ECFMG: Changes to the Step 3 Examination in 2014

Source:  ECFMG Reporter – Issue 211

As previously announced, changes to the Step 3 examination will occur in 2014.

The current Step 3 examination is administered in two 8-hour test sessions, which must be taken on consecutive days. The restructured examination will also be two test days; however, examinees will be able to schedule the two test days on non-consecutive days. The examination days will consist of the following:

Step 3 Foundations of Independent Practice (FIP): this test day will focus on assessment of knowledge of foundational medicine and science essential for effective health care. Content areas covered will include applying foundational sciences; biostatistics, epidemiology/population health, and interpretation of the medical literature; and social sciences, including communication and interpersonal skills, medical ethics, and systems-based practice/patient safety. The test day will also include some content assessing knowledge of diagnosis and management. This test day will consist solely of multiple-choice questions and will include some of the newer item formats, such as those based on scientific abstracts and pharmaceutical advertisements.

Step 3 Advanced Clinical Medicine (ACM): this test day will focus on assessment of applying comprehensive knowledge of health and disease in the context of patient management. Content areas covered will include assessment of knowledge of history and physical examination, diagnosis and use of diagnostic studies, prognosis/outcome, health maintenance/screening, therapeutics, and medical decision-making. This test day will include multiple-choice questions and computer-based case simulations.

A single score (with graphical performance profile information) and a single pass/fail outcome will be reported following completion of both examination days.

The restructured Step 3 examination will be administered beginning November, 2014. During an approximately one-month period (October, 2014), it is likely that no Step 3 examinations will be administered.

Practice materials for the restructured examinations will be posted to the USMLE website in mid-2014. Examinees should anticipate a score delay following the introduction of the restructured examinations. Additional information will be posted to the USMLE website as soon as it is available.