FSMB / NBME (USMLE program)

USMLE Step 3

United States Medical Licensing Examination Step 3

The final exam in the USMLE sequence, assessing whether a physician can practice medicine unsupervised. Typically taken during or after intern year and required for an unrestricted US medical license.

Day 1 about 7 hours; Day 2 about 9 hoursRequired to practice

What's on the exam

USMLE Step 3 content specifications (physician tasks/competencies)

Applying Foundational Science Concepts

11–12%

Mechanisms of disease · Pharmacologic principles · Pathophysiology applied to care · Genetics and immunology in practice

Diagnosis: History, Exam, Studies, and Prognosis

33–36%

History and physical examination · Selection of laboratory and diagnostic studies · Formulating the diagnosis · Prognosis and outcome · Recognizing emergent conditions

Management: Health Maintenance, Pharmacotherapy, and Interventions

32–35%

Health maintenance and disease prevention · Pharmacotherapy · Clinical interventions and procedures · Mixed management decisions · Monitoring and follow-up

Systems-Based Practice, Patient Safety, and Evidence

12–16%

Patient safety and quality improvement · Biostatistics and epidemiology · Interpretation of the medical literature · Health systems and care transitions

Communication, Professionalism, and Practice-Based Learning

~7%

Patient communication and counseling · Informed consent and shared decision-making · Professionalism and ethics · Self-directed learning

Frequently asked questions

How much does the USMLE Step 3 cost?

Fees vary. Approximately $925 (FSMB application fee); confirm the current fee schedule.

How long is the USMLE Step 3 and how many questions does it have?

About 412 multiple-choice items plus 13 CCS cases across both days — Day 1 about 7 hours; Day 2 about 9 hours.

What do you need to pass the USMLE Step 3?

Minimum passing score of 200 on the three-digit scale.

Can you retake the USMLE Step 3?

No more than four total attempts; waiting periods apply between attempts.

What is the best way to study for the USMLE Step 3?

Study the official blueprint, not random material: the exam is weighted by domain (Applying Foundational Science Concepts 11–12%, Diagnosis: History, Exam, Studies, and Prognosis 33–36%, Management: Health Maintenance, Pharmacotherapy, and Interventions 32–35%, Systems-Based Practice, Patient Safety, and Evidence 12–16%, Communication, Professionalism, and Practice-Based Learning ~7%). Spaced-repetition flashcards built domain-by-domain against that blueprint are the most time-efficient way to cover everything the exam tests.

Program in development

We're building a blueprint-complete program for this exam. Meanwhile, explore live programs across 7 exam.

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