As of 2025, the USMLE allows a maximum of four attempts to pass Step 3. This includes every attempt, whether you completed the exam, received a failing score, or ended up with an incomplete result.
Here’s what that means in practice:
- You may take Step 3 up to four times in total.
- If you fail on your first, second, or third try, you can retake it (as long as you still have attempts remaining).
- Your fourth attempt is the final one. If you do not pass on the fourth try, you become permanently ineligible to retake Step 3.
Additional important restrictions:
- You must pass Step 3 within seven years of passing Step 1 or Step 2 CK (whichever you passed first). Some state medical boards have stricter time limits.
- After a third failure, you must wait at least 365 days before registering for your fourth and final attempt.
- The old rule limiting candidates to six attempts in a 12-month period across all Steps has been removed; the current policy focuses only on the four-attempt limit for Step 3.
There is no appeal process or waiver for extra attempts, even in cases of illness or extenuating circumstances. Exhausting all four attempts without passing generally prevents you from obtaining licensure in the United States, as most residency programs and state boards will not accept applicants who have failed Step 3 four times.
In short: you have exactly four chances to pass Step 3. Multiple failures are viewed very seriously by residency programs, and running out of attempts can end a medical career in the U.S. Treat every attempt with maximum preparation.