Step 3 Content Description
The design of the Step 3 Content Outline has been influenced by the review of empirical data drawn from several sources, including, for example, the National Ambulatory Medical Care Survey and the National Hospital Discharge Survey. The diseases noted in the outline do not represent an all-inclusive registry of disorders about which questions may be asked. Questions are generally, but not exclusively, focused on the listed disorders. In addition, not all listed topics are included on each examination.
General Principles
Normal Development
Infancy/Childhood (eg, normal growth and development)
Adolescence (eg, sexuality, physical changes of puberty)
Adult (eg, normal physical findings and lifestyle issues)
Senescence (eg, normal physical and mental changes of aging)
Medical Ethics and Jurisprudence
Consent and Informed Consent to Treatment (eg, full disclosure, advance directives/health care proxy, permission to treat/refusal of treatment, competency)
Physician/Patient Relationship (eg, truth-telling, confidentiality, privacy, autonomy, public reporting)
Death and Dying (eg, diagnosing death, organ donation, euthanasia/physician-assisted suicide, palliative care)
Applied Biostatistics and Clinical Epidemiology
Understanding Statistical Concepts (eg, understanding statistical concepts, calculations of one thing/multiple things, mixed calculations/interpretations)
Interpretation of the Medical Literature (eg, interpretation of a study statement, reading a table or graph, evaluation of the validity of the author's conclusion, identification of the study flaw, design of a study)
Systems-Based Care and Patient Safety
Systems-Based Practice and Quality Improvement (eg, microsystems and teams including hand-offs, standardization of processes, reducing deviance)
Patient Safety, Medical Errors and Near Misses (eg, sentinel events, problem identification, root cause analysis)
Disorders of the Nervous System and Special Senses
Degenerative/Developmental Disorders (eg, Alzheimer disease, Parkinson disease, multiple sclerosis, cerebral
palsy)
Neuromuscular/Degenerative Disorders of the Cervical Region (eg, paraplegia, neuropathy, myasthenia
gravis, spinal stenosis, neuritis)
Peripheral Nerve Diseases (eg, carpal tunnel syndrome, nerve compression)
Cerebrovascular Diseases (eg, intracranial hemorrhage, transient cerebral ischemias, stroke, vascular dementia
[multi-infarct dementia])
Headache and Movement Disorders (eg, seizure disorder, trigeminal neuralgia, Bell palsy, torticollis)
Sleep Disorders (eg, night terrors and sleepwalking, cataplexy and narcolepsy)
Infectious Diseases (eg, tetanus, Creutzfeldt-Jakob disease, meningitis, encephalitis)
Neoplasms (eg, meningioma, metastatic lesions)
Trauma and Toxic Effects (eg, intracranial injury, brain death, coma, concussion)
Disorders of the Eye (eg, glaucoma, retinal detachment, cataract, corneal abrasion)
Disorders of the Ear (eg, perforation of tympanic membrane, acoustic neuroma, hearing loss, vertigo)
Disorders of the Respiratory System
Obstructive Airways Disease (eg, cystic fibrosis, chronic bronchitis, emphysema, asthma)
Respiratory Failure & Pulmonary Vascular Disease (eg, pulmonary hypertension, respiratory distress syndrome, atelectasis, pulmonary embolism)
Pneumoconiosis/Fibrosis or Restrictive Pulmonary Disorders (eg, sarcoidosis, asbestosis, pneumoconiosis,
pulmonary fibrosis)
Upper Respiratory Conditions (eg, sinusitis, peritonsillar abscess, otitis, streptococcal throat infection)
Lung Infections (eg, pulmonary tuberculosis, pneumonia, influenza, respiratory syncytial virus)
Neoplasms (eg, mesothelioma, paraneoplastic syndrome)
Trauma and Toxic Effects (eg, pleurisy, pleural effusion, pneumothorax, drowning and nonfatal submersion)
Cardiovascular Disorders
Hypertensive Disease (eg, hypertension, elevated blood pressure)
Hypotension (eg, orthostatic hypotension, hypotensive emergency)
Ischemic Heart Disease and Atherosclerosis (eg, myocardial infarction, ischemic heart disease, angina pectoris, hyperlipidemia)
Congestive Heart Failure (eg, congestive heart failure, left heart failure)
Dysrhythmias (eg, atrioventricular block, paroxysmal supraventricular tachycardia, fibrillation and flutter, cardiac arrest)
Disorders of the Great Vessels (eg, atherosclerosis of aorta, dissecting aneurysm, aortic aneurysm)
Valvular Heart Disease (eg, rheumatic heart disease, bacterial endocarditis, valve disorders, functional murmurs)
Peripheral Arterial Vascular Diseases (eg, Raynaud syndrome, intermittent claudication, arterial embolism/thrombosis, venous insufficiency)
