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The Benefits of a High Step 3 or Level 3 Score


Step 3 and Level 3 Score and Importance


USMLE Step 3 and COMLEX Level 3 are the final tests required to obtain a medical license to practice without supervision in the United States. Both tests are two days and comprised of multiple-choice and case-based questions. Studying for Step 3 or Level 3 can be challenging. You will likely be busy with your residency schedule, long hours, night shifts, call days, etc. It is easy for many residents to leave studying on the back burner until a few weeks before the test, but I encourage you to create a Step or Level 3 study plan like you probably did or Step 1 or 2 and put in the effort to score high, or at least better than your previous board scores. The good news is that according to USMLE and COMLEX performance data, the first-time pass rates are extremely high. In 2022, Step 3 had a 97% first-time pass rate while Level 3 was 97.1%. 



Benefits of a High Step and Level 3 Score


So why should you try to score high on Step and COMLEX 3? The obvious benefit of scoring well is for personal reasons. It just feels good to get a great score and have your hard work pay off. Plus, you don’t want failing Step 3/Level 3 to be the reason you can’t finish residency.


However, another major benefit of studying and scoring well is to help your in-service exam score. Some specialties such as emergency medicine, internal medicine, and family medicine cover a broad range of topics with significant overlap between Step and COMLEX. Studying for one exam will help you with the other, but consider spacing them out so you can have dedicated study time for each.


Importance for Fellowship Applications


The biggest argument for trying to get a high Step or Level 3 score is for those applying to fellowships. Now Step/Level 3 is unlikely to be at the top of the list in deciding who to interview and rank. However, it is an objective piece of data and program directors will look at the trend of your board scores. Doing average or slightly above average on Step or Level 3 is unlikely to help your application, but failing or doing poorly can hurt you. Just like residency, some fellowships bear more weight on Step 3/Level 3 than others. 


Fellowship Program Directors’ Survey Data


Below is data from the 2022 fellowship and residency program directors’ survey. Always take into consideration that only a small number of programs respond to national surveys. This is also the average results from all available fellowships. Check out the report yourself for a more detailed breakdown by fellowship type!

For Level 3, 56% of programs just looked for a passing score, 17% had a target score, and 27% didn’t consider Level 3 score when deciding who to interview.

Chart showing the percent breakdown of fellowships that consider Level 3 scores.

For Step 3, 65% of programs looked for a passing score, 23% had a target score, and 12% didn’t consider Step 3 when considering which applicants to interview.

Chart showing the percent breakdown of fellowships that consider Step 3 scores.


Overall it seems that for fellowships passing is more important than trying to score in the 99th percentile. However, at the end of the day, try to do the best you can to give yourself the best chance for fellowship opportunities in the future. Balancing residency with board exam studying and in-service studying can be challenging but starting early will help you be prepared to do well on exam day!


For more help studying for Step/Level 3 or board exams consider enlisting the help of a 1-on-1 tutor! Schedule your complimentary consultation today to learn more about how Elite Medical Prep can help you succeed.

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