USMLE Step 2 Clinical Skills

Step 2 Clinical Skills (Step 2 CS) of the United States Medical Licensing Examination (USMLE) is an exam that is currently administered to medical students/graduates who wish to become licensed physicians in the U.S.. It is comparable to the COMLEX-USA Level 2-PE exam, taken by osteopathic medical students/graduates who seek licensure as physicians in the U.S. From January 2011, the registration fee for the test is $1,355. Historically, US students have taken Step 2 CS late in their senior year, prior to graduation. However, some residency programs (such as those at the University of California, San Francisco) now require students to record a passing score for both Step 2 CS and CK prior to February 15 of the application year. This has led some US medical schools in 2009 and 2010 to begin recommending that students take Step 2 CS in the Fall of their senior year.

Structure

The USMLE Step 2CS exam consists of a series of patient encounters in which the examinees must see standardized patients (SPs), take a history, do a physical examination, determine differential diagnoses, and then write a patient note based on their determinations. The topics covered are common outpatient or Emergency Room visits which are encountered in the fields of internal medicine, surgery, psychiatry, pediatrics, and obstetrics and gynecology. Examinees are expected to investigate the simulated patient's chief complaint, as well as obtain a thorough assessment of their past medical history, medications, allergies, social history (including alcohol, tobacco, drug use, sexual practices, etc.), and family history. Usually, examinees have one telephone encounter, speaking to an SP through a microphone during which there is no physical exam component.