Clarification on Completing the Step 2 Clinical Skills (CS) Patient Note
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.
Test-taking Reminders for Step 2 Clinical Skills (CS) Examinees
In December 2011 USMLE announced a number of changes to the Step 2 Clinical Skills (CS) examination program; these were implemented in mid-2012.
It is important for examinees to focus on the specific details of each case when interacting with standardized patients. Their actions should be guided by case details and by the information gathered from the standardized patient and from physical findings. Disregard for details of the case, as well as unfocused history questions or physical examination maneuvers, will likely make it difficult to manage testing time properly and may result in a lower score.
The December 2011 announcement also described changes to the Communication and Interpersonal Skills (CIS) subcomponent of the examination, which assesses an examinee’s performance in five functions. Examinees should be attentive to these functions throughout their interactions with the standardized patients.
In addition, the December 2011 announcement described changes to the patient note that is completed after each standardized patient encounter. Please note that examinees are expected to complete all components of the patient note. An incomplete patient note can result in a lower score.
Examinees can find information on what to expect during their Step 2 CS experience, and for all USMLE examinations, in the USMLE Bulletin of Information. Additional information about the Step 2 CS examination is available in the Step 2 Clinical Skills Content Description and General Information booklet.
ECFMG 2013 Information Booklet and Application Materials Are Available
The ECFMG 2013 Information Booklet and the 2013 exam application materials are now available on the ECFMG website.
For Step 1/Step 2 CK, you can use the 2013 materials to apply for:
- available Step 1/Step 2 CK eligibility periods ending in 2012 (September 2012-November 2012 and October 2012-December 2012) and
- all Step 1/Step 2 CK eligibility periods ending in 2013, beginning with the November 2012-January 2013 eligibility period.
For Step 2 CS, you can use the 2013 materials to obtain a 12-month eligibility period that begins on the date that the processing of your application is completed.
(posted August 1, 2012; updated September 12, 2012)
Updated Step 2 CK Tutorial and Practice Multiple Choice Questions Available
An updated Step 2 Clinical Knowledge (CK) tutorial and practice multiple choice questions have been posted to the USMLE website.
Updated Practice and Orientation Materials for Step 2 Clinical Skills (CS) Exam Have Been Posted
March 23, 2012
Filed under: 2012 Information Booklet Updates, Comprehensive Review of USMLE, Exam Preparation, Step 2 CS
Filed under: 2012 Information Booklet Updates, Comprehensive Review of USMLE, Exam Preparation, Step 2 CS
As previously announced, a new patient note and redesigned Communication and Interpersonal Skills subcomponent will be introduced in the USMLE Step 2 CS examinations beginning June 17, 2012. Updated practice and orientation materials reflecting these changes have been posted to the USMLE website.
Examinees who plan to take the Step 2 CS examination on or after June 17, 2012 should review the updated materials, which include:
• An updated version of the CS Content Description and General Information booklet
• An updated onsite orientation CS video
• A new version of the practice patient note program
• New sample patient notes
View full announcement on the USMLE website.
Mid-2012 Temporary Shutdown of Step 2 Clinical Skills (CS) Testing; Score Report Delay for Examinees Testing June 17, 2012 through November 3, 2012
March 23, 2012
Filed under: 2012 Information Booklet Updates, Comprehensive Review of USMLE, Exam Preparation, Step 2 CS, USMLE Score Reporting
Filed under: 2012 Information Booklet Updates, Comprehensive Review of USMLE, Exam Preparation, Step 2 CS, USMLE Score Reporting
As previously announced, changes to the Step 2 Clinical Skills (CS) examination are scheduled for implementation beginning June 17, 2012. As a consequence of the introduction of these changes, exam scheduling and result reporting will be impacted for some individuals.
- There will be no Step 2 CS examinations delivered from May 20 through June 16, 2012.
- The interval between testing and score reporting for examinees testing from June 17, 2012 through November 3, 2012 will be 2-3 weeks longer than for examinees testing during other periods.
