USMLE Step 3 Exam


About USMLE Step 3

What is USMLE Exam?

USMLE is a US medical Licensing Examination. It is  a screening test for the candidates who want to practice unsupervised medicine in United States. USMLE, known formally as United States Medical Licensing Examination is a 3 step exam. Three USMLE steps are as follows:

  1. USMLE Step 1

  2. USMLE Step 2 CK and Step 2 CS

  3. USMLE step 3

The Step 3 can be taken after you have cleared step 1 and step 2, and by the candidates who have graduated from the medical school. Candidates will get medical licence after they clear this examination, and will be allowed to practice medicine without supervision.

Here, we are providing all the information about USMLE Step 3 registration, USMLE Step 3 exam dates, USMLE Step 3 questions, USMLE step 3 fees, and USMLE step 3 scores to clear the examination:

USMLE Step 3 Eligibility:

  • Only the Candidates who have cleared the Step 1, Step 2 CK and Step 2 CS test can appear for the Step 3.
  • The candidate must have a degree equivalent to Canadian or US MD degree from a medical school that is listed in World Directory of Medical Schools. Candidates can check if their university or college is listed in World Directory of Medical Students or not on WDOMS website.
  • Candidates should hold Fifth Pathway Certificate issued through 31-12-2009.
  • ECFMG certification is not accepted for the students who do not have Fifth Pathway Certificate.

USMLE Step 3 Subjects & Syllabus:

Given below are the details of the different competencies and the weightage they hold for USMLE Step 3 exam.


Foundations of Independent Practice

Advanced Clinical Medicine

Communication and Professionalism

8% - 12%


Medical Knowledge / Scientific Concepts

18% - 22%


Systems-based Practice / Patient Safety and Practice-based Learning

22% - 27%


Patient Care: Diagnosis

  1. History/Physical Examination
  2. Laboratory/Diagnosis Studies
  3. Diagnosis

40% - 45%




20% - 25%

Patient Care: Management

  1. Health Maintenance/Disease Prevention
  2. Pharmacotherapy
  3. Mixed Management
  4. Surveillance for Disease Recurrence
  5. Clinical Interventions


75% - 80%

USMLE Step 3 Exam Dates:

  • There are no fixed USMLE dates to appear for USMLE test 3 exam. It is a two-day examination. Candidates can choose a three-month eligibility period to appear for the test. The Step 3 examination can only be taken in USA. Therefore, candidates from outside USA will have to travel to the US for USMLE Step 3.
  • The three-month eligibility period is available for USMLE test dates all around the year. However, a candidate cannot get USMLE Step 3 scheduling before six month to the examination. The eligibility period cannot be chosen for first week of January and major holidays. Seats will be allotted as first come first serve basis.

USMLE Preparation:

How to Study for USMLE Step 3?

Normally, USMLE Step 3 Preparation time is three to four weeks. It changes from specialisation to specialisation and individual to individual. Which residency they are doing, or have done, and what are the goals, both score wise and career wise.

Refer to USMLE Step 3 study materials such as USMLE books and USMLE sample questions from USMLE question bank. Give online USMLE practice tests of Step 3 CCS (Computer based Case stimulations) for USMLE exam Preparation.

USMLE Registration:

Candidates will have to fill USMLE Step 3 Registration Form through Federation of State Medical Boards (FSMB), unlike Step 1 and Step 2 where international students have to register for USMLE Step 3 via ECFMG (Educational Commission for Foreign Medical Graduates). Candidates can choose a three-month eligibility period, which is not falling in first week of January and on major holidays. However, keep in mind that you cannot get a scheduling before six months to the examination.

USMLE Step 3 Fees:

Given below is the USMLE Exam fees for Step 3, and additional USMLE Step 3 costs.

Fee Structure:

Application Fee


Rescheduling Fee



Rescheduling Fees:

Days before scheduled test

Testing Region


31+ days before the test date

All testing regions

No Fee

Less than 31 days to more than 5 days before the test date

All testing regions


5 or fewer days before the test date

US and Canada


Africa, Asia (including Hong Kong and Pakistan),

Australia, China, India, Indonesia, Latin America,

Middle East (including Egypt), Thailand


Europe (including Israel), Korea, Taiwan





USMLE Step 3 Test Centres:

USMLE Step 3 test centres are all located in the USA and its territories. Candidates will have to travel to USA to appear for Step 3 exam.

USMLE Test Centers

  1. American Samoa
  1. Guam
  1. Northern Mariana Islands
  1. Puerto Rico
  1. United States of America (All the States)
  1. Virgin Islands (U.S)


USMLE Step 3 Questions and Exam Pattern:

The Step 3 is an assessment of candidate’s ability to practice medicine without any supervision. The medical license will be provided only after the candidate clears USMLE Step 3 exam.

Step 3 examination is a two-day examination, divided into two subcategories:

  1. Foundations of Independent Practice
  2. Advanced Clinical Medicine

USMLE Step 3 Day 1: Foundation of Independent Practice (FIP)

  • Along with diagnosis and diagnostic studies, the first day of USMLE Step 3 test is an assessment of candidate’s knowledge of basic medical principles for effective healthcare. It also assesses the knowledge of patient history and physical examination.
  • The examination duration for Day 1 is 7 Hours. The day is divided into 6 blocks. Each block will have 38 to 40 items respectively.  The total number of USMLE Step 3 questions for the first day will be maximum of 260.

USMLE Step 3 Day 2: Advanced Clinical Medicine (ACP)

  • Day 2 of USMLE Step 3 exam is an assessment of candidate’s ability in application of knowledge for manifestation of disease and patient management. Along with that, it also assesses various aspects such as health maintenance and screening, therapeutics, diagnosis and prognosis, and medical decision making.
  • The examination duration for Day 2 is 9 hours. The day is divided into 6 blocks. Each block will have 33 questions respectively. The total number of USMLE Step 3 questions for the second day will be maximum of 200.
  • Computer based case stimulations are also included in USMLE Step 3 exam.

USMLE Exam Pattern for Step 3:

USMLE Step 3


Total Questions


No. of Question in each Block

USMLE Step 3-Day 1

7 hours




USMLE Step 3-Day 2

9 hours


6 (30-45 minutes each)


(13 case stimulations)


USMLE Scores for Step 3:

There is no specific score provided by USMLE that is required to qualify. USMLE results for step 3 are declared in three digits. The current USMLE Step 3 passing scores for the examination are 196.

If you want your USMLE transcripts sent to licensing authorities, contact FSMB. If you have not taken or registered for step 3, you should contact NBME of ECFMG as per requirements. USMLE Step 3 results normally take three to four weeks from the date of examination.

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