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Get to Know USMLE Step 3: Format and Content

Get to Know USMLE Step 3: Format and Content

USMLE Step 3 of the United States Medical Licensing Exam is the last hurdle you must scale in your licensing journey. Let’s be real—you’ve survived Steps 1 and 2; you crammed biochemical pathways, diagnosed all sorts of diseases, and mastered clinical vignettes. Step 3 is like the final boss in a video game, rising up to inspire fear and worry in you. But here’s the good news: like every good game, you must have gathered the skills and knowledge needed to conquer before you can face the boss. Step 3 isn’t about proving you can memorise facts; rather, it is where you show the world that you’re ready to think like a doctor. No more training wheels, so let’s break down what’s ahead.

Overview of Step 3

USMLE Step 3 content is designed to model cases that can and have been seen during generalist medical practice in the United States. The test items and cases reflect the clinical situations that a general, as-yet undifferentiated, physician might encounter within the context of a specific setting. Your knowledge of normal conditions and disease categories will be tested by questions related to basic concepts, normal human growth and development, and general clinical principles. Your ability to handle various clinical encounter frames, including initial workups, ongoing patient care, and urgent interventions, will also be assessed during this exam. Finally, you should expect questions about key physician tasks such as applying scientific concepts, diagnosing based on patient history, physical examinations, lab findings, and effectively managing patient care.

Clinical encounter frames represent common scenarios that general practitioners face in different healthcare settings, ranging from routine nonemergency cases to long-term patient management and critical, life-threatening emergencies. The questions can simulate these scenarios in emergency departments, clinics, private offices, long-term care facilities, inpatient units, or even over the phone. Each test item within an encounter frame aligns with one of the six core physician tasks.

The exam is unique in that you do not have to write the two parts on consecutive days; you can choose to write it a few days later if you need to recuperate or have a prior commitment.

Day 1: Foundations of Independent Practice (FIP)

The first day of the exam is designed to test your ability to diagnose, treat, and navigate public health dilemmas. Imagine sitting down for an exam that feels like a cross between Jeopardy! and a medical crossfire. You’ll face 232 multiple-choice questions split into six blocks, each with 38–39 questions. The clock? It’s your frenemy. You will be given approximately 7 hours for the first day, including 45 minutes of break time and a 5-minute optional tutorial. Each block lasts for 60 minutes, which sounds generous until you’re knee-deep in a question about how to manage a difficult patient within protocols or to calculate vaccine efficacy rates. The topics range from pharmacology (“Which antihypertensive is safe in pregnancy?”) to ethics (“How do you handle a non-compliant diabetic patient?”).

Day 2: Advanced Clinical Medicine (ACM)

Next up is Day 2, known as Advanced Clinical Medicine, where you’ll start by facing 180 more MCQs, followed by 13 Computer-Based Case Simulations (CCS). For each of the 13 CCS questions, you are given a time of 10 to 20 minutes to read, process, understand, and fulfill whatever task is asked of you. In the CCS section, you are expected to manage a virtual patient, making key medical decisions in real-time. Envision this scenario: You are responsible for the immediate care of one virtual patient, perhaps a single 45-year-old man experiencing chest pain. You will be expected to order labs, prescribe meds, and diligently schedule multiple follow-ups, all while the clock ticks.

These cases test how you handle anything from emergency decisions to long-term planning. You have to make all these decisions while time accelerates. Wait too long to act, and your patient might code. Move too fast, and you’ll miss critical clues. During this exam, you must draw heavily on your experience as a resident.

Content Breakdown

The Clinical Disciplines Tested will include:

  • Basic science topics in biochemistry and genetics
  • Basic medical topics from preclinical studies, including physiology, pathology, pathophysiology, pharmacology, and microbiology
  • Subjects from clinical experiences, including internal medicine, surgery, paediatrics, OBGYN, emergency medicine, family medicine, neurology, psychiatry, etc.
  • Biostatistics
  • Social sciences
  • Medical ethics
  • Epidemiology

How to Get Ready for USMLE Step 3

How Much Time Should I Spend Studying for Step 3?

Step 3 differs from Step 1 and Step 2 CK in that it requires a less strict and more flexible learning strategy. This is because the majority of US and Canadian medical graduates take the exam during their first or second year of residency (PGY-1 or PGY-2); therefore, they have limited time to devote to preparation. Unlike medical school, residency is accompanied by a heavy scheduling of clinical duties, which makes it impossible to schedule long study blocks.

