United States Medical Licensing Examination - Step 3

Step 3

USMLE Step 3 is the final exam in the USMLE series designed to assess whether a medical school graduate can apply medical knowledge and understanding of biomedical and clinical science essential for the unsupervised practice of medicine. Graduates of US medical schools typically take this exam at the end of the first year of residency. Foreign medical graduates can take Step 3 before starting residency in about ten U.S. states. Connecticut is frequently chosen for such purpose because it does not require simultaneous application for licensure, unlike New York. Starting from 2014 USMLE Step 3 will be divided into two separate parts.

• Step 3 is 16 hour examination divided over two-days. Each day of testing must be completed within eight hours.
  • The first day of testing includes 336 multiple-choice items divided into 7 blocks, each consisting of 48 items. Examinees must complete each block within sixty minutes.
  • The second day of testing includes 144 multiple-choice items, divided into 4 blocks of 36 items. Examinees are required to complete each block within forty-five minutes. Approximately 3 hours are allowed for these multiple-choice item blocks. Also on the second day are twelve Clinical Case Simulations, where the examinees are required to 'manage' patients in real-time case simulations. Examinees enter orders for medications and/or investigations into the simulation software, and the condition of the patient changes . Cases are of 20 or 10 minutes.
• Approximately forty-five minutes to one hour is available for break time on each of the two days of testing.