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100+ Free APMLE Part III Practice Questions

Pass your American Podiatric Medical Licensing Examination Part III (Licensure) exam on the first try — instant access, no signup required.

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A 60-year-old has severe pes cavus with multiple ulcers on lateral foot, weakness of peroneal muscles. Best biomechanical orthotic prescription:

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B
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APMLE Part I Basic Sciences (Podiatry)

Practice Questions

APMLE Part II Clinical (Podiatry)

Practice Questions
2026 Statistics

Key Facts: APMLE Part III Exam

200 (150 scored)

Total / Scored Items

APMLE Part III Candidate Bulletin (Meazure)

4 hr

Content Time

Meazure Learning APMLE Part III administration

28%

Medicine Weight

Largest single domain on Part III outline

75

Scaled Passing Score

Set by NBPME for all APMLE parts

$925

Exam Fee

APMLE 2024-2026 fee schedule

PGY-1

Typical Timing

Taken during or after first year of podiatric residency

MA/FL/IL

Pre-Approval States

Require state board approval before Part III testing

APMLE Part III is the case-based final licensure exam for podiatric medicine, taken during residency. It contains 200 items (150 scored, 50 pretest) over 4 hours and is heavily clinical, with case scenarios, radiographs, and photographs. The blueprint is Medicine 28%, Surgery 26%, Orthopedics/Biomechanics 22%, Imaging 15%, Anesthesia 9%. A scaled score of 75 is required to pass; the fee is $925 and Meazure Learning administers the exam. Some states (MA, FL, IL) require board approval before testing.

