The United States Medical Licensing Exam is composed of three parts, or steps. Step 3 of the USMLE judges whether the candidate can apply medical knowledge and an understanding of biomedical and clinical science in order to practice medicine independently. This exam places special emphasis on managing patients in an ambulatory setting. The successful candidate will demonstrate the ability to provide effective medical care without supervision.

Step 3 USMLE Format

The USMLE Step 3 is composed of approximately 480 multiple-choice questions. These are administered in groups of 30 to 50 in testing periods that last between 45 and 60 minutes. Of these questions, approximately nine will be computer-based case simulations, which must be completed within 25 minutes.

The entirety of the Step 3 exam is administered over the course of two eight-hour days.

Step 3 USMLE Content

The content of the USMLE Step 3 can be broken down from two perspectives: physician task and clinical encounter frame.

From the perspective of physician task, 8-12% of the exam focuses on obtaining a patient history and performing a basic physical examination; 8-12% on using laboratory and diagnostic studies; 8-12% on formulating the most likely diagnosis; 8-12% on evaluating the severity of the patient's problems; 8-12% on applying scientific concepts and an understanding of the mechanisms of disease; and 45-55% on managing the patient. This last content category includes legal and ethical issues, the maintenance of health, clinical therapeutics, and clinical intervention.

From the perspective of clinical encounter, 20-30% of the exam focuses on initial care; 50-60% on continued care; and 15-25% on emergency care. It is easy to see how these two perspectives on the content of the USMLE Step 3 can coexist. Questions regarding initial care, for instance, will generally involve obtaining the patient history and performing the physical examination, while emergency care will more often involve formulating a diagnosis, evaluating the severity of the patient's problems, and managing health.

USMLE Preparation information provided by Morrison Media LLC.

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