USMLE Step 3 Review Course - Live and Online Course in the USA
Live and online USMLE Step 3 prep course for students from USA, Canada, Europe, Australia, Asia and rest of the world. We provide the best USMLE Step 3 review course and preparation classes in 2020 with a success rate of 99% and over 24,383 passing AMG/IMG students. USMLE Step 3 is the third and final USMLE exam essential for US medical license. In this exam, physicians are finally tested for their ability to provide medical care independently. Our objective is to help you in scoring higher grades. We also aim to help you in becoming a multi-talented clinician.
USMLE Step 3 is based on two steps:
The Multiple Choice Exam:
On the first day of exams, the examinees solve approximately 330 – 480 multiple choice questions based on clinical situations.
The Computer-Based Case Simulation:
The students have to solve 9 open-ended Computer-Based Case-simulation in half day.
Step 3 Prep Course with 99% Success Rate and High Yield
We make sure that our students pass their USMLE Step 3 in the first attempt. We provide complete preparation guidelines to step 3 candidates. Each candidate has a chance to learn and practice under the supervision of competent doctors.
When preparing our students for step 3 USMLE, we utilize a different approach than that is used for USMLE step 1 and 2. Attending our best USMLE Step 3 preparation and review course will enable you to appear in your exam with confidence.
We set up your study plan in accordance with your scheduled date for the exam. Our USMLE prep course will cover both parts of the exam in a comprehensive and timely manner.
USMLE Step 3 Live and Online Workshops
With a heavy focus on identifying KEYWORDS in case vignettes GoldUSMLE review will help you attain your desired test score. Our experienced GoldUSMLE faculty have several years of teaching experience in the field and will help bring out the best in you for your USMLE Step 3 exam.
Step 3 consists of multiple-choice items and computer-based case simulations, distributed according to the content specifications. The examination material is prepared by examination committees broadly representing the medical profession. Step 3 is a two-day examination. The first day of testing includes 233 multiple-choice items divided into 6 blocks of 38 to 40 items; 60 minutes are allotted for completion of each block of test items. On the first day the test session is approximately 7 hours including 45 minutes of break time and a 5-minute optional tutorial. Note that the amount of time available for breaks may be increased by finishing a block of test items or the optional tutorial before the allotted time expires.
There are approximately 9 hours in the test session on the second day. This day of testing includes a 5-minute optional tutorial followed by 180 multiple-choice items, divided into 6 blocks of 30 items; 45 minutes are allotted for completion of each block of test items. The second day also includes a 7-minute CCS tutorial. This is followed by 13 case simulations, each of which is allotted a maximum of 10 or 20 minutes of real-time.
Multiple-choice Items. One-best-answer formats are used. Items may stand alone or may be grouped together as a set of 2 to 3 items. Some sets are considered sequential and function differently than other sets. It is important to study the descriptions in the USMLE Step 3 Sample Test Questions booklet. Test items present detailed clinical situations usually from the patient’s perspective. The presentation may be supplemented by one or more pictorials or audio. Assessing the patient’s situation in the context of his or her environment or family is an important element of many Step 3 questions.
Items with an associated pharmaceutical advertisement or scientific abstract are included in the examination. Each pharmaceutical advertisement or scientific abstract will appear as a 2- or 3-item set; you will see no more than 5 of these item sets in the examination.
During the time allotted to complete the test items in a block, you may answer the items in any order (excluding sequential item sets), review responses, and change answers. After exiting a block, no further review of items or changing of answers within that block is possible. Practicing with the multiple-choice items on the Web site will provide you with a realistic understanding of the computer interface and timing of the examination.
A table of normal laboratory values for frequently ordered laboratory tests, including standard international conversions, will be available as an online reference when you take the examination.
You will manage one case at a time. Free-text entry of patient orders is the primary means of interacting with the format. Buttons and checkboxes are used for ordering a physical examination, advancing the clock, changing the patient’s location, reviewing previously displayed information, and obtaining updates on the patient.
