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The Step 3 Free 137 is the official USMLE sample test: 137 multiple-choice questions in seven blocks, four from Day 1 and three from Day 2, published free as a PDF with an answer key (USMLE sample questions booklet). It is the closest thing to real Step 3 items you can get without paying, but it has no explanations, no CCS cases and no official score conversion.
Below: what is in the booklet, how to time it, what a score on it can and cannot tell you, and how to review your misses when USMLE only gives you the letters.
The Free 137 and the other official practice
| Topic | Official rule | Source |
|---|---|---|
| NBME scored practice (CCMSA) | Comprehensive Clinical Medicine Self-Assessment: 200 questions in four sections of 50, 1 hour 15 minutes per section standard-paced, $62. | NBME: CCMSA |
| Free 137 (sample booklet) | 137 multiple-choice sample questions in seven blocks: blocks 1-4 are Foundations of Independent Practice (items 1-77), blocks 5-7 are Advanced Clinical Medicine (items 78-137). Answer key included. Booklet updated June 2026. | USMLE Step 3 Sample Test Questions (PDF) |
| Passing score | 200 on the three-digit scale, for exams taken on or after January 1, 2024. | USMLE: results and scoring |
| Results | Typically within four weeks of the test date; USMLE advises allowing at least eight weeks. | USMLE: results and scoring |
What is in the Free 137
The current booklet says it was updated in June 2026, and it splits the 137 items by exam day the same way the real test does (USMLE booklet):
- Blocks 1 to 4, items 1 to 77: Foundations of Independent Practice, the Day 1 content. Expect biostatistics, reading an abstract or a drug advertisement, ethics, patient safety and the foundational science behind practice.
- Blocks 5 to 7, items 78 to 137: Advanced Clinical Medicine, the Day 2 content. These are management and prognosis vignettes, closer to what residents see on the wards.
Some items come as sequential sets: two or three questions on one patient, where you cannot go back and change an earlier answer once you move on. The booklet is honest about its limits. It leaves out the CCS case simulations and the audio items, and it warns that its questions may not match the content mix of any one exam (USMLE booklet).
Searches for an “old Free 137” turn up earlier versions passed around online. USMLE posts one booklet at a time; use the one on usmle.org so the item formats match what you will see.
How to take it so the result means something
USMLE suggests a maximum of 30 minutes per block, three and a half hours for all seven (USMLE booklet). That matches the 30-minute blocks the current Bulletin describes for the real exam (USMLE Bulletin), so time it strictly. The booklet itself adds that most people feel more time pressure on test day than at home.
We suggest two sittings that mirror the two exam days: blocks 1 to 4 in one two-hour session, blocks 5 to 7 in a second one on another day. Take them in the interactive version rather than on paper if you can. USMLE publishes the same style of questions as an interactive testing experience (USMLE sample questions), and the software was updated for exams from March 10, 2026 (USMLE formats page). Learning the lab-value panel, the highlighter and the sequential-item rule on a free test is cheaper than learning them on test day.
What your Free 137 score can tell you
USMLE publishes no conversion from a Free 137 percentage to a three-digit Step 3 score. The “correlation” tables you find on Reddit are self-reported by people who chose to post, so treat them as anecdotes rather than a predictor. If you scored around 60% and want to know what that means, the honest answer is that nobody can turn it into a number for you.
What the Free 137 does tell you, reliably, is where your misses cluster. Split your result by day: a weak Day 1 block usually means biostatistics or ethics, which are fast to fix; a weak Day 2 block points to management decisions. If you want a scored checkpoint, NBME's Comprehensive Clinical Medicine Self-Assessment is the paid option built for that (NBME CCMSA). Step 3 passes at 200 (USMLE scoring), and most first takers pass: 96% of US MD graduates in 2025 (USMLE performance data). The Free 137 is best used to make sure you are not one of the few who lose points to format and timing.
Reviewing 137 questions without explanations
The booklet gives an answer key and nothing more. That is less of a problem than it looks, because the review that moves a score is your own reasoning, not someone else’s paragraph. For every miss and every lucky guess, write three lines:
- The clue you used and the clue you should have used.
- Why your answer was wrong, in one sentence, before you look anything up.
- The type of miss: knowledge (you did not know the fact), reasoning (you knew it but chose the wrong next step) or timing (you rushed or ran out).
Look up the knowledge misses in your question bank or a reference. Reasoning misses are the ones worth bringing to a tutor. In our sessions Sean works through items like these live and asks you to commit to an answer before reading the options, which shows quickly whether the problem is what you know or how you decide.
When to take it, and what to do about CCS
Most residents use the Free 137 in the last one to two weeks before the exam, after their question bank and any NBME self-assessment, as a dress rehearsal for format and pace. If your test date is less than a week away, take at least the Day 1 blocks; the biostatistics and abstract items are where unfamiliar formats cost the most time.
The Free 137 does not prepare you for CCS. For that, use the six CCS practice cases in USMLE’s interactive materials (USMLE Step 3 common questions) until ordering, advancing the clock and changing location feel routine. If you also want to see a real test center before exam day, USMLE lets registered examinees book a Prometric practice session for a fee (USMLE). For how the Free 137 fits into a whole plan, see our Step 3 study plan and the Step 3 format guide.