To make the most of your time, we recommend that you adopt a study period of 2-3 months, with 1-2 hours of study per day. Rather than extensive content memorisation, you should focus on reviewing your resources from Steps 1 and 2 and utilise a question-based learning format. Compared to Step 1 and Step 2 CK, Step 3 has the most workload, so test-takers must be strategic about their study efforts to accommodate their busy schedules.

Suppose you are in a speciality that focuses on Step 3 materials (Internal Medicine, Family Medicine, Pediatrics). In that case, you will require fewer revisions for the topics you will experience during your clinical rounds. On the other hand, if you are in a surgical specialty with limited general medicine exposure, you may require more training.

Study Resources

Choosing the right study materials is critical for optimising your preparation within a limited timeframe. Below are some of the best resources:

  • CanadaQbank for Step 3 – One of the gold-standard resources for MCQs and CCS cases. It provides targeted practice that mimics the actual exam and features three key components:
    • MCQ QBank: 330 multiple-choice questions covering all Step 3 topics with detailed explanations, customisable test modes, and performance tracking.
    • Testlet QBank: 307 simulated Testlet cases with 614 associated questions, providing a structured review of case-based scenarios.
    • CCS QBank: 80 high-yield clinical cases, including encounter stations and post-encounter probes to simulate real-life patient management.
  • First Aid for Step 3 – A concise, high-yield review book covering essential Step 3 topics, making it a great reference for reinforcing concepts.
  • CCS Cases – The CCS questions are unlike any questions you’ve encountered before, and it is essential you properly prepare by practising interactive CCS cases. The CCS cases and your copy of CanadaQbank will help you become comfortable with the format and decision-making process.

Strategy for Studying

To ensure that the preparation is systematic and does not interfere with other residency duties, you should:

  1. Learn the Hard Topics: Determine your weak areas and allocate your time to work on them first. If a subject was difficult for you at Step 2 CK, you will need to dedicate more time to improving your understanding.
  2. Take Advantage of Clinical Rotations: If your rotation involves an area (e.g., ICU, internal medicine, OB/GYN), make the most of your time in that unit to learn in the first person; use the practice to reinforce your knowledge in those areas. This will allow you to focus on other more demanding areas.
  3. Use Learning from Clinical Practice: Step 3 focuses heavily on clinical decision-making and interactions. Pay attention to the patients and senior doctors during your rounds and write down the therapeutic decisions made. Understand why they chose that line of treatment, and you can use this information when solving CCS cases.
  4. Review Previous Study Materials: Step 3 is meant to assess your overall medical knowledge, including topics covered in Steps 1 and 2. Using the same materials you used to study for the previous exams will trigger your memory and make recalling what you previously learned easier.
  5. Create a Study Schedule: Ideally, you should start studying 8–12 weeks before your exam. Your schedule should be flexible to account for your rotation and your personal idiosyncrasies. A rigid schedule may do more harm than good. The schedule should include daily MCQs, weekly CCS case practice, and periodic content review.

Common Pitfalls to Avoid

  • Underestimating CCS Cases: Many test-takers focus too much on MCQs and neglect CCS preparation. However, strong performance in CCS can make up for weaker MCQ sections.
  • Poor Time Management in MCQ Blocks: Step 3’s MCQs are long and scenario-based. If you don’t pace yourself, you may run out of time. Practising timed question blocks ensures efficiency.
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How to Study for USMLE Step 3

How to Study for USMLE Step 3

The USMLE Step 3 is the final exam you must conquer in your battle to become licensed to practice medicine in the United States. The exam tests your clinical knowledge and skills and how well you can apply them in an ambulatory setting. Step 3 is rumored to be hard to pass as it is spread out over two days and consists of over 400 multiple-choice questions and 13 case simulations designed to assess if you are ready for the unsupervised practice of medicine in the United States. It seeks to test how well you understand the biomedical and clinical sciences needed to safely, ethically, and efficiently dispense treatment to U.S. citizens.

For many U.S.-trained physicians, Step 3 comes up during residency, a tumultuous period where you have to juggle a lot of duties and responsibilities while getting what feels like the barest minimum hours of sleep. Others may take it before applying for a residency program, as it can boost your prestige and make you more appealing to hospitals. Your choice will affect how you design and organize your study schedule; we’ll discuss this later.

