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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.


2016 schedule for reporting Step 2 Clinical Skills (CS) results is available

Posted: April 07, 2015

The 2016 schedule provides examinees, and others who rely on Step 2 CS results, with guidelines regarding when a result will be reported for a given exam date. Click here to view the schedule.


Expanded Version of USMLE Content Outline

Posted: April 06, 2015

An expanded version of the USMLE Content Outline, which provides a common organization of content across all USMLE examinations, is now available.

The expanded version provides additional detail about subcategories of the 18 sections of the content outline. It is important to note that the USMLE Content Outline is not intended as a curriculum development or study guide. It provides a flexible organization of content for test construction that can readily accommodate new topics, emerging content domains, and shifts in emphasis. The categorizations and content coverage are subject to change.

While the USMLE Content Outline is common to all exams, each exam continues to have its own test specifications. Each exam emphasizes certain parts of the outline, and no single examination will include questions on all topics in the outline.

Additional information about the organization of the USMLE examinations is provided in the USMLE Physician Tasks/Competencies, a publication that provides a common organization of competencies and tasks assessed in USMLE examinations. Also, information concerning content specifications for each Step examination is available:


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