first year of residency. The USMLE Step 3 exam requires FSMB registration. After you have applied for the exam via the FSMB portal, it takes 5-7 business days for the entire registration. The process of registration starts when you have filled the USMLE Step 3 application form along with the exam fees. Also, make sure you meet all the eligibility requirements so that you don’t face any trouble in the middle of the application procedure. The eligibility requirements are listed below.

  • You must have passed the USMLE Step 1 and Step 2 (CK&CS)
  • You must hold an MD or any other equivalent degree
  • The total attempts for the exam are 6 (six)
  • You can only appear thrice for the exam in a year
  • In case you are appearing for the 4th time, then it must be at least after one year of your first attempt and 6 months after your most recent attempt


USMLE® is a joint program of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). None of the trademark holders are affiliated with MOKSH or this website.

ACGME® is a registered trademark of the Accreditation Council for Graduate Medical Education.

The ECFMG® is a registered trademark of the Educational Commission for Foreign Medical Graduates.

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Electronic Residency Application Service (ERAS®) is a program of the Association of American Medical Colleges and is not affiliated with MOKSH.

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