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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.

USMLE Step 2 is a one-day (8 hours) exam. Similar to the Step 1, the test items are divided into blocks, and test item formats vary within each block, with the total number of exam questions equaling to 355.

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