Step 3 Content Description

Step 3 Clinical Settings

The items in each test are usually arranged by the setting in which the encounter first occurs. There are three settings. To help orient you, each setting is described at the beginning of the corresponding test block. Remember, the practice materials available on the USMLE website contain an additional block of items with associated audio or video findings.

Setting I: Office/Health Center

You see patients in two locations: your office suite, which is adjacent to a hospital, and at a community-based health center. Your office practice is in a primary care generalist group. Patients are seen for routine and urgent care at the office and health center. Most of the patients you see are from your own practice, although occasionally you will see a patient cared for by one of your associates and reference may be made to the patient's medical records. Known patients may be managed by telephone, and you may have to respond to questions about information appearing in the public media, which will require interpretation of the medical literature. The laboratory and radiology departments have a full range of services available.

Setting II: Inpatient Facilities

You have general admitting privileges to the hospital, including the children's and women's services. On occasion you see patients in the critical care unit. Postoperative patients are usually seen in their rooms unless the recovery room is specified. You may also be called to see patients in the psychiatric unit. There is a short-stay unit where you may see patients undergoing same-day operations or being held for observation. Also, you may visit patients in the adjacent nursing home/extended-care facility and detoxification unit.

Setting II: Emergency Department

Most patients in this setting are new to you, but occasionally you arrange to meet there with a known patient who has telephoned you. Generally, patients encountered here are seeking urgent care. Also available to you is a full range of social services, including rape crisis intervention, family support, and security assistance backed up by local police.