The multiple-choice question (MCQ) portions of the Step 3 examination are organized into blocks that correspond to the clinical settings for the patient encounters. Each setting is described at the beginning of the block. The settings have been organized according to three types: (1) office/health center; (2) inpatient facilities; and (3) emergency department.
Beginning mid-to-late March 2007, items in the inpatient facilities and emergency department settings will appear together in the same block. This is a change in the way items are grouped within each block -- there is NO change to the types of items that will be encountered.
There will also be NO change to the total number of MCQ blocks (seven on Day 1 and 4 on Day 2) or to the total number of items per block (48 items per block on Day 1 and 36 items per block on Day 2).
The introductory screen for the emergency department and inpatient facilities settings appears below:
Emergency Department and Inpatient Facilities
You encounter patients in the emergency department and inpatient facilities, including the hospital, the adjacent nursing home/extended-care facility, and detoxification unit. Most patients in the emergency department are new to you and are seeking urgent care, but occasionally, you arrange to meet there with a known patient who has telephoned you. You have general admitting privileges to the hospital, including to the children's and women's services. On occasion you see patients in the critical care unit. Postoperative patients are usually seen in their rooms unless the recovery room is specified. You may also be called to see patients in the psychiatric unit. There is a short‑stay unit where you may see patients undergoing same‑day operations or being held for observation. Also available to you are a full range of social services, including rape crisis intervention, family support, and security assistance backed up by local police.
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