Before we discuss the steps to take in your journey to master the necessary knowledge and techniques required by the medical board, we should first explain the format, nature, and statistics surrounding the Step 3 exam.

Understanding the USMLE Step 3 Exam

The USMLE Step 3 exam is a two-day event organized by the USMLE test committee to thoroughly assess your ability to identify, treat, and manage patients dealing with illnesses common in the United States. The committee gathers data from hospitals nationwide to design questions that reflect actual case scenarios physicians can and will encounter throughout their practice.

Day 1 of the exam focuses on the foundational knowledge and medical principles necessary for independent clinical practice. A seven-hour exam consisting of approximately 232 multiple-choice questions (MCQs) checks your understanding of basic science concepts, medical knowledge, and diagnostic reasoning. You will be tested on your knowledge of the epidemiology and pathophysiology of diseases, pharmacology, and basic courses like anatomy, pathology, and physiology.

Day 2 focuses on clinical decision-making and patient management over a longer period. It assesses your ability to manage patients in a continuum, either as a new doctor-patient interaction or assuming you are familiar with the patient’s history and previous conditions. Day 2 lasts about nine hours and is divided into two parts: the first in the morning includes 180 MCQs, followed by a 45-minute break. The second part, which occurs after the break, involves 13 computer-based case simulations (CCS), which give you a virtual patient requiring ongoing care. You must order tests, prescribe treatments, and manage patient progress based on real-time feedback from the simulation, which responds to your actions like a real patient.

Step 3 is scored on a three-digit scale, and the minimum pass score ranges between 198 and 200. Your final score is obtained by combining your MCQ and CCS performance. As of 2023, the exam had a pass rate of 97% for first-time test takers from U.S. and Canadian medical schools. Those retaking the exam had a pass rate of 64% – 76%, showing that experience is not always a guarantee. Medicine, Surgery, Pediatrics, Psychiatry, Obstetrics and Gynecology, Preventive Medicine, and Public Health are some major categories tested in the Step 3 exam.

How Long Should You Study

There is no official timeframe for how long you should prepare for Step 3; it depends on you, your circumstances, and how quickly you can re-assimilate your academic knowledge. As noted before, many American-trained doctors choose to take this test during their early residency, while some prefer to take it earlier in their journey as medical students. Some candidates take it before residency to free up time during the more demanding years that follow. Most agree that three to four months is enough to cover the tested topics. Some factors that can affect your decision include how much free time you have to dedicate to studying, how knowledgeable you are at patient management, your prior performance on Steps 1 and 2, how long ago you left school, and how much residual knowledge you have. Finally, you must consider your study habits and how long it takes you to assimilate information.

How to Study for USMLE Step 3

Preparing for the Step 3 exam can be time-consuming and stressful, especially if not properly planned. Below are some techniques to streamline the process and hopefully reduce stress and panic.

Narrow Your Resources

There are countless resources available online that claim to contain the secret to passing. The key to using resources is to pick a few, and we recommend no more than five, which thoroughly explain and review the high-yield topics most likely to be tested. First Aid for the USMLE Step 3 is great for a detailed summary and overview of the exam. CanadaQBank is a highly recommended question bank that exhaustively covers both aspects of the Step 3 exam. It provides detailed answers and explanations for each question, allows the option of practicing under simulated testing conditions, and is continuously updated. Their CCS Qbank offers all that and goes even further by providing a clinical encounter and post-encounter probe, as well as relevant questions you should ask during history taking.

Identify Your Strengths and Weaknesses

Before you begin studying, you should take a timed and unbiased simulation of the full exam to identify the areas where you struggle. The test results will show you the areas that need improvement and those where you can focus less.

Create a Study Schedule

A good study schedule should consider your free time, responsibilities, strengths and weaknesses, and health. It should not be too cluttered but rather spaced out to give you time to do justice to the individual topics and not neglect your responsibilities or health. Areas where you are weak or have a higher yield should be allocated more time when studying, while your strengths should require less, as you understand them better. The schedule should allow for regular testing and a revision period toward the start of the exam.

Practice, Practice, Practice

It cannot be stressed enough how important it is for you to practice regularly for the exam. The most obvious benefit will be improving your stamina, which matters a lot given that the exam lasts for two days and several hours each day. Regular practice will also help you identify simple mistakes and allow you to compensate for them. Furthermore, regular practice with a good Qbank like CanadaQBank will boost your confidence and reinforce your knowledge, even if you haven’t revised it.

