USMLE Step 3
Updated on Oct 24, 2018 - 3 p.m. IST by Shivani Bhatt

USMLE Step 3 is the final step step of the USMLE series of test. Once the aspirant successfully clears the USMLE Step 3 2018, s/he is become eligible to practice medicine in USA. USMLE 2018 Step 3 tests the aspirants understanding of medical science and whether they can practice medicine in USA without supervision. The USMLE Step 3 exam is spanned over two days and covers two important areas: Foundations of Independent Practice (FIP) and Advanced Clinical Medicine (ACM). Know all about USMLE 2018 Step 3 such as eligibility criteria, dates, application form, exam pattern, syllabus and scores.


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Eligibility Criteria for USMLE 2018 Step 3

As opposed to the USMLE Step 1 and Step where students pursuing a their medicine degree can take the tests,  USMLE Step 3 can only by aspirants who have completed their medicine course from a medical institution listed in the World Directory of Medical colleges. Candidates can ascertain whether their institution is  find whether your college is listed or not by searching for your college name in the World Directory of Medical Colleges website.

 Below are the Eligibility Criteria of USMLE Step 3:

  • The USMLE Step 3 aspirants should have passed the USMLE Step 1USMLE Step 2 CK and Step 2 CS

  • The USMLE Step 3 aspirants are required to mandatorily have a degree equivalent to a the USA and Canadian MD degree or should have a degree from a medical school listed in the World Directory of Medical Schools.

  • Candidates possessing valid Fifth Pathway certificates issued by December 31, 2009 are eligible take Step 3.

Application Process for USMLE 2018 Step 3

The USMLE application process for USMLE Step 3 has to be completed through the Federation of State Medical Boards (FSMB). Candidates can take the USMLE Step 3 in the USA only. The examination is available throughout the year except in the first week of January and on major holidays. Similar to the USMLE Step 1, the eligibility period of USMLE Step 3 is 3 months. The USMLE Step 3 test dates are available on a first-come-first-serve basis. However, candidates cannot schedule a test date more than six months before the examination. 

The application fee for USMLE Step 3 is $850.

USMLE Step 3 Dates

The Federation of State Medical Boards (FSMB) has not specified any specific date for  USMLE Step 3. The candidates are required to select a test date from the three-month eligibility period.


USMLE 2018 Step 3 Exam Pattern

The two-day USMLE step 3 exam has evaluation of Foundations of Independent Practice (FIP) and Advanced Clinical Medicine (ACM). The FIP has 233 multiple choice questions to be completed in 7 hours. The day one of USMLE Step 3 exam has 6 blocks of 38-40 questions which are allotted an hour (60 minutes) each.


The day two of the USMLE Step 3 exam evaluates the aspirants Advanced Clinical Medicine skills. The total duration for ACM on day two is 9 hours and includes 180 multiple-choice to be completed in 6 blocks. With approximately 30 questions in each block, the aspirants are given 45 minutes to complete each block.

The written section is followed by 13 case simulations. Each case simulation is to be completed in a maximum of 10 or 20 minute. A maximum of 45 minutes break time is available. Candidates can also complete an optional survey if time permits.


USMLE Step 3 Exam Pattern 2018




Step 3(FIP)

233 MCQs divided into six 60-minute blocks, each block contains approximately 38-40 questions

7 hours

Step 3(ACM)

180 MCQs divided into six 45-minute blocks, each block contains approximately 30 questions

9 hours

 The minimum passing scores in USMLE 2018 Step 3 is 196.

USMLE 2018 Step 3 Syllabus


The courses covered in Foundations of Independent are biostatistics and epidemiology/population health, interpretation of medical literature, application of foundational sciences etc. The USMLE Step 3 day one exam has a multiple-choice based question paper.

