Guide to taking the usmle step 3 examination

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General Exam Info:
Step 3 is a two-day computerized examination. Although you may leave early on either or both days, expect to be at the center from approximately 8am-5pm (actual times will vary with your testing center).
Day one consists of multiple choice questions in a format similar to Steps 1 and 2. Day two consists of some blocks of multiple choice questions, as well as “Computer-based Case Simulations” (CCS), which are basically like seeing “standardized patients” in cyberspace.

Please see the general website for the USMLE for information about test content, helpful hints, and all other general exam information:
For registration, as you will read below, you will use the Federation of State Medical Boards (FSMB) website:
Overall, when thinking about Step 3, PLAN EARLY - as you will see below it is tedious!

When can I take Step 3?
You may take Step 3 at any time during your internship or residency (It is available to all medical school graduates who have passed Steps 1 and 2). You must pass Step 3 to apply for a full license. The test is not offered on federal holidays, or during the first 2 weeks of January. It is not offered on Sundays, although some, but not all, test sites offer Saturday tests.
**Note: Some subspecialty programs may require that prelims take their examination during intern year, so we suggest asking your particular residency program about this.
Here at BIDMC, you may only schedule your Step 3 exam during vacation, elective, or ambulatory time. (You will NOT be excused from your normal continuity clinic to take the Step 3 exam, so don’t schedule it for that day!)

When should I register for Step 3?
Complete registration for Step 3 within 90 days of when you wish to take the examination. The clock begins when you complete registration. (Technically this is a 90-day eligibility period and the clock starts when your mailed AND on-line forms are all received.) You may not specify another eligibility period – you are assigned the period for the 90 days beginning immediately after your registration is complete. (There is a one-time only extension of this eligibility period for another 90 days if you tell them in time - see the FSMB website for details).
**Note: You will not be entering the exact date that you would like to take the test, nor the exact test center on your application, so you do not need this information as long as you know it will fall within your eligibility period.**
**Note: The cut-off for registration during a given calendar year is usually early September of that year! ** (Translation: you can’t decide in October that you want to take it in December – it will be too late to register! You’ll be forced to wait until January.) The exact September deadline is on the FSMB website.

How do I register for Step 3?
Register for Step 3 on-line through the Federation of State Medical Boards (FSMB) website:

(In case of changes in website addresses, this link is also available on the USMLE website above.)

- Click on “Examination Services” and “Step 3.”
- As you proceed through the website, you will see a list of states. You MUST pick a state when applying for Step 3. (This is theoretically the state in which you are most likely to apply for a full license. Generally speaking, if you don’t know, you should select Massachusetts, however if you know you are going on to another state for further training, it is worthwhile to read the information about that state to see if you should apply through them instead of MA, as fees may vary by state.)

  • Fill in and submit the on-line registration form (you may also print this out and mail it in), complete with your payment (this changes yearly but is generally more than you would like to pay, and is posted on the USMLE website).

  • You must print out a Post-Graduate Training Form and bring this to Jennifer Lynch or Dr. Reynolds so that they can complete this, notarize it and mail it to the FSMB verifying that you really are training here! Be sure to allow some time for our IM residency office to process your form and send it on, as your registration is not considered complete until it arrives!

  • You must also fill out a Certificate of Identity Form, which includes a passport-type photo of yourself. To find this form, click on “paper application” and then “forms” on the website. After filling it out and attaching your photo, bring this with the Post-Graduate Training Form to the IM Residency office to be notarized and mailed in. Again, your registration is not considered complete until it arrives.

  • WATCH YOUR EMAIL INBOX for your scheduling permit and DON’T DELETE IT. You will need it both to schedule and to take your test (print it out).

How do I schedule my test?
Step 3 is offered at Prometric Test Centers. You can take the test anywhere (in any state – it need not be in the state under which you “registered.”)

  • As soon as your scheduling permit arrives via email, call the central phone number for Prometric test centers. You will be asked to select a city and state, as well as a date for your examination.

    • TIP: If you would like to take it in Coolidge Corner, say “Brookline” rather than “Boston.” (The Boston site is downtown, and you are calling a central line so you are not speaking with someone from the area who can correct you.)

    • Note that because there are so many residents in this city, it can be very difficult to schedule a test in Boston/Brookline and you may not get your first choice date, even 1-2 months in advance, so PLAN EARLY and consider other sites! Call the day your email arrives for best results.

    • The test is NOT offered on Sundays. Some centers will offer a Fri-Sat test, however this is not universally true at all centers.

    • Note the person on the phone may not be familiar with this test and be sure they book you for 2 consecutive days!

  • As soon as you have selected your exam date, email either the inpatient chiefs (if during elective) or the primary care chief (if during ambulatory) so that your schedule can be blocked off from clinical duties for those two days. You may need to arrange coverage.

  • All cancellations or re-scheduling must be done at least a week in advance (see the FSMB website for more details).

How should I study?
No one can answer this one for you, but after registering, you will receive a CD in the mail with test information and sample test questions from the USMLE. It is essential that you go over the information on this CD – especially the “Computer-based Case Simulations” section. This section requires you to navigate software you have never seen before and that is not necessarily intuitive. Try the software out beforehand so you save time (and actually know what you’re doing) on your test day.
For general study, many residents have used commercially available review books, such as “Crush Step 3” or “First Aid for USMLE Step 3,” computerized question banks, although there are mixed reviews of all of these, and other, resources. You can browse the Coop, ask other residents for their opinions, borrow books from each other, or buy used books from residents or fellows who have already completed the exam. The most worthwhile sections to hit are those to which you have had limited exposure, like Ob/Gyn, Pediatrics, and Surgery, but don’t assume you shouldn’t look over the other sections too.

When will I get my score?
Allow up to 8 weeks to receive your score report. You will receive an email with a link to a website containing your score.

USMLE Checklist (Print this out):
[ ] On-line registration form filled out and submitted
[ ] “Post-Graduate Training Form” printed out and given to the IM Residency office (Jennifer Lynch). Allow time for this process and consider a friendly follow-up.
[ ] “Certificate of Identity” form filled out, including passport-type photo, and given to the IM Residency office (Jennifer Lynch). See above.
[ ] Email with scheduling permit received
[ ] Contacted Prometric ASAP and selected location and date for test
[ ] Received USMLE CD in mail and went over it (especially CCS section!)
[ ] Printed out scheduling permit and brought it, along with government issued ID, to the test
[ ] Rocked the test!
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