USMLE Step 2 CS is designed to assess clinical skills through simulated patient interactions, in which the examinee interacts with standardized patients portrayed by actors. Each examinee faces 12 Standardized Patients (SPs) and has 15 minutes to complete history taking and clinical examination for each patient, and then 10 more minutes to write a patient note describing the findings, initial differential diagnosis list and a list of initial tests.
The Step 2 Clinical Skills (Step 2 CS) portion of the Step 2 exam assesses whether you can demonstrate the fundamental clinical skills essential for safe and effective patient care under supervision. There are three subcomponents of Step 2 CS:
Communication and Interpersonal Skills (CIS)
Spoken English Proficiency (SEP)
Step 2 CS uses standardized patients, i.e., people trained to portray real patients in the examination. You are expected to establish rapport with the patients, elicit pertinent historical information from them, perform focused physical examinations, answer patient questions, and provide counseling when appropriate. After each patient interaction, you will record pertinent history and physical examination findings, list diagnostic impressions, and outline plans for further evaluation, if necessary. The cases cover common and important situations that a physician is likely to encounter in common medical practice in clinics, doctors' offices, emergency departments, and hospital settings in the United States.
Test Length and Format
Step 2 CS has twelve patient cases. You will have fifteen minutes for each patient encounter and ten minutes to record each patient note. If you do not use the entire fifteen minutes for the patient encounter, the remaining time will be added to the time you have to record the patient note. The testing session is approximately eight hours. Step 2 CS cases must be taken in the order presented. After you exit the case or session, or when time expires, you can no longer review test items or cases, change answers, or collect additional information.
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