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Usmle Step3

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The USMLE Step 3 examination has two parts. It is a computerized examination administered over a 2-day period.

Examination details

Usmle Step 3 assesses whether you can apply medical knowledge and understanding of biomedical and clinical science essential for the unsupervised practice of medicine, with emphasis on patient management in ambulatory care settings.

Last step before being eligible for full licensure

Step 3 provides a final assessment of physicians assuming independent responsibility for delivering general medical care. In most states in the United States, a successful completion of the USMLE step 3 is one of the prerequisites for being eligible to apply for a full medical licensure.

Examination material selection

The FSMB prepares the examination material is prepared by examination committees.

Examination committee

The committees comprise recognized experts in their fields, including both academic and non-academic practitioners, and some members of state medical licensing boards.

Two day and two types of testing

Step 3 content reflects the clinical situations that a general physician might encounter within the context of a specific setting.

The first day of the 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

Step 3 Foundations of Independent Practice (FIP) This is similar to the other steps, but with more focus on the application of knowledge in foundational sciences; understanding of biostatistics and epidemiology/population health, and interpretation of the medical literature; and application of social sciences, including communication and interpersonal skills, medical ethics, systems-based practice, and patient safety.

It also includes assessing knowledge of diagnosis and management, particularly focused on knowledge of history and physical examination, diagnosis, and use of diagnostic studies.

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

Time allowed - 7 hours

The first day of testing includes 232 multiple-choice items divided into 6 blocks of 38-39 items; 60 minutes are allotted for completion of each block of test items. There are approximately 7 hours in the test session on the first day, including 45 minutes of break time and a 5-minute optional tutorial.

Day 2

Step 3 Advanced Clinical Medicine (ACM) This test day focuses on assessment of the ability to apply comprehensive knowledge of health and disease in the context of patient management and the evolving manifestation of disease over time. Content areas covered include assessment of knowledge of diagnosis and management, particularly focused on prognosis and outcome, health maintenance and screening, therapeutics, and medical decision making. Knowledge of history and physical examination, diagnosis, and use of diagnostic studies also is assessed. This test day includes multiple-choice questions and computer-based case simulations.

Time allowed - 9 hours

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, divided into 6 blocks of 30 items; 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, which can be completed if time allows.


An applicant must apply to the Federation of State Medical Boards and the Michigan Board of Medicine in order to take the USMLE Step 3 examination.

Resources for Step 3 on WikiMD (popular)

Step3 Materials on WikiMD

Step3 Qbank

We are building a free database of Open Source Usmle Step3 Qbank.

USMLE step 3 Notes > Asters Notes


USMLE step 3 forums:

  1. Forum
  2. Online MedEd


1. Step-Up to Step 3
2. First Aid for Step 3
3. Master the Boards for Step 3


  • Official website:
  • Telephone: Federation of State Medical Boards (FSMB):817-868-4041.


Popular: Usmle Step 3 CCS | Usmle Step 3 CCS cases part 2 - over 70 solved cases

Asters Notes > Asters Notes I | Asters Notes II | Asters Notes III

Other resources: Usmle Q Banks | Residency Wiki

List of patient cases

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