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Step 1 of the USMLE (United States Medical Licensing Examination) is the first part of the United States Medical Licensing Examination. It is open to medical school student and graduates to assess their ability to apply important concepts fundamental to the practice of medicine. While American medical students usually take USMLE Step 1 at the end of the second year of medical school, all graduates of foreign medical schools must take this exam is they intend to practice medicine in the United States.

USMLE Step 3 is open to candidates who already hold their USMLE Step 1 and Step 2 certificates. Step 3 is a two-day exam that assesses whether candidates are able apply medical knowledge and understanding of biomedical and clinical science essential to unsupervised medical practice. This is the final USMLE exam which leads to the license to practice medicine without supervision - the ultimate goal of medical students and professionals willing to practice medicine in the United States. Step 3 represents the final assessment of physicians assuming independent responsibility for delivering general medical care.

Reference: http://www.usmle.org/step-1/#question-formats

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