At the beginning of each case, you will see the clinical setting, simulated case time, and introductory patient information. Photographs and sounds will not be provided. Normal or reference laboratory values will be provided with each report; some tests will be accompanied by a clinical interpretation.
Purpose and Design of the Examination
The Step 3 examination devotes attention to the importance of assessing the knowledge and skills of physicians who are assuming independent responsibility for providing general medical care to patients. The first day of the Step 3 examination is referred to as Foundations of Independent Practice (FIP), and the second day is referred to as Advanced Clinical Medicine (ACM).
Step 3 Foundations of Independent Practice (FIP)This test day focuses on the assessment of knowledge of basic medical and scientific principles essential for effective health care. Content areas covered include application of foundational sciences; understanding of biostatistics and epidemiology/population health and interpretation of medical literature; and application of social sciences, including communication and interpersonal skills, medical ethics, systems-based practice, and patient safety. This test day also includes content assessing knowledge of diagnosis and management, particularly focused on knowledge of history and physical examination, diagnosis, and use of diagnostic studies. This test day consists solely of multiple-choice questions and includes 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 focuses on the assessment of the ability to apply comprehensive knowledge of health and disease in the context of patient management and the evolving manifestation of disease over time. Content areas covered include assessment of knowledge of diagnosis and management, particularly focused on prognosis and outcome; health maintenance and screening; therapeutics; and medical decision making. Knowledge of history and physical examination, diagnosis, and use of diagnostic studies also is assessed. This test day includes multiple-choice questions and computer-based case simulations.
Why Our USMLE Step 3 Review Course is Best for You?
We guide you to practice the questions through our High Yield Question Sets. We provide questions specific to step 3. These questions are challenging and require you to step into details before concluding the answers. They will cover all expected day 1 questions related to ethics and biostatistics. Our live and online lectures will help you in revising all that you had learned over the years. You will also learn how to utilize this knowledge in the examination hall.
We provide ample practice opportunity to the candidates for the standard Computer-Based Case-Simulation (CCS) with the Primum CCS format. We know that a lack of practice on the software may lead to failure. Practice under the supervision of our qualified doctors will let you master the time management skill. Our teachers focus on guiding the marking scheme so that you may score higher.
WE WILL EMPHASIZE THE FOLLOWING TOPICS IN OUR RAPID REVIEW
- Multisystem Processes
- Pharmaceutical Advertisement
- Research Abstracts
- Patient Care: Management
- Patient Care: Diagnosis
- Communication/Professionalism/Systems-based Practice & Patient Safety
- Behavioral Health
- Pregnancy, Childbirth, Female Reproduction, and Breast
- General Principles of Foundational Science
- Immune System, Blood & Lymphoreticular System, and Multisystem Processes/Disorders
- Behavioral Health
- Nervous System & Special Senses
- Skin & Subcutaneous Tissue
- Musculoskeletal System
- Cardiovascular System
- Respiratory System
- Gastrointestinal System
- Renal/Urinary & Male Reproductive Systems
- Pregnancy/Childbirth & Female Reproductive System & Breast
- Endocrine System
- Biostatistics & Epidemiology/Population Health & Interpretation of the Medical Literature
- Social Sciences: Communication Skills/Ethics/Patient Safety
USMLE Step 3 Exam breakdown
The USMLE Step 3 is a two-day exam:
- Day 1: Foundations of Independent Practice (FIP) determine’s the student’s knowledge of basic medical and scientific principles essential for effective health care.
- 7 hours long
- approximately 240 MCQ’s covered
- Divided into six 60-minute sections, each containing approx. 40 items per block
- Day 2: Advanced Clinical Medicine (ACM) evaluate’s the student’s ability to apply comprehensive knowledge of health and disease in the context of patient management and the evolving manifestation of disease over time.