- Examinees will continue to receive a graphical performance profile on the second page of their Step 2 CS score report. However, due to the need to accumulate data on these new changes over an extended period, individuals who test on or after June 17, 2012 will see less detailed feedback on their graphical performance profiles than has been provided to examinees in the past. The performance profiles are provided as an assessment tool for the examinee’s benefit and are not reported or verified to any third party. The profiles summarize relative areas of strength and weakness to aid in self assessment.
Please note that examinees who test on or before December 31, 2012 will have scores reported in time for the 2013 “Match.”
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.
REMINDER: New Rules on Repeating USMLE Examinations
December 28, 2011
Filed under: 2012 Information Booklet Updates, Exam Preparation, Step 1, Step 2 CK, Step 2 CS
Filed under: 2012 Information Booklet Updates, Exam Preparation, Step 1, Step 2 CK, Step 2 CS
ECFMG would like to remind applicants that the USMLE program is introducing new rules on repeating USMLE examinations.
Time between Examination Attempts
The USMLE program sets rules on how quickly examinees can repeat the same Step or Step Component. As previously published, these rules will change for exam applications submitted on or after January 1, 2012.
For exam applications submitted on or after January 1, 2012, the following rules will apply to all Steps and Step Components. You may take the same examination no more than three times within a 12-month period. Your fourth and subsequent attempts must be at least 12 months after your first attempt at that exam and at least six months after your most recent attempt at that exam. Attempts at that examination (complete and incomplete) prior to January 1, 2012 will be counted in determining whether these rules apply. When you reapply, your exam eligibility period will be adjusted, if necessary, to comply with these rules.
For more information and examples, view the full announcement.
Attempt Limit for USMLE Examinations
As previously published, the USMLE program is introducing a limit on the total number of times an examinee can take the same Step or Step Component. When this limit takes effect, 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.
The effective date for the six-attempt limit depends upon whether an examinee has taken any Step or Step Component (including incomplete attempts) before January 1, 2012.
- If you have not taken any Step or Step Component before January 1, 2012, the six-attempt limit will go into effect for all exam applications that you submit on or after January 1, 2012.
- If you have taken any Step or Step Component (including incomplete attempts) before January 1, 2012, the six-attempt limit will go into effect for all exam applications that you submit on or after January 1, 2013.
For more information and examples, view the full announcement.
Changes to the Step 2 Clinical Skills (CS) Examination
December 20, 2011
Filed under: 2012 Information Booklet Updates, Comprehensive Review of USMLE, Exam Preparation, Step 2 CS
Filed under: 2012 Information Booklet Updates, Comprehensive Review of USMLE, Exam Preparation, Step 2 CS
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:
- Fostering the relationship
- Gathering information
- Providing information
- Making decisions: basic
- 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 June 17, 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 (or refutes) 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.
Practice materials
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.
Field Trial of New Step 2 CS Assessment Formats
The National Board of Medical Examiners® (NBME®) is developing new assessment formats for use in its Step 2 Clinical Skills (CS) examination. A field trial of these new formats is planned between January 11 and January 23, 2012, at the National Board of Medical Examiners, Philadelphia, PA. This trial is primarily a test of new case formats and measurement instruments that will resemble USMLE Step 2 CS. It will give participants a chance to “practice” a clinical skills examination under USMLE conditions.
View full announcement on the USMLE website.
(posted September 9, 2011; updated December 7, 2011)
Important Information about Step 2 CS Testing and Score Reporting in 2012
October 3, 2011
Filed under: 2012 Information Booklet Updates, Exam Preparation, Step 2 CS, USMLE Score Reporting
Filed under: 2012 Information Booklet Updates, Exam Preparation, Step 2 CS, USMLE Score Reporting
As noted in the 2012 USMLE Bulletin of Information, changes to the assessment of communication skills and patient note are planned in mid-2012. In order to introduce these changes to the examination, there will be no Step 2 Clinical Skills (CS) examinations from May 20 through June 16, 2012.
Please note the following information regarding the testing schedule in the second half of 2012:
- Additional testing sessions – including evening and weekend sessions – have been added to the calendar before and after the May/June shutdown.
- 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.
- Examinees who test on or before December 31, 2012 will have results reported in time for the 2013 “Match.”
View the 2012 Step 2 CS score reporting schedule.