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Adaptive prep across the two-day FIP + ACM structure with CCS case strategy — grounded in US guideline sources and recent NBME format updates.
Full USMLE Step 3 bank, AI Tutor and timed mocks — $29/month or $99/year. All paid exam banks included.
232 MCQs divided into 12 blocks of 18–20 items · 30 minutes per block · approximately 7-hour testing session.
180 MCQs in shorter blocks plus 13–14 computer-based case simulations (CCS) · approximately 9-hour testing session.
Computer-based case simulations requiring orders, timing, monitoring, escalation and disposition decisions.
From 10 March 2026 Step 3 uses the updated USMLE delivery software with 30-minute blocks. The 2026 Step 3 fee is $955; Step 3 is administered only at Prometric test centres in the United States.
Day 1 emphasises foundational sciences and biostatistics; Day 2 emphasises longitudinal patient management and CCS clinical reasoning.
Source: official NBME + FSMB blueprint
Topics that dominate the Day 2 MCQ blocks and CCS cases.
Longitudinal management — chronic disease titration over multiple visits, response to results, escalation pathways
CCS clinical reasoning — ordering appropriate tests, advancing the clock, recognising deterioration, dispositioning correctly
Outpatient primary care management — screening, preventive care, vaccination schedules
Inpatient acute care — sepsis bundles, AKI management, perioperative care
Ethics, communication and systems-based practice
Biostatistics and epidemiology — RCT interpretation, screening test characteristics, public health concepts
Recurring themes from recent Step 3 candidate feedback.
Candidate-reported observations — not official guidance.
Designed for residents preparing during intern or PGY-2 year.
A live item from the iatroX bank. Try it before launching a full session.
A 7-year-old has never been dry at night for more than two months. There are no daytime symptoms, constipation, dysuria, polydipsia, neurologic signs, or urinalysis abnormality. What is the best next step?
Why iatroX is built differently for USMLE Step 3.
Every iatroX item is tagged to a blueprint topic, so your performance dashboard mirrors the structure of the exam itself.
The engine surfaces your weakest topics first, in real time, instead of marching you through a static syllabus.
Incorrect items return at increasing intervals to interrupt the forgetting curve and lock knowledge into long-term memory.
Timed full-length simulations that mirror the official exam structure under realistic conditions.
One iatroX subscription includes the USMLE Step 3 bank, the Socratic Tutor inside supported sessions, and every other premium iatroX exam bank.
Cancel anytime · 7-day money-back guarantee on annual
Since 1 January 2024 the passing standard is 200 on the three-digit scale (raised from 198). The Mean for first-time takers is approximately 226 with SD 16.
From 10 March 2026 the total number of questions is unchanged but each day features more blocks of shorter duration. Day 1 became 6 × 60-minute blocks of 38–39 questions; Day 2 became 6 × 45-minute blocks of 30 MCQs plus the 13 CCS cases.
You must have passed Step 1, Step 2 CK and any Step 2 CS / clinical skills requirement. USMLE recommends completion of (or near completion of) at least one postgraduate year of accredited US graduate medical education.
Step 3 is administered only at Prometric test centres in the United States, unlike Step 1 and Step 2 CK which are administered internationally.
Yes. A single iatroX subscription includes the Step 3 bank alongside every other premium iatroX exam bank.
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Reviewed by Dr Kola Tytler MBBS CertHE MBA MSt MRCGP · Last reviewed 12 May 2026
See our methodology and editorial policy.