Step 3 Content Description

Clinical Context of Step 3

Step 3 is the final examination in the USMLE sequence leading to a license to practice medicine without supervision. The test items and cases reflect the clinical situations that a general, as-yet undifferentiated, physician might encounter within the context of a specific setting.

The expected outcome of the USMLE process is a general unrestricted license to practice medicine without supervision. Although you may already have begun specialist training, for this examination you are expected to assume the role of a general, as yet undifferentiated, physician. You are a member of an independent group practice affiliated with a number of managed care organizations. Your office has regularly scheduled hours. You can admit patients to a 400-bed regional hospital, which provides care for both the urban and the outlying rural communities. The hospital provides standard diagnostic, radiologic, and therapeutic options, including ICUs and cardiothoracic surgery. There is a labor and delivery suite. A fully equipped emergency department adjoins the hospital, and medical evacuation helicopter service is available for emergency transfer to a regional trauma center. You do not have specialty-oriented hospital privileges, but you may request any specialty consultation. The laboratory values, included as an on-screen reference in the sample test materials, are the normal ranges for this hospital.

Step 3 patients are intended to reflect the diversity of health care populations with respect to age, sex, cultural group, and occupation. The patient population mix is intended to be representative of data collected from various national databases that study health care in the United States.