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The USMLE Step 3 Exam Summary

The USMLE Step 3 is the final in the series of USMLE exams that candidates need to pass in order to qualify to practice medicine in the U.S. There have been a few quite substantial changes, content assessed in the exam and also the format that the test is administered. 

Summary of changes: 

  • Although the Step 3 will remain a 2-day exam, candidates can schedule the these on non-consecutive days
  • The State Board will no longer sponsor the Step 3 exam. 
  • Score report will result in a single score and a single pass/fail outcome. 

The two days of testing are now broken down into: 

DAY 1:

Foundations of Independent Practice (FIP) will focus on the application of knowledge in foundational medicine and sciences, testing your knowledge of diagnosis and management. This will contain only multiple-choice questions, including some new question formats that are based on a scientific abstract or pharmaceutical advertisements.

You will answer 256 multiple choice items, split up into 6 blocks. You will have 1 hour to answer all the questions in each block. You will also have 45 minutes break time and an optional 5-minute tutorial. You are able to increase your break time by finishing a question block early.    

DAY 2:

Advanced Clinical Medicine (ACM) focuses on your knowledge of health and disease in the context of patient management and the changing manifestation of disease. This part of the test includes both multiple-choice questions and computer-based case simulations (CCS).

There are around 9 hours of testing during this part of the exam, where you will complete 198 multiple-choice questions, broken up into 6 blocks. You have 45 minutes to complete each block. This is followed by 13 case simulations, each with 10 or 20 minutes of time to complete. Similarly to FIP you will have a minimum of 45 minutes break time, which can be increased by finishing the question blocks before the timer runs out for that section.