The USMLE Step 2 CS (Clinical Skills) exam is conducted only in the United States. It is clinical case taking exam where the examinees are required to take a proper history, conduct a focussed physical exam and counsel the patient. After this a patient report needs to be written.
Exam Registration
Similar to the previous steps, applicants may register for Step 2 CS either online or via regular mail with the ECFMG. Once applicants are registered for the exam they are alloted a 1 year period during which they may take the exam. Since there are only 5 centers in US to take this exam, it is advisable to book the exam date 3-4 months in advance.
The centers at which the exam may be taken are – Philadelphia, Los Angeles, Chicago, Atlanta and Houston.
The candidates should be dressed in a professional attire and should wear a clean white coat without any identification on it. Men should preferably wear a tie.
Exam Design and content
There are 12 clinical encounters on a single exam day. All patients are normal people and are trained to simulate actual patients. The examinee is given 15 minutes for each clinical encounter followed by 10 minutes to write the case report. Out of the 12 encounters only 10 are scored. One clinical encounter is for experimental purpose.
The cases which an examinee faces are generally those which are frequently seen by primary care physicians in the United States. Therefore most of the clinical scenarios belong to one of the major clinical realms tested on Step 2CK (E.g Chest pain, Abdominal pain, drug refill, STD’s, cough, pediatric telephone encounter with mother, depression etc).
One point to note is that pelvic, rectal and female breast examination is prohibited and mention of this should be made in the case report if the examinee wishes to perform it.
The examinees are evaluated by the simulated patients (SP). These SP’s are given a checklist of all the necessary questions and physical examination related to the particular case and they tick the ones which have been performed by the examinee.
The examinee is tested in the following areas:-
- Integrated clinical Skills
- Spoken English Proficiency
- Communication and interpersonal Skills
The candidate is required to pass in all these areas separately. The time required to prepare is generally 1 – 2 months.
Result reporting
The Step 2CS exam result is reported as Pass / Fail status. There is no 2 or 3 digit score as in Step 1 or Step 2 CK.
