Hi, older AMG needs help to see if I can still take Step 3 or have I timed out?

[oldAMG]

Hi, to briefly summarize I am an AMG who graduated in 2014. I passed Step 1 in 2009 and Step 2 CK/CS in 2014.

It seems each state has different requirements, many of which include passing all 3 steps within 7 years, which obviously I cannot currently do unless I were to take Steps over.

Would it be possible for me to apply to a state like NY, which has no such requirement? If so does that bind me to NY in any way, or could I still potentially do residency in another state?

It would be helpful to know all of this before I try to take Step 3, so that I don't put massive effort into it without actually having a chance at residency/licensure.

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[NotAProgDirector]

It's confusing, agreed.

The USMLE has no rules about when scores expire. As far as they are concerned, you can take S1/S2 in any order you want and at any time, and once both are passed and you have graduated medical school you can take S3. No time limits at all.

Various states have decided to implement time limits. They vary from state to state, as you have noted.

You can only retake the step exams if you have a requirement, from one of these states, saying that you must. So, you apply for a full license. The state may decide to just give you a license. if not, and if the issue is the 7 year rule, then you can apply to the USMLE to take the exams over again.

As far as residency is concerned, the 7 year rule isn't a problem in most states. In most states you'll be on a training license for residency -- and those usually don't have any limits to exams (as most peopl egetting a training license wouldn't have S3 complete at all). There are a few states where after 1-2 years on a training licence, you may need to get a full license. The common one was Cali -- but they changed their rules a few years ago and now you can complete 3 years of residency on a training license, so it would depend upon the field you were in and whether it was >3 years. In any case, to avoid the situation completely you would focus on states where you can stay on a training license indefinitely for training, which is most of them.

The challenge you're going to face is the huge gap you have. You had a 5 year gap between S1 and S2, and now an almost 10 year gap since then. Very few residency programs are going to consider you with a gap that big -- most will assume that your skills, no matter how good they were at the time, have atrophied during the gap.

Honestly, I don't think S3 will make much difference. I guess you could hope that a good score on S3 would prove that your skills remain intact -- and there's probably some truth to that. But I think you're going to find it a real challenge to find a residency spot with or without it.