Changes to the Step 2 Clinical Skills (CS) examination
Posted: December 15, 2011
One of the recommendations emerging from the Comprehensive Review of USMLE (CRU) process is that USMLE consider ways to further enhance the testing methods used in the Step 2 Clinical Skills (CS) examination. As previously announced in the 2012 Bulletin of Information, these enhancements are scheduled for implementation in mid-2012. These changes will be introduced in Step 2 CS for examinations delivered beginning June 17, 2012.
The reporting schedule for examinees testing from June 17, 2012 through November 3, 2012 will be 2-3 weeks longer than for examinees testing during other periods.
More information about the Step 2 CS score reporting dates for examinations delivered in 2012 is provided in the Step 2 CS Score Reporting Schedule.
Changes to the assessment of Communication and Interpersonal Skills (CIS)
The CIS subcomponent of Step 2 CS has been redesigned to assess a fuller range of competencies. Background information about these changes is provided on pages 5-6 of the Fall 2010/Winter 2011 NBME Examiner. The new approach divides communication skills into a series of functions. These functions have been further divided into sub-functions. Beginning June 17, 2012, the Communication and Interpersonal Skills (CIS) scale will focus on five functions:
1. Fostering the relationship
2. Gathering information
3. Providing information
4. Making decisions: basic
5. Supporting emotions: basic
Several additional functions are still under development; these include making decisions: advanced; supporting emotions: advanced; and helping patients with behavior change. A list of the functions and sub-functions is available.
Changes to the patient note
Also beginning June17, 2012, a new patient note will be introduced. The patient note is completed by the Step 2 CS examinee after the encounter with the standardized patient. In the new note, examinees will continue to be asked to document relevant history and physical examination findings and to list initial diagnostic studies to be ordered. Examinees will also be asked to create a reasoned, focused differential (maximum of three diagnoses) listed in order of likelihood and to indicate the evidence obtained from the history and physical examination that supports each potential diagnosis. The new patient note provides examinees with an opportunity to document their analysis of a patient's possible diagnoses. A sample of the new patient note is available for review.
Updated practice materials for Step 2 CS will be posted to the USMLE website in March 2012. These include the Step 2 CS Content Description and General Information Booklet, onsite orientation video, sample patient notes, and a simulation of the program for typing patient notes.
Review of USMLE Step 2 Clinical Knowledge (CK) minimum passing score
Posted: May 17, 2013
As noted in the USMLE Bulletin of Information, the level of proficiency required to meet the recommended minimum passing level for each USMLE Step examination is reviewed periodically and may be adjusted at any time. Notice of such review and any adjustments are posted on the USMLE website.
Every three to four years the Step Committees are asked to complete an in-depth review of standards, and they may schedule more frequent reviews.
At its June 2012 meeting, the Step 2 Committee conducted a review for USMLE Step 2 Clinical Knowledge (CK). As a result of its review, the Step 2 Committee decided to raise the current minimum passing score recommended to pass Step 2 CK from 189 to 196. As previously reported, at that time the Committee decided to closely monitor the effects of this decision on examinees and schools, and to examine trends in performance on an annual basis.
The Committee will review the three-digit score recommended to pass Step 2 CK at its June 2013 meeting. If the Committee determines that a change is appropriate, the new recommended minimum passing score will become effective for all examinees who take a Step 2 CK examination on or after July 1, 2013.
USMLE Step 1 Score Reporting
Posted: March 25, 2013
Most score reporting of Step 1 results occurs within four weeks of testing. However, because of necessary modifications to the test item pool, there will be a delay in reporting for some examinees testing beginning the week of May 13th. The target date for reporting Step 1 scores for most examinees testing the week of May 13th through late June will be Wednesday, July 10, 2013. For examinees whose circumstances require that they receive Step 1 scores before July 10, it is recommended that they take Step 1 no later than May 10, 2013.