USMLE Step 3

USMLE Step 3 is the final exam on the way to becoming a licensed medical physician in the US. This test tests your knowledge to practice medicines without any supervision. In this article, we will try to cover the basic steps, a brief overview, and tips to pass this 2-day trial.

This test is entirely computer-based, featuring a mixture of multiple choice questions and clinical simulations. Before the end of your residency, you probably have to go through the final and the giant stage of the USMLE three-step series on your path to becoming a doctor.


USMLE Step 3 can only be taken after graduation after you have passed STEP-1, STEP-2 CK, Step-2 CS, by,

  • US and Canadian Med-School Students recognized by Liaison Committee on Medical Education (LCME)
  • US and Canadian Med-School Students recognized by American Osteopathic Association
  • Students outside US and Canadian Med-Schools recognized by International Medical Education Directory (IMED) and Educational Commission for Foreign Medical Graduates. (ECFMG).

Format of USMLE Step 3

As already mentioned above, USMLE STEP-3 is a 2 day crushing part of the USMLE series. USMLE Step 3 is broken into two parts;

  • Foundations in Independent Practice (FIP)
  • Advanced Clinical Medicines (ACM)

Given below is the brief description and overview of the structure of USMLE Step 3:

What is asked? Ability to, apply clinical science knowledge to patients without any supervision.

When to take? After, graduation.

Time Duration: Step-3 usually takes 2 days.

MCQ Questions: Usually500 MCQ’s

Format: Computer-Based

Place: Prometric Test Sites in the USA

  • DAY 1: Foundations in independent Practice (FIP)
  • What is asked? What are the scientific principles for effective medical care? (Concepts based)
  • Time: 7 hours (one day)
  • MCQ Questions: 260 MCQs
  • DAY 2: Advanced Clinical Medicines (ACM)
  • What is asked? Patient Management and Evolving Disease Process by applying medical knowledge.
  • Duration: 9 hours (one day)
  • MCQ Questions: 200 MCQs

  • 7 hours long
  • 260 MCQs, multiple-choice questions divided into six 60-minute blocks
  •  43–44 questions per block
  • 45 minutes of break time


  • Application of foundational sciences
  • Biostatistics, epidemiology, and population health, plus interpretation of relevant medical literature
  • Social sciences, including communication and interpersonal skills, medical ethics, systems-based practice, and patient safety
  • Medical diagnosis and management
  • Understanding of scientific abstracts and pharmaceutical advertisements


  • 9 hours long
  • 200 MCQs, divided into 6, 45 minutes blocks
  • 33 MCQs in each block
  • Seven-minute CCS tutorial
  • 13 case simulations, each lasting for 10 or 20 minutes
  • 45 minutes of break time
  • Optional survey at the conclusion of the test


  • 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
  • Multiple-choice questions and computer-based case simulations



Recommended Articles:

USMLE [A General Study Guide To All USMLE Steps]

USMLE Step-1 [A Comprehensive Guideline]

USMLE STEP-2 CK [Study Guideline]



USMLE Step 3 Comprehensive Study:

Given below is the brief overview of the subjects to focus on:


  • Immune system
  • Blood and lymphatic system
  • Behavioral health
  • Nervous system and special senses
  • Skin and subcutaneous tissue
  • Musculoskeletal system
  • Cardiovascular system
  • Respiratory system
  • Gastrointestinal system
  • Renal and urinary system
  • Pregnancy, childbirth, puerperium
  • Female reproductive system and breast
  • Male reproductive system
  • Endocrine system
  • Multisystem processes and disorders



USMLE Step 3 Content/Material/Resources:


U world 300x87 - What is the USMLE Step 3 | Is USMLE Step 3 required for residency?

USMLE World is the gold standard for the preparation. It contains so many cases that are very close to the actual test exam. Go through these cases to strengthen your knowledge.

Kaplan Q-Bank:

Kaplan 300x101 - What is the USMLE Step 3 | Is USMLE Step 3 required for residency?


NBME 300x86 - What is the USMLE Step 3 | Is USMLE Step 3 required for residency?

As it has been mentioned in previous articles that NBME is also the gold standard for your self-assessment. Taking NBMEs give you an idea of how much do you know?

