USMLE Step 3 Comprehensive Guide (Updated for 2024)

USMLE Step 3 Guide

The United States Medical Licensing Examination (USMLE) Step 3 stands as the final hurdle before a medical school graduate can practice medicine independently. Designed to evaluate one’s ability to apply medical knowledge and skills without supervision, it’s essential to be thoroughly prepared. This guide provides an extensive breakdown, preparation tips, and resource suggestions.

Content Overview

  1. Detailed Exam Breakdown: Delving deep into the exam format and components.
  2. Preparation Techniques: Strategies to ensure efficient studying.
  3. Top Recommended Resources: Unbiased reviews of essential study aids.
  4. Insights for Exam Day: Essential tips to navigate the examination.

Detailed Exam Breakdown

General Information:

  • Duration: Two days.
  • Question Types: Multiple Choice Questions (MCQs) and Computer-based Case Simulations (CCS).

Day 1: Foundations of Independent Practice (FIP):

  • Duration: Approximately 7 hours.
  • Content: Biostatistics, interpretation of medical literature, application of basic science, patient safety, and population health.
  • MCQ Blocks: Six blocks, each containing 38–40 questions.

Day 2: Advanced Clinical Medicine (ACM):

  • Duration: Approximately 9 hours.
  • Content: Diagnosis, management, prognosis, and understanding of various diseases.
  • MCQ Blocks: Six blocks, each containing 33–35 questions.
  • CCS Cases: 13 computer-based case simulations.


  • Scale: Three-digit score with 198 as the current passing score (2023 data).
  • Results: Typically released 3-4 weeks post-exam.

USMLE Step 3 Preparation Techniques

  • Study Plan: Construct a timeline, breaking down topics to cover each week.
  • Active Learning: Engage in discussions, teaching, or group studies.
  • Simulation Practice: Familiarize with the software and CCS cases using the USMLE practice software.
  • Review & Revisit: Periodically review previously studied material.
  • Wellness: Ensure regular sleep, exercise, and a balanced diet.

  • BoardVitals QBank: Renowned for its high-quality questions and detailed explanations.
  • First Aid for the USMLE Step 3: Comprehensive guide covering high-yield topics.
  • Kaplan USMLE Step 3 Prep Course: Offers interactive live lectures and Qbank.

Exam Day Insights

  • Preparation: Ensure all required documents are ready a day before.
  • Dress Comfortably: Wear layers to adjust to varying room temperatures.
  • Time Management: Especially crucial for CCS cases.
  • Stay Hydrated and Nourished: Consume light meals to avoid sluggishness.
  • Mental Calmness: Trust in your preparation and approach the exam with confidence.

USMLE Step 3 Eligibility and Requirements Guide

The USMLE Step 3 serves as a critical juncture for medical graduates, assessing their capability to practice medicine unsupervised. Before registering for this examination, candidates must fulfill specific eligibility criteria.

1. Eligibility Criteria

Medical Degree Completion:

  • As of 2024, applicants must have obtained an MD or DO degree from a medical school accredited by the Liaison Committee on Medical Education (LCME) or the American Osteopathic Association (AOA).

For International Medical Graduates (IMGs):

  • They must hold a medical degree from an institution listed in the World Directory of Medical Schools.
  • IMGs must also have ECFMG certification, indicating that their medical education is on par with graduates from the U.S. and Canada.

Successful Completion of Previous USMLE Steps:

  • Candidates must have passed USMLE Step 1, Step 2 CK, and Step 2 CS.

State Medical Board Requirements:

  • Some state medical boards have additional requirements or stipulations for USMLE Step 3. Candidates are advised to check with the specific licensing board of the jurisdiction where they intend to seek licensure.

2. Application Process and Requirements

Online Registration:

  • Candidates can register and schedule their exam dates via the Federation of State Medical Boards (FSMB) website or the National Board of Medical Examiners (NBME) website.


  • Proof of medical degree: Transcripts or a copy of the diploma.
  • ECFMG certification for IMGs.
  • Confirmation of successful completion of USMLE Step 1 and Step 2.


  • As of 2023, the fee for USMLE Step 3 is $895. It’s worth noting that fees are subject to change and may vary slightly depending on the location of the test center.

Testing Regions and Test Centers:

  • USMLE Step 3 is administered at Prometric test centers. Ensure to select a convenient location when scheduling.

3. USMLE Step 3 Attempt Limits

  • Candidates are allowed a maximum of six attempts to pass the USMLE Step 3.
  • After three failed attempts, some medical boards require the candidate to complete additional training before another attempt.

4. Other Essential Points

Score Reporting:

  • Scores are typically released within 3-4 weeks after the test date. Candidates can access their scores online via the NBME or FSMB portals.

Retaking the Examination:

  • If a candidate does not pass USMLE Step 3, they must reapply and pay the examination fee for each subsequent attempt.

Validity of Previous USMLE Steps:

  • There’s no expiration period for scores from Step 1 and Step 2; however, some state medical boards have their validity periods.


Understanding and fulfilling the USMLE Step 3 eligibility and requirements is paramount for a smooth application process. It’s advisable to refer to the official USMLE website or consult with the respective state medical board for any specific queries or updates. Proper planning and ensuring all criteria are met will set you on a clear path towards a successful Step 3 experience.

Remember, the landscape of medical examinations can evolve, so ensure that you’re referencing the most up-to-date information from authoritative sources.

James Edge

James Edge

James is on a mission to uncover the greatest study guides and prep courses to ensure you pass your exam on your first attempt. He has personally assessed hundreds of study materials and developed courses himself.

Crush Your Exam
Enable registration in settings - general
Shopping cart