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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.


State board sponsorship for Step 3 discontinued

Posted: October 14, 2013
Updated: October 22, 2014

With the introduction of the restructured Step 3 examination in 2014, the USMLE program no longer requires examinees to apply for Step 3 under the eligibility requirements of a specific medical licensing authority.

All other Step 3 eligibility requirements (i.e., medical degree, passing Steps 1-2, ECFMG certification for IMGs) remain applicable, as do all other USMLE program requirements (e.g., no more than 6 attempts at a Step or a Step component).

Note: Removing state board sponsorship as part of the Step 3 examination application does not impact medical licensing requirements in the United States. Most medical licensing authorities have, and will continue to maintain, specific criteria for completion of the USMLE, such as time and attempt limits. A summary of these requirements can be found on the Federation of State Medical Boards website.

At this time, there are no plans for the USMLE program to impose a minimum residency training requirement as part of the Step 3 eligibility criteria. However, the USMLE program will likely continue to recommend that individuals take Step 3 at or near the completion of the first year of residency training.


A message about the Ebola outbreak for individuals scheduled to take USMLE Step 2 Clinical Skills (CS)

Posted: October 21, 2014

The United States Centers for Disease Control (CDC) has issued travel notices for several countries in connection with the Ebola Virus outbreak.   For the most current information concerning affected countries, please see http://wwwnc.cdc.gov/travel/diseases/ebola.

If you reside in or have recently traveled to any country subject to a travel notice, or if you might have come in contact with anyone with Ebola, and have concerns about your health and/or the health and safety of those with whom you might come in contact, you are strongly encouraged to contact your registering entity to reschedule your Step 2 CS examination, at no additional fee. Contact information is available at http://www.usmle.org/bulletin/communicating/.


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