Diseases of Veins (eg, phlebitis/thrombophlebitis, deep venous thrombosis, varicose veins)
Congenital Disease (eg, ventricular/atrial septal defect, patent ductus arteriosus, coarctation of aorta, tetralogy of Fallot)
Diseases of Myocardium (eg, hypertensive cardiomegaly, arteriosclerosis, hypertrophic cardiomyopathy, myocarditis)
Diseases of Pericardium (eg, pericarditis, pericardial tamponade)
Trauma and Toxic Effects (eg, cardiovascular injury, fat embolism)
Nutritional and Digestive System Disorders
Disorders of Mouth, Salivary Glands, and Esophagus (eg, malignant neoplasm of mouth/salivary
glands/esophagus, esophageal varices, esophagitis/esophageal reflux, diaphragmatic hernia)
Stomach (eg, neoplasm of stomach, gastric ulcer problems, peptic ulcer problems, gastritis and duodenitis)
Disorders of Small Intestine/Colon and Rectum (eg, inflammatory bowel disease, diverticula, anal fissure or fistula, celiac disease)
Gallbladder and Bile Ducts (eg, calculus of gallbladder, cholangitis, obstruction of common bile duct and biliary atresia)
Liver (eg, acute hepatic failure, cirrhosis, ascites, fatty liver disease)
Pancreas (eg, neoplasm of pancreas or Islets of Langerhans, pancreatitis, cyst and pseudocyst of pancreas)
Nutrition (eg, obesity, malnutrition and malabsorption)
Infections (eg, gastroenteritis, coxsackievirus, candidiasis of mouth [thrush], hepatitis A/B/C, Helicobacter pylori)
Trauma and Toxic Effects (eg, food poisoning, hernia of abdominal cavity, ventral hernia)
Behavioral/Emotional Disorders
Psychotic Disorders (eg, schizophrenia, paranoid state, psychotic disorder)
Anxiety Disorders (eg, panic disorder [panic attacks], phobic disorders, obsessive-compulsive disorders, posttraumatic stress disorder)
Mood Disorders (eg, dysthymic disorder, depressive disorders, bipolar disorders, postpartum depression)
Somatoform Disorders (eg, somatization disorder, malingering, conversion disorder, hypochondriasis [including body dysmorphic disorder])
Eating Disorders and Other Impulse Control Disorders (eg, pica, bulimia, disorders of impulse control [gambling, shoplifting], binge eating disorder)
Disorders Originating in Infancy/Childhood/Adolescence (eg, oppositional defiant disorder, attentiondeficit/hyperactivity disorder, developmental speech or language disorder, autistic disorder)
Personality Disorders (eg, antisocial personality disorder, dependent personality disorder, paranoid personality disorder, schizoid personality disorder)
Psychosocial Problems (eg, adult maltreatment [including elder abuse], child maltreatment [child abuse], psychosexual dysfunction, bereavement)
Substance Use Disorders (eg, alcohol abuse and dependence, alcohol withdrawal syndrome, cocaine/opiates/sedatives/hypnotics abuse and dependence)
Toxic Effects (eg, poisoning by psychotropic agents, including antidepressants)
Disorders of the Musculoskeletal System
Degenerative/Metabolic Disorders (eg, gout, osteoarthritis, avascular necrosis of bone, disc displacement)
Inflammatory/Immunologic Disorders (eg, ankylosis/spondylopathy, rheumatoid arthritis,
synovitis/tenosynovitis, myalgia and myositis)
Hereditary/Developmental Disorders (eg, genu valgum or varum, congenital dislocation of hip, scoliosis,
varus/valgus deformities of feet)
Infections (eg, infective arthritis, infective myositis, Lyme disease, osteomyelitis)
Neoplasms (eg, secondary malignant neoplasm of bone and bone marrow, osteosarcoma)
Traumatic Injuries (eg, tears, fractures, dislocations, contusions)
Disorders of the Skin/Subcutaneous Tissue
Skin Eruptions (eg, contact dermatitis, erythema multiforme, psoriasis, decubitus ulcer)
Disorders of Nails/Hair/Sweat Glands (eg, ingrowing nail, seborrhea capitis/folliculitis/sycosis, hirsutism,
hyperhidrosis)
Lumps/Tumors of the Skin (eg, malignant melanoma of skin/lip, keratoderma, sebaceous cyst,
neurofibromatosis)
Infections (eg, tinea infections, cellulitis and abscess, erythema infectiosum, molluscum contagiosum)
Trauma and Toxic Effects (eg, wounds or burns affecting the skin or subcutaneous tissue, keloid scar, Stevens-Johnson syndrome, frostbite)
Disorders of the Endocrine System
Thyroid Disorders (eg, malignant neoplasm of thyroid gland, thyrotoxicosis, hypothyroidism, thyroiditis)
Diabetes Mellitus (eg, ketoacidosis, renal manifestations, neurologic manifestations, hypoglycemic shock)
Adrenal Disorders (eg, neuroblastoma, hyperaldosteronism, congenital adrenal hyperplasia, corticoadrenal
insufficiency [Addison disease])
Parathyroid/Pituitary Disorders (eg, hyperparathyroidism, hypoparathyroidism, prolactinoma,
