USMLE step 3

About USMLE Step 3.

usmle step 3It is important for every student to know exactly what is USMLE step 3. USMLE Step 3 assesses whether you can apply the medical knowledge gained during the Residency period. It focuses on testing your knowledge and clarity of understanding of biomedical and clinical science essential. The skills set is required to be suitable for the unsupervised practice of medicine, with emphasis on patient management in ambulatory settings. Step 3 USMLE is the final examination in the USMLE sequence leading to a license to practice medicine without supervision. That is why it is categorised as Licensure exam. This completes your dream to study Medicine in USA right up to PG.

The USMLE Step 3 examination material is prepared by examination committees broadly representing the medical profession. The committees comprise recognised experts in their fields. They include both medical professors and non-academic practitioners. It also includes the members of state medical licensing boards. Step 3 content reflects a data-based model of medical practice in the United States. The test items and cases reflect the clinical situations. In relates widely to an undifferentiated, physician might encounter within the context of a specific setting. USMLE Step 3 provides a final assessment of medical professionals aiming for independent responsibility for delivering general medical care.

The first day of the USMLE Step 3 examination is referred to as Foundations of Independent Practice (FIP), and the second day is referred to as Advanced Clinical Medicine (ACM).

Day 1.
USMLE Step 3 Foundations of Independent Practice (FIP).
This test day focuses on assessment of knowledge of basic medical and scientific principles essential for effective health care. Content areas covered includes:

  • Application of Basic sciences.
  • understanding of bio-statistics.
  • Epidemiology/population health.
  • Interpretation of the medical literature.
  • Application of social sciences.
  • Communication and interpersonal skills.
  • Medical ethics, systems-based practice, and patient safety.
  • Content assessing knowledge of diagnosis and management.
  • Knowledge of history and physical examination.
  • Diagnosis, and use of diagnostic studies.

This test day consists solely of multiple-choice questions. It includes some of the newer item formats, such as those based on scientific abstracts and pharmaceutical advertisements.

Day 2.
Step 3 Advanced Clinical Medicine (ACM).
This test day focuses on assessment of the ability to:

  • Apply comprehensive knowledge of health.
  • Disease in the context of patient management.
  • Evolving manifestation of disease over time.
  • Assessment of knowledge of diagnosis and management on prognosis and outcome.
  • Health maintenance and screening.
  • Therapeutics.
  • Medical decision making.

This test day includes multiple-choice questions and computer-based case simulations. You might now have a question on your mind - how to prepare for USMLE step 3 ?


You can see from above that step 3 USMLE has a vast course content. USMLE Step 3 is a 2 day exam. The first day of testing includes 233 multiple-choice items divided into 6 blocks of 38-40 items. Exactly 60 minutes are allotted for completion of each block of test items. Items with an associated pharmaceutical advertisement or scientific abstract are included in each of these multiple-choice blocks. There are approximately 7 hours in the test session on the first day. This includes 45 minutes of break time and a 5-minute optional tutorial.

There are approximately 9 hours in the test session on the second day. This day of testing includes a 5-minute optional tutorial followed by 180 multiple-choice items. It is divided into 6 blocks of 30 items. Exactly 45 minutes are allotted for completion of each block of test items. The second day also includes a 7-minute CCS tutorial. This is followed by 13 case simulations. Each of which is allotted a maximum of 10 or 20 minutes of real time. A minimum of 45 minutes is available for break time. There is an optional survey at the end of the second day.


You definitely need to go through a systematic USMLE step 3 preparation course. Basically there are 4 tools utilized by most of the aspirants.

  • Step 3 USMLE books.
  • step 3 USMLE video lectures (Archer videos Free lectures available for download on internet).
  • USMLE step 3 practice questions / Q bank free download (Kaplan USMLE step 3 Qbank).
  • Step 3 USMLE forums on internet act as guides and exam experience sharing platform.
  • Lastly USMLE step 3 review course / CCS tips.

One can pay the USMLE step 3 registration fee and get the login for the exam.


Generally, the medical practitioners in USA after passing USMLE Step 3 earn on an average US$ 250,000. It takes around 10 years for a student to reach this stage. It also depends on the specialization chosen by the Medical doctor. In case the specialisation is surgical, it would take around 12 years!

Reference taken from:

USMLE Official Website