Sample APMLE Part III Practice Questions

Try these sample questions to test your APMLE Part III exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 62-year-old diabetic with HbA1c 9.4% has a 3-week-old plantar 2nd metatarsal head ulcer (2 cm, full thickness, exposed tendon). Probe-to-bone is positive. WBC 12,500, ESR 92, CRP 8.5. X-ray shows cortical erosion of the 2nd metatarsal head. Next best step is:
A.Outpatient oral cephalexin alone
B.Admit for IV antibiotics (vanco + pip-tazo), MRI to define osseous extent, surgical debridement with bone biopsy/culture, glucose control, vascular workup
C.Wait 2 weeks and reassess
D.Topical silver dressing only
Explanation: Positive probe-to-bone with elevated inflammatory markers and cortical erosion strongly suggests osteomyelitis. IDSA recommends admission for IV broad-spectrum antibiotics covering MRSA and gram-negatives (and anaerobes if deep), MRI for osseous extent, surgical debridement with bone biopsy/culture to direct therapy, glycemic optimization, and vascular workup (ABI/TBI). Oral monotherapy is insufficient for moderate-severe DFI with osteomyelitis.
2A 70-year-old has rest pain in the forefoot at night relieved by hanging foot over the bed, with shiny atrophic skin and absent pedal pulses. ABI 0.32. The next step is:
A.Discharge to PT for exercise
B.Urgent vascular surgery consult for revascularization (CLI: chronic limb-threatening ischemia)
C.Cast immobilization
D.Start gabapentin
Explanation: Rest pain (Rutherford 4), ABI less than 0.4, and trophic skin changes define chronic limb-threatening ischemia (CLI). Urgent vascular surgery consult for revascularization (endovascular or surgical bypass) is critical to prevent tissue loss and amputation. Medical optimization (antiplatelet, statin, smoking cessation) is necessary but does not replace revascularization in CLI.
3A 55-year-old diabetic presents with hot swollen midfoot, no ulcer, temperature 99.8F. X-ray shows fragmentation of the Lisfranc complex with subluxation. MRI shows marrow edema and no soft-tissue collection. WBC normal. The most likely diagnosis is:
A.Osteomyelitis
B.Acute Charcot neuroarthropathy (Eichenholtz stage 1)
C.Gout flare
D.Septic arthritis
Explanation: Acute Charcot in a diabetic with neuropathy presents with warm, swollen, often erythematous foot - frequently mistaken for cellulitis or osteomyelitis. The absence of skin ulcer, normal WBC, and characteristic midfoot fragmentation/subluxation on imaging support Charcot. Differentiation from osteomyelitis is helped by WBC scan, FDG-PET, or biopsy when needed. Treatment: immediate offloading with total contact cast and orthopedic referral.
4A 45-year-old with end-stage ankle arthritis (post-traumatic) has tried bracing, NSAIDs, and injections without relief. Imaging shows global ankle joint destruction, preserved subtalar joint, neutral hindfoot alignment, no avascular necrosis. The best surgical option is:
A.Subtalar arthrodesis
B.Total ankle arthroplasty or ankle arthrodesis based on patient activity demands, age, and surgeon experience
C.Lateral ankle ligament reconstruction
D.Triple arthrodesis
Explanation: End-stage isolated ankle arthritis is treated with either total ankle arthroplasty (TAA) or ankle arthrodesis. TAA preserves motion, reduces adjacent-joint arthritis, and is preferred in lower-demand older patients with good bone stock and neutral alignment. Arthrodesis is preferred in young high-demand patients, avascular necrosis, severe deformity. Preserved subtalar joint helps both options.
5A 25-year-old soccer player has chronic lateral ankle pain after multiple sprains. Physical exam shows positive talar tilt and anterior drawer; subtalar instability also suspected. MRI shows ATFL, CFL tears, and posterior facet effusion. Best surgical approach is:
A.Modified Brostrom-Gould lateral ligament reconstruction with anatomic ATFL and CFL repair plus inferior extensor retinaculum augmentation; consider subtalar arthroscopy
B.Triple arthrodesis
C.Cast immobilization for 6 months
D.Achilles tendon repair
Explanation: Chronic lateral ankle instability after failed conservative therapy is best treated with anatomic Brostrom-Gould repair of ATFL and CFL. Subtalar instability may co-exist and warrants arthroscopic evaluation. Tendon graft reconstruction (e.g., allograft Chrisman-Snook modification) is reserved for failed Brostrom or hyperlaxity. Concurrent peroneal pathology and cavovarus must be addressed.
6An 18-year-old athlete sustained an inversion ankle injury and now has lateral pain. X-ray shows a small fleck of bone off the lateral malleolus distal tip; otherwise normal. The most likely diagnosis is:
A.ATFL avulsion fracture
B.Lisfranc injury
C.Calcaneal stress fracture
D.Talar dome OCD
Explanation: A small bony fleck at the distal lateral malleolus after inversion injury represents an avulsion of the ATFL. Treatment is generally the same as a high-grade ATFL sprain: functional rehabilitation with brace, early ROM, peroneal strengthening, and proprioceptive training. Large fragment or chronic instability may need fixation or ligament reconstruction.
7A 38-year-old runner has anterior shin pain for 6 weeks, worse with running, with focal tenderness at the anterior mid-tibia. X-ray shows the dreaded black line on the anterior cortex. The most appropriate management is:
A.Continue running with NSAIDs
B.Strict rest, non-weight-bearing, and consideration of surgical intramedullary nailing given high nonunion risk
C.Single steroid injection
D.Achilles tendon stretching
Explanation: The dreaded black line is a transverse anterior tibial cortex stress fracture on the tension side - high-risk for nonunion or complete fracture. Treatment requires non-weight-bearing, prolonged rest (often 4-6 months), and consideration of IM nailing or drilling for high-demand athletes or progression to nonunion. Bone health workup (vitamin D, calcium, RED-S evaluation) should be done.
8A 32-year-old male with chronic Achilles tendinopathy refractory to PT and orthotics for 8 months. Ultrasound shows non-insertional thickening with neovascularization. The next step is:
A.Eccentric loading protocol if not already done, plus extracorporeal shockwave therapy or platelet-rich plasma injection; surgical debridement with gastrocnemius recession for refractory cases
B.Corticosteroid injection into the tendon
C.Complete bedrest for 6 months
D.Total ankle arthroplasty
Explanation: Chronic non-insertional Achilles tendinopathy is managed initially with eccentric calf loading (Alfredson protocol, gold standard), then ESWT or PRP for refractory cases. Surgical debridement of degenerative tendon with possible FHL transfer (for greater than 50% involvement) or gastroc recession (if equinus) is reserved for refractory cases. Steroid injection into the Achilles is contraindicated due to rupture risk.
9A 50-year-old has insidious onset medial heel pain worse with first steps in morning, improves with walking, recurs after rest. Tender at medial calcaneal tubercle. The first-line treatment is:
A.Plantar fascia surgery
B.Stretching (plantar fascia-specific and Achilles), supportive shoes, OTC arch supports, NSAIDs, night splints
C.MRI
D.Steroid injection
Explanation: Classic plantar fasciitis is managed conservatively with plantar fascia-specific stretching (morning before standing), Achilles stretching, supportive shoes, OTC arch supports/orthotics, NSAIDs, night splints. About 80-90% resolve within 6-12 months. Steroid injection considered for refractory pain (carries rupture and fat pad atrophy risk). Surgery (partial fasciotomy + gastroc recession if equinus) for greater than 6-12 months conservative failure.
10A 60-year-old with hallux valgus (IMA 16, HVA 38, congruent joint, no degeneration) wants definitive correction. Most appropriate procedure is:
A.Austin (Chevron) distal osteotomy
B.Proximal first metatarsal osteotomy (closing/opening base wedge or crescentic) or Lapidus arthrodesis combined with distal soft-tissue release
C.Keller arthroplasty
D.Cheilectomy
Explanation: Severe hallux valgus (IMA greater than 15, HVA greater than 30) requires proximal first metatarsal correction (proximal osteotomy or Lapidus first TMT arthrodesis) combined with distal soft-tissue release (lateral capsule release, adductor tenotomy, sesamoid release). Distal osteotomies (Austin) cannot adequately correct severe deformity. Keller and cheilectomy are inappropriate for severe HV without arthritis.

