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Clarification on completing the Step 2 Clinical Skills (CS) patient note

Posted: January 02, 2013

Changes were introduced to the Step 2 CS examination program in mid-June 2012. These included changes to the patient note that examinees must complete after each standardized patient encounter.

As described in the Step 2 CS Content Description and General Information booklet, examinees should record pertinent medical history and physical examination findings obtained during the encounter, as well as initial differential diagnoses (maximum of three). The diagnoses should be listed in order of likelihood, most likely to least likely. Examinees should also indicate the pertinent positive and negative findings obtained from the history and physical examination to support each potential diagnosis. 

To clarify previous language about USMLE expectations for examinees completing the patient note: while it is acknowledged that it is important for a physician to be able to recognize the findings that rule out certain diagnoses, the task for Step 2 CS examinees at this time is to record only the most likely diagnoses along with findings (positive and negative), that support them.

Additional information about the Step 2 CS examination, and about all USMLE examinations, is available in the USMLE Bulletin of Information.

Instructions for completing the patient note, as well as a simulation program for practicing the note, and sample patient notes, are available in the Practice Materials section of the USMLE website.


Step 2 Clinical Skills (CS) Content Description and General Information booklet

Posted: February 10, 2015

An updated version of the Step 2 Clinical Skills (CS) Content Description and General Information booklet is available.


Scheduling Reminder for Step 2 CS

Posted: February 04, 2015

Schedules at all test centers fill up quickly. We strongly encourage examinees to complete their scheduling before May 31 of the calendar year in which they plan to test. Testing appointments are typically completely filled at least three to four months in advance. If you try to schedule after August 1, you may find that there are no available testing appointments through the end of the year unless there are cancellations.

More information is available in the Applying for the Test and Scheduling Your Test Date section of the Bulletin of Information.


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