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.
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
Practice-Based Learning and Improvement
11–13%Biostatistics and epidemiology · Interpretation of the medical literature · Evidence-based medicine · Population health
Communication, Professionalism, Systems-Based Practice, and Patient Safety
7–9%Patient communication and counseling · Informed consent and shared decision-making · Professionalism and ethics · Patient safety and quality improvement · Health systems and care transitions
Frequently asked questions
How much does the USMLE Step 3 cost?
The USMLE Step 3 costs $955. Approximately $955 (FSMB application fee) for 2026.
How long is the USMLE Step 3 and how many questions does it have?
About 412 multiple-choice items (232 on Day 1, 180 on Day 2) plus 13–14 CCS cases on Day 2 — 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?
Start from the official outline and your primary study materials: 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%, Practice-Based Learning and Improvement 11–13%, Communication, Professionalism, Systems-Based Practice, and Patient Safety 7–9%). Once you've learned the material, spaced-repetition flashcards organized by those domains are an efficient way to retain it and refresh it before test day.
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