Step 3 Content Description Online

Please Note: Some modifications have been made to the 2008 Step 3 Content Description. These modifications do not reflect major revisions to the underlying structure of the examination.  Rather, they reflect some reorganization of the content description to be more closely aligned to the content descriptions used for Steps 1 and 2.  Some portions of the content description are still undergoing reorganization, so topics may be listed in more than one dimension.  A brief summary of the modifications appears below:

  1. Several topics in the list of problems and diseases that used to appear as separate categories have now been incorporated into all relevant organ systems and diseases.  These include ill-defined symptoms, toxic effects and trauma, infections, and health/health maintenance.
  2. Two new sections have been added: a general principles section, and a section on immune disorders.  The general principles section includes a description of medical ethics and jurisprudence.  This topic is also described in the Step 3 Physician Tasks under legal/ethical objectives.
  3. Several disease categories have been collapsed or combined.  These include the nervous system and special senses, and pregnancy and child/neonate.

Click on the links to the right to view sections of the Step 3 content description in hypertext format.

Purpose

The purpose of Step 3 is to determine if a physician possesses and can apply the medical knowledge and understanding of clinical science considered essential for the unsupervised practice of medicine, with emphasis on patient management in ambulatory care settings. The inclusion of Step 3 in the USMLE sequence of licensing examinations ensures that attention is devoted to the importance of assessing the knowledge and skills of physicians who are assuming independent responsibility for providing general medical care to patients.

  • Step 3 emphasizes selected physician tasks, namely, evaluating severity of patient problems and managing therapy. Assessment of clinical judgment will be prominent.
  • Clinical problems involve mainstream, high-impact diseases. Provision is made for less common but important clinical problems as well.
  • Test items and cases are patient centered, starting with a description of a clinical encounter (vignette). Both the multiple-choice items and case simulations pose action-related challenges that require clinical decisions or judgment.
  • Emphasis is on ambulatory patient encounters; however, inpatient encounters of significant complexity and reflecting contemporary trends also are represented.
  • Provision is made for incorporating applied basic science concepts, especially as they relate to justification for prognosis or management. It is assumed that basic science and clinical fundamentals have been assessed adequately in the prerequisite Step 1 and Step 2 examinations.