USMLE Step 3 exam guide
How the two Step 3 days are built, what they cost and what changed in 2026, all in one place.
Step 3 at a glance
| Detail | Day 1 | Day 2 |
|---|---|---|
| Focus | Foundations of Independent Practice | Advanced Clinical Medicine |
| Content | Multiple-choice only | Multiple-choice and case simulations |
| Blocks | 12 blocks of 30 minutes | 9 multiple-choice blocks of 30 minutes, plus 13 to 14 case simulations |
| Length | About 7 hours | 9 hours |
| Detail | Step 3 |
|---|---|
| Result | Score and pass or fail |
| Exam fee | US$ 955, for both days |
| Where | Prometric test centres in the United States only |
Sources: usmle.org software update (Step 3 moved to the new software on 10 March 2026) and fsmb.org, checked October 2026.
Your two days, side by side
Day 1: foundations
Twelve multiple-choice blocks of 30 minutes on the foundations of independent practice. The day takes about 7 hours.
Day 2: advanced clinical medicine
Nine multiple-choice blocks of 30 minutes plus 13 to 14 case simulations, each up to 10 or 20 minutes. The day takes 9 hours.
Registering and fees
| Item | Amount |
|---|---|
| Exam fee | US$ 955 |
| Where it is given | Prometric test centres in the United States only, so no surcharge |
Sources: fsmb.org and the ECFMG surcharge page, checked October 2026. India adds its own tax; see the South Asia guide.
Try the official CCS tutorial
Case simulations
Our Qbank covers the multiple-choice content. Practise the computer-based case simulations with the free official tutorial and samples on usmle.org.
Open on usmle.orgWhat changed in 2026
New software, shorter blocks, FSMB registration and higher surcharges, explained on one page.
Read the 2026 changesPast papers and syllabus
USMLE publishes no past papers, so prepare from the official content outline and the free official samples.
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