USMLE™ Step 2 CS

What You Need to Know to Prepare

About the USMLE Step 2 Clinical Skills Exam

The USMLE ™ Step 2 CS exam assesses a candidate’s knowledge, skills, and understanding of the clinical science essential for the provision of patient care under supervision and emphasizes health promotion and disease prevention. It is used to demonstrate that a student has the foundation necessary for practicing safe and competent medicine.

The USMLE Step 2 CS (Clinical Skills) uses standardized patients to test a student’s ability to gather information, perform physical examinations, and communicate their findings to patients and colleagues. The exam is structured around three parameters: ICE = Integrated Clinical Encounter, CIS = Communication and Interpersonal Skills and SEP = Spoken English Proficiency.

Scheduling and Studying for the Step 2 CS Exam

To take the USMLE Step 2 Clinical Skills, you’ll need to book your exam and travel accommodations well in advance.

  • Plan to take the CS 2 before July 15th in the year you intend to apply for residency. If you don’t, your score will not be reported until October 11th, which will be too late to include with your application to residency programs.
  • Make sure you register with the correct organization.
  • The cost of the exam is expensive (up to $1,565), so make sure you have prepared financially ahead of time.
  • Refer to the Step 2 CS calendar and book an appointment early, as dates for the Step 2 CS are usually booked up to 6 months in advance. Look for an appointment about half a year before you want to take the test and grab it (you can reschedule free of charge up to 15 days before the exam). The test must be taken in the US and is available to take only in the following cities’ test centers:
    • Atlanta, GA
    • Chicago, IL
    • Houston, TX
    • Los Angeles, CA
    • Philadelphia, PA

New USMLE Step 2 CS Scoring Guidelines

While the pass rate for the Step 2 Clinical Skills is traditionally very high for US medical students, the test recently underwent a change in performance standards that affects students and graduates who take it after September 10, 2017. Under the new standards, it is expected that the overall pass rate will drop by approximately 3% for examinees from US medical schools, and by approximately 8% for those from international medical schools.

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Taking the Step 2 CS Exam

The CS exam is one day long and is made up of 12 standardized patient encounters (and possibly some supplemental multimedia content). In general:

  • Each encounter includes 15 minutes for a history, a physical exam, and patient counseling.
  • Each encounter also includes 10 minutes for writing a patient note, which consists of a differential diagnosis and workup.

You will receive two 15 minute breaks and one 30 minute break for lunch.

Students will be graded on and must pass all three of the following areas in order to pass the Step 2 CS exam:

1. ICE = Integrated Clinical Encounter

2. CIS = Communication & Interpersonal Skills

3. SEP = Spoken English Proficiency

For more information, here is a helpful video from the USMLE on the Step 2 CS.

For TIPS & TRICKS during the exam, visit the AMBOSS Step 2 CS Tips & Tricks Learning Card.

How to Study for the Step 2 Clinical Skills Exam

Traditionally, Step 2 CS study resources are in paperback form, with few robust digital options available. Below is a list of popular options amongst students preparing for the exam:

  • FirstAid for the® USMLE Step 2 CS (book)
  • Kaplan® USMLE Step 2 CS Strategies, Practice & Review (book)
  • Bates’ Guide® to Physical Examination and History Taking

Until recently, alternatives to books have included classes offered by some medical schools, expensive in-person classes, and minimal digital resources only offering a few cases.

However, your AMBOSS account also includes a comprehensive study package tailored specifically to help you master the Clinical Skills exam.

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