We urge all prospective examinees to read the 2019 USMLE Bulletin of Information the Content Description and General Information Booklet and watch the Step 2 CS Orientation Video and the USMLE Security Video. Here is important information you must be aware of before applying for the USMLE Step 2 CS:

Step 2 CS recheck

If you apply for a Step 2 CS recheck, understand that the process involves retrieval of the RATINGS that the examinee received from the SPs and from the physician note raters. These values are re-summed and re-converted into final scores, in order to confirm that the reported pass/fail outcome was accurate. There is NO re-rating of the original encounter or of the patient note. Videos are NOT used in the score recheck process. So essentially, rechecking is simply recalculation. Therefore a change in outcome is very rare.

Attempt limits

There are new attempt limits that apply to ALL steps of the USMLE exam. As per new rules, you may take the same examination no more than THREE times within a 12-month period. An examinee will be ineligible to take a Step or Step Component if the examinee has made SIX or more prior attempts to pass that Step or Step Component, including incomplete attempts.

Step 2 CS scheduling system

The system does not allow an applicant to reserve his/her testing appointment for another applicant. We recommend that you utilize the Step 2 CS Scheduling Email Notification System, which allows registered applicants to indicate their preferences for test dates and centers. There are now apps available that automatically refresh/watch the CS scheduling system for you in order to secure your preferred date.

Typed Patient Notes 

As of July 17, 2011, all examinees taking the Step 2 CS will be required to TYPE the patient note. Written patient notes are no longer being utilized except in cases of examinees who have a disability or computer malfunction.

Examination fees increase 

Examination fees are now $1290 for American students and $1565 for IMGs.

MAJOR CHANGES HAVE BEEN MADE to the USMLE STEP 2 Clinical Skills Exam after June 17th, 2012

Patient Note format

A new patient note format has been introduced. Click here for the interactive practice patient note simulation.

CIS component

This component has been redesigned to assess a fuller range of competencies. Look for an upcoming article regarding this subject on our blog.

ICE component

There are indeed new changes to the ICE component as well, although most examinees are not aware of this.

As of January 1st 2013 there are new changes to scoring

DSM-V Criteria

The new 5th edition of the DSM was released in May 2013. USMLE testing content and terminology will be impacted by changes made in all exams starting in 2014 from the transition of DSM-IV to DSM-V Criteria.

Unified Content Outline

All USMLE exams will begin to utilize a new Unified Content Outline in 2014 consisting of 18 general principles and organ systems.

3 breaks

There are now THREE breaks during the exam instead of two. The 1st break is after the 3rd encounter and is 10 minutes long. The 2nd break is after the 6th encounter and is a 30 minute break with a light lunch provided. The 3rd and final break is after the 9th case and is 10 minutes long.

Rescheduling Fees

Rescheduling Fees have been revised. There is NO fee if rescheduling your exam date is more than 2 weeks prior to your exam date. Therefore this “2 week window” is a key time-frame to keep in mind when formulating your study plan. If you decide to reschedule between 3-14 days notice then the fee will be $400. If it is 2 days notice the fee will be $642.50. If it is anywhere within 24hrs of notice the fee will be $1285.

USMLE Security

The USMLE has provided new information regarding security and violations in and outside the examination center. Please click HERE for more information. We urge all prospective examinees to watch the video.

Digital Images

SPs may present examinees with digital images from a touchscreen tablet computer during history taking. This may be a photograph, X-ray, MRI or CT.

Examinees should be prepared to know how to enlarge images on the type of tablet used at the exam center. There is an opportunity during the exam orientation to gain familiarity of viewing and enlarging images using a sample image.

Not every exam session will include images. If a particular exam session does include an image, there will be a maximum of one case with images per exam session.

Enhanced Security Procedures

All eyeglasses and simple hair accessories are now subject to visual inspection by test center administrators. Ornate hair clips, combs, headbands and barrettes are prohibited. All types of jewelry are now prohibited except for wedding or engagement rings. Any of these items can be stored in the storage locker before the exam begins.

New CIS Targeted Cases

Starting May 21, 2017,  examinees may see a case in which the primary goal is to assist the SP with "making decisions" or a challenge based on disease/problem management. In these cases you will not have to perform a physical examination.

Not every exam session will include this type of case. If a particular exam session does include one, there will be a maximum of one case of this type per exam session.

As of September 10tH 2017 there are new changes to scoring

Changes to the Patient Note Program

Starting September 10, 2017, the patient note will now "auto-submit" at the end of the total 25 minutes allotted for each case. Examinees will no longer end the encounter by having to "submit" the patient note manually.

Just as before, examinees that leave the patient encounter before 15 minutes have expired, will have this additional time added to the 10 minutes allotted for the patient note.

The new patient note program will also incorporate a new countdown timer in the right hand corner that will display how much time remains. There will still be a 2 minute audible warning through the overhead speakers. When the countdown timer reaches 30 seconds, the color of the timer will turn red and blink till the time runs out. Once the patient note "auto-submits" you will not be able to type any characters. An updated online patient note program is available on the USMLE website for examinees to practice with.

List of commonly presenting signs and symptoms

A list has now been provided that includes the most commonly presenting signs and symptoms used in patient encounters. Please click HERE to see the list.

Step 2 CS Sample Videos

The USMLE has provided brief sample videos. The examinees in the videos demonstrate what would be considered an “acceptable level” of performance by the USMLE. Please click here to see the sample videos.

New changes for the USMLE Step 2 CS continue to be researched and developed. The Clinical Skills Evaluation Collaboration review committee has historically implemented changes with little to no warning; so be aware that anything is subject to change at any time.

We realize that these new changes may be confusing to most examinees. Information regarding changes in format and scoring is vague and limited. Not all literature has been updated on these new changes. You have found the right source. YES! We are now using our NEW modified curriculum that tackles the new format. You are assured that STEP2IT incorporates the latest information and cutting edge strategy so that you will be fully prepared for TODAY'S exam.

In the last few years the entire USMLE process has rapidly evolved at an even accelerated pace than previous years. All indications are that this trend will continue. We will update this page as we learn more.


Resources: http://www.usmle.org/ http://ecfmg.org/ http://www.nbme.org