pheochromocytoma)
Trauma and Toxic Effects (eg, heat syncope, heat stroke and sun stroke, heat exhaustion)
Renal and Urinary Disorders
Lower Urinary Tract (eg, neurogenic bladder, enuresis/incontinence of urine, urinary obstruction, cystitis)
Upper Urinary Tract (eg, glomerulonephritis, renal failure/insufficiency, polycystic kidney disease, calculus of
kidney/ureter/urinary tract)
Fluid, Electrolyte, and Acid-Base Disorders (eg, dehydration, hypovolemia, electrolyte imbalances, metabolic
disorders)
Infections (eg, pyelonephritis, urethritis, urinary tract infection)
Trauma and Toxic Effects (eg, extravasation of urine)
Diseases/Disorders of the Female Reproductive System
Breast (eg, fibrocystic/solitary cyst of breast, hypertrophy of breast, disorders of lactation, mastitis)
Uterus (eg, leiomyoma of uterus, postcoital bleeding, endometriosis of uterus, uterine prolapse)
Ovary, Fallopian Tube, & Broad Ligament (eg, ovarian or fallopian tube torsion, ovarian cyst, ovarian failure,
benign neoplasm of ovary)
Cervix (eg, cervix uteri, cervicitis and endocervicitis, dysplasia of cervix [uteri], abnormal Pap smear of cervix)
Vagina/Vulva (eg, vaginitis and vulvovaginitis, prolapse of vaginal walls, imperforate hymen, vaginismus)
Menstrual Disorders (eg, dysmenorrhea, premenstrual tension syndrome, irregular menstrual cycle, ovulation
bleeding)
Menopause Disorders (eg, postmenopausal hormone replacement therapy, premenopausal menorrhagia, postmenopausal bleeding, postmenopausal atrophic vaginitis)
Female Fertility/Infertility (eg, contraception, pre-pregnancy counseling, dyspareunia, female infertility)
Pelvic Relaxation (eg, stress incontinence, uterine prolapse, prolapse of vaginal walls, cystocele/rectocele)
Infections (eg, human papillomavirus, sexually transmitted diseases, pelvic inflammatory disease, salpingitis and
oophoritis)
Neoplasms (eg, malignant neoplasm of breast, uterus, ovary, vagina/vulva; cervical cancer)
Trauma and Toxic Effects (eg, injuries, wounds, toxic effects, or burns affecting the female reproductive system)
Pregnancy/Labor and Delivery/Fetus and Newborn
Pregnancy, Complicated (eg, gestational diabetes, ectopic/tubal pregnancy, preeclampsia or eclampsia, cervical
incompetence)
Pregnancy, Uncomplicated (eg, supervision of normal pregnancy, examination of liveborn before admission to
hospital)
Labor, Delivery, or Postpartum (including placenta abnormalities) (eg, premature rupture of membranes,
infections complicating childbirth, cesarean delivery, immediate postpartum hemorrhage)
Fetus & Newborn (eg, congenital anomalies, Down syndrome, neonatal hypoglycemia, feeding problems in
newborn [breast-feeding])
Infections (eg, congenital cytomegalovirus infection, neonatal conjunctivitis and dacryocystitis, neonatal sepsis,
herpes simplex virus)
Disorders of Blood
Splenic Disorders (eg, traumatic and nontraumatic diseases of spleen)
Anemias and Cytopenias (eg, iron deficiency anemia, hereditary spherocytosis, hemoglobinopathies, thrombocytopenic purpura and ITP)
Bleeding Disorders (eg, coagulation defects, congenital factor VIII disorder/hemophilia, von Willebrand disease,
disseminated intravascular coagulation)
Reactions to Blood Components (eg, transfusion reaction, ABO incompatibility reaction, Rh incompatibility
reaction)
Infections (eg, infectious mononucleosis, cat-scratch disease, septicemia, lymphadenitis)
Malignant Neoplasias (eg, Hodgkin disease, lymphomas, multiple myeloma, leukemia)
Toxic Effects (eg, heparin-induced thrombocytopenia)
Disorders of the Male Reproductive System
Male Reproductive System (eg, neoplasm of male breast/prostate/testes, prostatitis, torsion of testes, orchitis/epididymitis)
Infections (eg, human papillomavirus, sexually transmitted diseases)
Trauma and Toxic Effects (eg, injuries, wounds, toxic effects, or burns affecting the male reproductive system)
Disorders of the Immune System
Immune Deficiency Disorders (eg, hypogammaglobulinemia, IgA deficiency)
HIV (eg, AIDS, AIDS-related complex, pneumocystosis, Kaposi sarcoma)
Vascular/Arterial Disorders (eg, Wegener granulomatosis, arteritis)
MSK/Connective Tissue Disorders (eg, dermatomyositis, polymyositis, polymyalgia rheumatica, systemic lupus
erythematosus)
Vaccinations/Chemotherapy (eg, routine and nonroutine, including travel vaccinations, prophylactic and maintenance chemotherapy)
Anaphylaxis/Immunologic reactions (eg, anaphylaxis, reactions to venomous bites, desensitization to allergens)
Infections (eg, scarlet fever, toxic shock syndrome, Rocky Mountain spotted fever, retrovirus)