Progress, Not Perfection: You Can’t Know It All

Finally, you should remember that it is impossible to be 100% knowledgeable about any subject. The aim should be to be better than you were yesterday, so that when exam day comes, you will have built a solid foundation to help you puzzle out answers to questions you don’t know. Another perk of having this mindset is that you will have greater control over your emotions and won’t have a breakdown if you fail to review all the topics you set out for yourself. Anxiety, stress, and worry will do more damage to you during the exam than any perceived lack of preparedness.

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Tips to Help You Study for USMLE Step 3

Tips to Help You Study for USMLE Step 3

Look, as a resident finding time to balance out studying, working, and scheduling your life as a whole is a big deal. It can seem like an arduous task because now you’re always tired, feeling like you aren’t doing enough. Terrible, isn’t it?

However, it doesn’t have to be like that. With the right tips and plans, you can glide through your USMLE Step 3.

But before we go on, what is the USMLE Step 3

USMLE Step 3

The USMLE Step 3 is the culmination of your medical knowledge and its practical application in clinical settings, ultimately leading to your licensure as a medical doctor. While it marks the final step in the USMLE journey and signifies how far you’ve come (be proud). So, it’s important to maintain focus and avoid complacency.

The examination for USMLE Step 3 is meticulously crafted by esteemed experts, including individuals from academic and non-academic backgrounds, as well as members of state medical licensing boards.

USMLE Step 3 assesses your proficiency in independently managing various clinical cases. Throughout the exam, you’ll be entrusted with providing medical care without direct supervision. The first day, known as Foundations of Independent Practice (FIP), will test your foundational knowledge and skills. The second day, Advanced Clinical Medicine (ACM), delves into more complex clinical scenarios, challenging your ability to apply your expertise effectively.

As you prepare for the USMLE Step 3, remember that this examination evaluates your readiness to handle real-world clinical situations with autonomy. Emphasize the integration of your medical knowledge and practical skills, as you will be assuming the role of an independent practitioner. Stay diligent, maintain a thorough understanding of the exam content, and approach the challenges with confidence.

Tips to pass USMLE Step 3

Here are some tips to pass the USMLE Step 3

1.   Take the exam as close as possible to when you left medical school

Incorporating USMLE Step 3 into your already demanding schedule can be quite challenging. While most residency programs don’t specify a specific timeframe for taking USMLE Step 3, as long as it’s completed before your final year’s oral boards, it is advisable to tackle it during your intern year. This allows you to retain the knowledge from medical school before it fades away completely. Even if you’re in a demanding field like surgery and don’t have light weeks, effective planning can still lead to a high USMLE Step 3 score.

To help you remember, you can use CanadaQBank, which has various resources tailored specifically to help you.

2.   Understand your strengths and weaknesses

As a pediatrics resident, it’s likely that you already have a solid foundation in pediatrics, which means you don’t need to dedicate as much time to studying this subject compared to, let’s say, neurology. To optimize your study plan, identify your strong subjects based on your performance in past USMLE exams. Create a list of these subjects and allocate limited study time for them.

Next, identify the subjects you believe you can re-learn but require additional attention and focus. This middle group should be your main priority, and you should dedicate more time to studying these subjects thoroughly.

Lastly, acknowledge the subjects that you think will pose a challenge for you. Then, choose the most challenging subject from that list and eliminate it. Recognize that the USMLE exam covers an extensive amount of information, and trying to cover every single topic may not be realistic or productive.

By strategically prioritizing your study time and focusing on the subjects that require the most effort, you can make efficient use of your preparation time.

3.   Utilize the marking scheme To your advantage

To optimize your retention and recall of information, it’s advisable to concentrate on subjects of moderate difficulty. Your strong subjects already form a solid foundation, and a broad review of them should be sufficient as you encounter these concepts regularly in your residency. The exam will likely trigger your memory of the details without explicitly revisiting each one.

For the subjects in the middle difficulty range, as we discussed before, engaging in more USMLE Step 3 sets and taking comprehensive notes will prove beneficial. Reviewing the details as you progress will help solidify your understanding. Regarding your weak subjects, focus on establishing a foundation through broad-stroke overviews. Then assess whether you can retain specific details, such as Wallenberg syndrome, or if your understanding is limited to recognizing the three segments of the brainstem.