- 9 hours
- Approximately 180 MCQ’s covered
- Divided into six 45-minute sections, each containing approx. 30 items per block
Each CCS case is a dynamic, interactive simulation of a patient-care situation designed to evaluate your approach to clinical management, including diagnosis, treatment, and monitoring. The cases provide a means for observing your application of medical knowledge in a variety of patient care situations and settings over varying periods of simulated time. As simulated time passes, a patient’s condition may change based on the course of the underlying medical condition(s), or your management, or both. Patients may present with acute problems to be managed within a few minutes of simulated time or with chronic problems to be managed over several months of simulated time.
The cases used in the CCS portion of the Step 3 examination are based upon a CCS examination blueprint. The blueprint defines the requirements for CCS examination forms. The CCS blueprint is used to construct CCS examination forms focusing primarily on presenting symptoms and presenting locations. Presenting symptoms are related to the USMLE Content Outline and include, but are not limited to, problems of the circulatory, digestive, renal/urinary, endocrine/metabolic, behavioral/emotional, respiratory, and reproductive systems. Presenting locations include the outpatient office, emergency department, inpatient unit, intensive care unit, and the patient’s home.
Case Interface and Format
You will manage patients using the software on our website. Information about a patient’s condition will be displayed on the computer screen. At the start of each case, you will receive a brief description of the reason for the encounter and the patient’s appearance and status along with the vital signs and history. You must initiate appropriate management and continue care as the patient’s condition changes over simulated time. Patient information will be provided to you in response to your requests for interval history and physical examination findings, tests, therapies, and procedures. Requests for interval history and physical examination automatically advance the clock in simulated time. To see results of tests and procedures and to observe effects of treatment, you must advance the clock in simulated time.
Physical examination should be requested if and when you would do the same with a real patient. You can begin management by selecting the desired components of a physical examination, writing orders before examining a patient, changing the patient’s location, or advancing the clock in simulated time. If physical examination reveals findings that you believe render selected orders inappropriate, and the orders have not yet been processed, you can cancel those orders by clicking on the order and confirming the cancellation. At subsequent intervals of your choosing, you can also request interval histories, which are analogous to asking the patient, “How are you?”
You will provide patient care and management actions by typing on the order sheet section of the patient chart. The order sheet enables you to request tests, therapies, procedures, consultations, and nursing orders representing a range of diagnostic and therapeutic management options. It is also your means of giving advice or counseling a patient (eg, “smoking cessation,” “low-fat diet,” “safe-sex techniques”). The order sheet has a free-text entry
Note: You can place orders only in the order sheet section of the patient chart. You cannot place orders on any other section of the chart (ie, Progress Notes, Vital Signs, Lab Reports, Imaging, Other Tests, Treatment Record).
In some locations (eg, the office, the inpatient unit), there may be cases where a patient already has orders on the order sheet at the beginning of the case. In these situations, the patient’s orders will be displayed on the order sheet (eg, “oral contraceptive”) with an order time of Day 1 @00:00. You must decide whether to continue or cancel the orders as you deem appropriate for the patient’s condition; these orders remain active throughout the case unless canceled.
You must advance the clock in simulated time to see results of tests and procedures, and to observe effects of treatment. After you enter and confirm all the orders you deem appropriate at a given time, you will see report times displayed on the order sheet. You must advance the clock to the indicated report times or the next time you wish to evaluate the patient in order to receive the study result and observe the effect of therapies. Note: In CCS numeric lab tests, normal ranges are included with the results; these normal ranges may differ slightly from those in the MCQ portion of the examination.
As simulated time passes, you might receive notification of change in a patient’s condition through messages from the patient or the patient’s family or from other health care providers if the patient is in a setting such as the hospital. You decide whether these messages affect your management plan.
Note that if a clock advance to a requested appointment time is stopped after reviewing results from processed orders, the requested appointment is canceled. Also note that if you advance the clock in simulated time and no results are pending, the case will advance to the next patient update or to the end of the case.