About the APMLE Part III Exam

APMLE Part III is the final licensure exam in the APMLE series and is taken during or after PGY-1 of a podiatric medical residency. It uses case presentations with radiographs and photographs to evaluate clinical competence across five domains: Medicine (28%), Surgery (26%), Orthopedics & Biomechanics (22%), Medical Imaging (15%), and Anesthesia (9%). Passing Part III is required for podiatric medical licensure in most U.S. jurisdictions.

Questions

200 scored questions

Time Limit

4 hours (up to 5 hours total with check-in and unscheduled breaks)

Passing Score

75 scaled score set by the NBPME (150 of 200 items scored)

Exam Fee

$925 per attempt (National Board of Podiatric Medical Examiners (NBPME), delivered by Meazure Learning)

APMLE Part III Exam Content Outline

28%

Medicine

Diabetic foot complications, infectious disease (cellulitis, osteomyelitis), vascular disease, dermatology, rheumatology, internal medicine impacting podiatric care

26%

Surgery

Forefoot/midfoot/rearfoot/ankle reconstruction, trauma fixation, surgical complications, revision surgery, and case-based surgical decision-making

22%

Orthopedics and Biomechanics

Gait analysis, orthotic prescription, pediatric foot deformities, sports medicine, conservative musculoskeletal management

15%

Medical Imaging

Radiograph, MRI, CT, ultrasound, and bone-scan interpretation in case-based decision-making

9%

Anesthesia

Local anesthetics, regional blocks (ankle, popliteal), sedation, general anesthesia considerations, and pain management

How to Pass the APMLE Part III Exam

What You Need to Know

  • Passing score: 75 scaled score set by the NBPME (150 of 200 items scored)
  • Exam length: 200 questions
  • Time limit: 4 hours (up to 5 hours total with check-in and unscheduled breaks)
  • Exam fee: $925 per attempt

Keys to Passing

  • Complete 500+ practice questions
  • Score 80%+ consistently before scheduling
  • Focus on highest-weighted sections
  • Use our AI tutor for tough concepts

APMLE Part III Study Tips from Top Performers

1Use case-based resources - Part III is heavy on multi-step case scenarios with radiographs, so read McGlamry's Foot and Ankle Surgery and PRESENT e-Learning podiatry cases
2Prioritize Medicine (28%) and Surgery (26%) - together they are over half the exam; build differentials for diabetic foot, vascular insufficiency, and forefoot surgery
3Drill imaging interpretation: stress fractures on MRI, osteomyelitis bone-marrow edema, Charcot patterns, Lisfranc injury on weight-bearing views
4Review ankle and popliteal block anatomy, dosing of lidocaine vs bupivacaine with epinephrine, and maximum safe doses by body weight
5Practice answering case stems efficiently - read the lead-in question first, then scan the vignette for the relevant data
6Pay attention to state-specific scope of practice issues, especially if you plan to license in Florida, Massachusetts, or Illinois (board pre-approval states)
7Use Statpearls APMLE Part 3 question bank and AENS/ACFAS clinical practice guidelines as evidence-base references
8Take at least one full-length 200-item timed practice exam to confirm 72-second-per-item pacing under case-based fatigue

Frequently Asked Questions

When can I take APMLE Part III?

After passing Parts I and II. Part III is taken during or after PGY-1 of a podiatric medical residency. Some states (Massachusetts, Florida, Illinois) require board approval before testing.

How many questions are scored?

The exam contains 200 items; 150 are scored and 50 are unscored pretest items used for future test development. Candidates do not know which items are scored versus pretest.

How is Part III different from Parts I and II?

Part III is case-based and emphasizes clinical decision-making. It uses extended case presentations with radiographs and photographs to evaluate evaluation, diagnosis, and treatment of patients across the full scope of podiatric practice.

How is Part III scored?

Scaled scoring with a passing standard of 75 set by the NBPME. Scores are based on the 150 scored items and release through the Meazure Connect portal on scheduled dates.

What is the exam time?

4 hours of content time. Up to 1 additional hour is available for check-in, unscheduled breaks, and the end-of-exam questionnaire, for up to 5 hours total at the testing center.

How much does Part III cost?

$925 per attempt. The same Meazure rescheduling fee structure applies: $50 reschedule or $100 transfer more than 28 days out, same fees 11-28 days, no refunds within 10 days.

Is Part III required for licensure?

Yes. Part III is required for podiatric medical licensure in nearly all U.S. jurisdictions. Some states have additional requirements such as a state jurisprudence exam or board interview.

Where is Part III administered?

At Meazure Learning testing centers nationwide. Candidates receive a Notice to Schedule (NTS) approximately 60 days before the published exam date and schedule through the Meazure Connect portal.