USMLE Step 2 CS Exam

Step 2 CS


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:

Integrated Clinical Encounter (ICE)

  • Data gathering - patient information collected by history taking and physical examination
  • Documentation - completion of a patient note summarizing the findings of the patient encounter, diagnostic impression, and initial patient work-up

Communication and Interpersonal Skills (CIS)

  • Questioning skills
  • Information-sharing skills
  • Professional manner and rapport

Spoken English Proficiency (SEP)

  • Clarity of spoken English communication within the context of the doctor-patient encounter

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.

Eligibility Criteria

To be eligible for Step 2 CS, you must be in one of the following categories at the time of application and on the test day:

  • a medical student officially enrolled in, or a graduate of, a US or Canadian medical school;
  • program leading to the MD degree that is accredited by the Liaison Committee on Medical Education (LCME);
  • a medical student officially enrolled in, or a graduate of, a US medical school leading to the DO degree that is accredited by the American Osteopathic Association (AOA); or
  • a medical student officially enrolled in, or a graduate of, a medical school outside the United States and Canada and eligible for examination by the ECFMG.
Disclaimer The information presented on this page is taken from the official USMLE website

Please refer to the official USMLE website for more information on Applying for the Test, Scheduling Your Test Date and up-to-date test information.