Cases end under different circumstances and after varying amounts of simulated and real time. A case will end when you reach the maximum allotted real time. Alternatively, a case may end when you have demonstrated your skills sufficiently. Encountering the Case-end Instructions screen before you think you are finished managing a patient does not necessarily mean you did something right or wrong. Once you are prompted with the Case-end Instructions screen, real time permitting, you will have a few minutes to finalize your orders and review the chart. At this point you can cancel orders and add new ones. Note that after receiving the Case-End instructions screen, you cannot order physical examination components, change the patient’s location, order a follow-up appointment, or see the results of any pending tests. After finalizing patient care, you must select Exit Case to enter the final diagnosis and exit the case. If you use the entire real time allotted after the Case-end Instructions screen, you will not be able to enter a final diagnosis. Note: Diagnoses entered are not used in scoring your performance.
If a case has not ended and you feel you have finished management of the case, you can end it by advancing simulated time. Use the clock as you normally would to receive results of pending tests and procedures. Once there are no longer any pending patient updates, tests, or procedures, use the clock to advance simulated time until the case ends.
Simulated patients may be from any age group, ethnicity, or socioeconomic background and may present with well-defined or poorly defined problems. Patients may present with acute or chronic problems, or they may be seeking routine health care or health maintenance with or without underlying conditions. Assume that each patient you are managing has already given his or her consent for any available procedure or therapy, unless you receive a message to the contrary. In the case of a child or an infant, assume the legal guardians have given consent as well.
USMLE Step 3 Prep: Responsibilities of the Physician
In the simulation, you should function as a primary care physician who is responsible for managing each simulated patient. Management involves addressing a patient’s problem(s) and/or concern(s) by obtaining physical examination results, diagnostic information, providing treatment, monitoring patient status and response to interventions, scheduling appointments and, when appropriate, attending to health maintenance screenings and patient education. You will manage one patient at a time and should continue to manage each patient until the end-of-case screen is displayed.
Assume that you are the primary care physician for each patient you manage. In this generalist role, you must manage your patient in both inpatient and outpatient settings. Sometimes this may involve management in several locations—initially caring for a patient in the emergency department, admitting the patient to the hospital, and discharging and following the patient in the outpatient setting.
You should not assume that other members of the health care team (eg, nurses, consultants) will write or initiate orders for you. Some orders (eg, “vital signs” at the beginning of a case and upon change of location) may be done for you, but you should not make assumptions regarding other orders. For example, orders usually requested to monitor a patient’s condition, such as a cardiac monitor and pulse oximetry, are not automatically ordered. You are responsible for determining needs and for making all patient management decisions, whether or not you would be expected to do so in a real-life situation (eg, ordering IV fluids, surgical procedures, or consultations). If you order a procedure for which you are not trained, the medical staff in Primum cases will either assist you or take primary responsibility for implementing your request.
As in real life, consultants should be called upon as you deem appropriate. Typically, consultants are not helpful since computer-based case simulations are designed to assess your patient management skills. However, requesting consultation at appropriate times may contribute to your score. In some cases, it may be necessary to implement a course of action without the advice of a consultant or before a consultant is able to see your patient. In other cases, a consultant may only be helpful if called after you have obtained enough information to justify referring the patient to his or her care.
Online Step 3 Prep Classes for Students from USA, Asia, Europe and Whole World
We provide live review and preparation classes in Houston and Atlanta. Our online Step 3 prep classes are for students from New York, Chicago, Florida, Toronto, USA, Canada, Australia, Asia, Europe and Australia. In short, students from all across the world can signup for our online step 3 review classes.
Our live prep course constitutes the following study aids:
Our preparation centers provide you an opportunity to learn from the USMLE experienced teachers and doctors. The course is distributed into lectures, question-solving practices, and lab sessions.
At each stage, you will get valuable tips and tricks for passing the exam.
Our comprehensive study notes include brief explanations, diagrams, tables, and valuable tips. We also provide flashcards for a quick review of major concepts.
Audio Visual Tools:
The Primum computer-based case simulations are an entirely new thing for step 3 candidates. They must have an idea of how the software is used, and how you are timed and scored. We provide complete and organized videos that will help you comprehend and practice the Primum Computer-Based Case Simulation software.