Online MedED

Online MedEd 300x169 - What is the USMLE Step 3 | Is USMLE Step 3 required for residency?

CCS (Computer-based cases simulation) Software

Computer-Based Cases Simulation Software is often very important for preparing step-3 but, at the same time, it is very complicated as well. There are some confusing cases in this software and there are so many cases that you may not be able to decide how much cases you have to take and practice. But, this is also considered very high yield by many of the interns who have taken step-3. Practice CCS again and again and familiarize yourself with this software.

USMLE Step 3 Triage

STEP 3 Triage 233x300 - What is the USMLE Step 3 | Is USMLE Step 3 required for residency?

This book is considered often very high yield and also contains the complete knowledge of the cases of dealing with a patient and managing patient. It is often more targeted than First Aid and even more easy to go through.

Master the Boards

Master the boards step 3 231x300 - What is the USMLE Step 3 | Is USMLE Step 3 required for residency?

This is one most complete and high yield book and in comparison to First Aid, is less complicated. Many of the interns also suggest this book to go through for the preparation of USMLE STEP-3.

Crush Step 3

Crush step 3 234x300 - What is the USMLE Step 3 | Is USMLE Step 3 required for residency?

This book is the fastest and far by easy of all the books. But, this book too has holes in its skeletal structure. It is fastest one to blaze through.

Step Up To Step 3

Step up to step 3 230x300 - What is the USMLE Step 3 | Is USMLE Step 3 required for residency?

Another source material for the preparation.

First Aid

First Aid Step 3 235x300 - What is the USMLE Step 3 | Is USMLE Step 3 required for residency?

First Aid also is a genuine and, not very high yield, the book to go through. But, most of the interns, due to their busy schedule, cannot go through this whole book. The outlines and the structure of this book are very complex and complicated. If you want to study this book as your study material for preparing USMLE STEP-3, you definitely will have to give it a lot of time.


Study Source Importance

Kaplan Q-Bank


CCS (App/Software)

Online MedEd


Very High Yield

Master The Board

Step-3 Triage

Crush Step-3

Step up to STEP-3


Very High Yield

High Yield

First Aid Not High Yield


Scoring/Grading Criteria

Testing Criteria Examinee Criteria
Passing Score

Mean Score

Standard Deviation


Graphical Performance profile

Three-digit Score


The result is available after 3-4 weeks after the exam but, it is recommended to wait 8 weeks for the result; owing to any irregularity.

TIPS to Take USMLE Step 3

There are some of the following tips you have to bear in mind during your preparation for the UMSLE Step 3 exam;

  • Choose the best time to take the test, bearing in mind that, what is your residency schedule?
  • Make a proper schedule before taking the exam; how you are supposed to make the best use of your breaks, when to eat, and also take the full-length test. If this isn’t working then switch to another schedule.
  • Taking a practice test early will show you where you are standing. Get used to the pace of the exam’s question blocks and get your body ready for the long and grueling two-day testing process.
  • Practice as many question banks as you can before taking the exam.
  • Focus on CCS preparation to gain familiarity with the software and on balancing efficiency with thoroughness in the virtual care of patients.
  • Work on completing the diagnosis and management aspects quickly; perform only a focused physical exam in an emergency; and avoid ordering tests that delay urgent treatment. Master the most common types of orders in real medical care — putting in an IV, getting patient consent for surgery, and providing counseling.
  •  Remember to order follow-up labs and procedures.
  • Identify your weaknesses and try to strengthen them.
  • Study what you don’t know again and again. It’s easy to fall into the trap of reviewing what you already know to boost your confidence. After mastering one subject try to master others.
  • If it is your 2nd or 3rd attempt then try to focus on the areas in which you were unable to excel.
  • Finally, take some breaks, go out, and exercise. Relieve your mind of any kind of pressure.



Do not take USMLE Step 3 lightly as many of the interns do because they have passed step 1 and step 2. If you have struggled so much to pass step-1 and step-2 then do struggle to take this step seriously. USMLE STEP-3 is only a test and tests only your ability to take the test, not to be a physician.

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Disclaimer: All contents of this article are for informational purposes only and not a substitute for professional advice, diagnosis, or treatment. Reliance on any information is solely at your own risk.



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