However, it’s important to note that fixating on your worst subject may not yield significant returns.

For instance. If a particular topic, like the surgical abdomen, is causing significant stress, dedicating excessive study hours to it may not be fruitful, considering it only accounts for a small fraction of the overall USMLE Step 3 exam. While the idea of not studying something might seem daunting, it’s worth noting that each subject represents, at most, approximately 6% of the total exam. It is essential to remember that cardiovascular, pulmonary topics and the central nervous system receive more substantial coverage and merit thorough review.

By adopting this approach, focusing on middle-difficulty subjects, and allocating your study time strategically, you can maximize your preparation for USMLE Step 3 and enhance your performance on the exam.

As a rule of cipf-es.org thumb, aim to complete 1-2 sets of practice questions from CanadaQBank each day.

4.   Prepare yourself mentally for day 2

There are two days for the USMLE. On the first day of USMLE Step 3, you’ll encounter multiple-choice questions exclusively. The second day consists of multiple-choice questions and computer cases, with the majority focused on the latter. These cases require you to approach them strategically, emphasizing the ability to recognize patterns and follow the necessary steps rather than solely relying on medical knowledge.

In approaching computer cases, it’s advisable to stay on the side of caution. If you can transfer the patient to the emergency department or admit them to the hospital, choose the latter. Similarly, consider ordering tests that may not be commonly utilized in real clinical practice but could prove useful in the exam’s context. If there’s a consultant available, don’t hesitate to seek their expertise and input.

An essential aspect of the exam is staying connected with your virtual patient. Regularly check their vital signs, respond to their questions, and repeat the physical examination whenever possible.

To gain familiarity with the scoring system and the nature of the cases, utilize the USMLE Step 3 cases in the week leading up to the exam. Additionally, the day before the exam, complete the USMLE practice cases to acquaint yourself with the software interface and functionality.

Conclusion

Choosing the right resources for studying USMLE Step 3 is crucial. The USMLE Step 3 CanadaQBank is highly recommended, offering over 1000 multiple-choice questions and cases that simulate the exam format. Many find CanadaQBank sufficient on its own, as it provides comprehensive highlights of tested topics.

But by adopting a strategic approach, understanding the exam’s requirements, and practicing with relevant cases, you’ll be better prepared to navigate the multiple-choice questions and computer cases effectively during USMLE Step 3.

Good luck!

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All You Need To Know About USMLE Step 3

First of all, congratulations! If you are ready to take the step 3 exam, you are one step away from being licensed in the US; this is no mean feat! It can be an exciting time, but this is also a time for you to buckle down and study in the midst of your busy schedule. In this article, we will review everything you need to know to ensure you are well-rounded for this last step. This will include frequently asked questions, some study tips, pass rates, and the modality of the exam. Let’s get right into it!

What’s The Format Of Step 3?

Unlike Step 1 and Step 2, Step 3 is the final exam in the United States Medical Licensing Examination. The two-day exam spans sixteen hours and consists of 500 multiple-choice questions. The first day of Step 3 is a seven-hour exam with an inclusion of a 45-minute break. You get to answer 232- multiple choice questions. These questions are divided into one-hour blocks, each consisting of 38-39 MCQs each. The second day of Step 3 is a nine-hour exam with an inclusion of a 45-minute break. You get to answer 180 questions divided into 45 minute blocks of 30 questions each. There are also 13 case simulations which are slated for 20-30 mins each. This tests your understanding of clinical and biomedical knowledge and evaluates if you are able to apply this knowledge to patients. The knowledge includes collecting vital history from the patient, performing an excellent physical examination, ordering diagnostic tests, and overall correctly managing a patient from start to finish. There is also a provision for a 5-minute optional tutorial at the beginning of both days. Watching the tutorial is recommended, so you are well-versed in the testing experience provided by USMLE.

What are the topics in Step 3?

1.   Step 3 Foundations of Independent Practice (FIP)

This exam is 7 hours long and focuses on fundamental scientific and medical principles, including the following areas.

  • Epidemiology/population health
  • Biostatistics
  • Foundational sciences
  • Medical literature
  • Social sciences (communication, interpersonal skills, medical ethics, systems-based practice, and patient safety)
  • Diagnosis and management (history, physical examination, diagnosis, and use of diagnostic studies)

The questions may vary in format, so it’s essential to understand each format before the day of your test.