The main focus of Advanced Clinical Medicine (ACM) is on patient management, diagnosis, prognosis, health maintenance, therapeutics, among others. Like the day one, this is also a multiple-choice question paper. The syllabus of USMLE 2018 Step 3 syllabus for FIP and ACM are:


USMLE Step 3 Syllabus 2018- FIP and ACM


Foundations of Independent Practice

Advanced Clinical Medicine

Medical Knowledge/Scientific Concepts

18% - 22%


Patient Care: Diagnosis

1. History/Physical Examination

2. Diagnosis

3. Laboratory/Diagnosis Studies

40% – 45%




20% - 25%

1. Patient Care: Management

2. Health Maintenance/Disease Prevention

3. Pharmacotherapy

4. Clinical Interventions

5. Mixed Management

6. Surveillance for Disease Recurrence


75% - 80%

Communication and Professionalism



Systems-based Practice/ Patient Safety and Practice-based Learning

22% - 27%


Source: USMLE

USMLE Step 3 Scores

The aspirant have to qualify the USMLE Step 3. The scores are calculated for both days; FIP and ACM. The qualifying marks for USMLE Step 3, is 196.

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Questions related to USMLE

Showing 71 out of 71 Questions

I am studying MBBS in China in Guangxi University Of Chinese medicine .This is my 3rd year .I am from India .I want to give USMLE and rest of the exams like MCI .How to apply what should I do now ..I need some suggestions

Animesh Vats Student Expert 18th Feb, 2020


Well I would like to tell you that after MBBS you can give USMLE exam in order to qualify for residency program in USA and for India you will have to give fmge qualifying exam and then you can practice medicine here. Either way the path is going to be difficult cause both the exams are difficult and USMLE happens in three levels.

I hope my answer helps.

All the best.


I have completed my MBBS in China in Xiamen university in 2011. In 2013 I got married. In 2014 I cleared fmge and did internship in osmania hospital. After that I went to Qatar with my husband for 2 years. I got degree on Sept 2017. Next month Im flying to US withm eligible for applying usmle

Animesh Vats Student Expert 17th Feb, 2020


Well I would like to tell you that after MBBS program ends a doctor can apply for USMLE exam . In USA once you are done with your studies, you are required to give USMLE exam which is organised in three levels and once you qualify all the three levels then you are allowed to get into residency program but finding one is really difficult. USMLE can not guarantee you residency rather it will only help you in allowing you to go search for residency in US hospitals. Same goes for international students as well but the level of difficulty is a lot and getting residency is the most difficult thing to do.

I hope my answer helps.

All the best.


what is the process of usmle for pg course! l want all information regarding usmle please

Sourandhi Saha Student Expert 17th Feb, 2020

You can appear for USMLE or United States Medical Licensing Examination in order to do medical pg courses from USA. It's same as All India PG Entrance exam where you study up all your MBBS Subjects and write the exam. USMLE is a three step process where you have to score a very high percentage. Based on your marks you will be given a stream to get your MD in. USMLE 1 and 2 can be given in India after getting an appointment but for Step 3 you have to go USA and sit for interview. You can check the detailed eligibility criteria here-


Why GATEIIT considered as the best Coaching centre for USMLE Licence exam preparation in India? How to join GATEIIT?

saad ali 29th Jan, 2020


GATEIIT is best in this domain for USMLE license preparation.

Well it is good because of the following reasons:

1) They are quite experienced in this field

2)Test series provided is very much similar to USMLE exam.

3) You are provided with several mock tests to give a brief idea about the exam.

To get admission in GATEIIT,you just have to pass 10+2 level of education.

Hope it helps!!


I am from India and I complete my MBBS degree from china but not clearing my FMGE exam..Can I eligible for USMLE EXAM?

Srijika Bhattacharyya 30th Jan, 2020
The USMLE exam has three steps- step 1, step 2cs and step 2ck.
The main eligibility criteria for USMLE is that you must have completed (in case of step 2) or must be pursuing(in case of step 1) mbbs in a medical college listed in the World directory of Medical colleges. If your college is listed in this directory you are eligible for the USMLE exam.
You can refer to this link for more details.
Hope this helps.

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