2.   Step 3 Advanced Clinical Medicine (ACM)

This 9-hour exam tests your clinical knowledge and evaluates if you are able to apply this knowledge with patients. The content areas include:

  • Health maintenance and screening
  • Diagnosis and management (mainly focused on prognosis and outcome)
  • Medical decision-making
  • Therapeutics
  • Knowledge of history and physical examination
  • Diagnosis and use of diagnostic studies

This consists of both MCQs and case simulations. There are tutorials on each case simulation and tutorials for each content area on the day of your test.

Who’s Eligible For Step 3?

To take the USMLE step 3, you must have taken and passed step 1, step 2, CK, and CS. You must also have an MD, MO, or an international medical degree, Educational Commission for Foreign Medical Graduates (ECFMG) certified. In addition, you must not have failed Step 2 CS four or more times.

When Can I take the USMLE step 3?

USMLE Step 3 is the final step of the United States Medical Licensing Examination. It is essential that you take step 3 once you are completing or close to completing one year of postgraduate training at a US-accredited graduate medical program. However, many residents in surgical specialties choose to take step 3 after they are done with medical school while the information is still fresh in their minds. For others whose specialties are broader and very general in scope, they wait until they are in the second or third year of residency. All in all, it’s important to note that Step 3 tests all aspects and plan accordingly. It is dependent on you when you want to write the exam but note that you’ll need a passing score to apply for licensure after your residency.

How Do I Register for Step 3?

Like Steps 1 and 2, you need to choose a 3-month eligibility period and schedule an appointment in the US and its environs. However, before then, you must apply for an exam in the Federation of State Medical Boards (FSMB) physician portal. Your application will only be successful once the FSMB receives your application, the certificate identity form, and the fee of $895. FSMB will also verify that you meet all the eligibility requirements. After submitting, you can change your eligibility period, but it’d require extra fees. An extra tip: you can schedule your dates early in the eligibility period to avoid the fees and stress that come with it. It’s also important to note that this is a two-day exam: you can schedule your test dates back to back or choose to break them apart, but it should be by no more than 14 days— and step 3, Day 1 must be written before the second day of step 3.

What is the pass rate of USMLE step 3?

As of 2020, the pass rate for examinees from US/Canadian schools was 98%, and for non-US/ Canadian schools, the pass rate was a bit lower, like 89%.

What Is the USMLE Step 3 Passing Score?

The recent passing score for USMLE step 3 is 198.

When And How Will I Receive My Scores?

Scores are available on the step 3 candidate website four weeks after the exam takes place. Like other steps, scores are released on Wednesdays, and candidates are notified through email. The scores remain on the website for a year, after which the scores are available via the USMLE transcript for a fee.

Tips for Preparing for Step 3

●    Know the format

It’s important to note that unlike Step 1 and Step 2, Step 3 is significantly more prolonged and consists of both multiple-choice questions and case simulations. The format of Step 3 can be presented in different ways, so it’s important to test yourself on the interactive testing experience a few days leading up to your exams. Getting familiar with what to expect can reduce your anxiety and increase your chances of acing the exam.

●    Practice computer-based simulations

Case simulations are essential in step 3 and should not be downplayed while studying. The exam board offers several case simulation practice questions to study before the exam, but there are other online resources. Be sure to familiarize yourself with each format of the simulations and how they can be presented to you in your exam.

●     Use your time judiciously.

Time management is an important skill to have as a doctor, regardless of your stage of training. This skill cannot also be overemphasized when preparing for Step 3. A lot of people take step 3 when they are in residency. This means they must study for this exam and have a full work schedule. For that reason, time management is vital. To increase your chances of coming out with flying colors, you should hold yourself accountable to a schedule and set time aside to study for Step 3.

Conclusion

The USMLE step 3 exam is a walk in the park once you adequately prepare for the test. By now, you might have taken Step 1 and Step 2, and you may feel somewhat prepared already. However, Step 3 comes with newer challenges, so getting correctly acquainted with it is essential. For better assimilation and retention, you can study in a group or hire a private USMLE tutor to assist you throughout the final exam. Also, you are one step closer to being a licensed, unsupervised physician, so make sure to pat yourself on the back once you’ve completed your exams!