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UPDATE - Review of USMLE Step 2 Clinical Skills minimum passing performance

Posted: January 24, 2017
Updated: April 19, 2017

Because severe winter weather resulted in cancellation and rescheduling of one of the standard setting panels that review test content for the USMLE Step 2 Clinical Skills (CS) examination, dates for the review by the USMLE Management Committee and for possible changes in the recommended minimum passing requirements to take effect have changed. Please see below for new dates.

The USMLE program recommends a minimum passing level for each Step examination. The USMLE Management Committee is responsible for establishing and monitoring these standards, and is asked to complete an in-depth review of standards for each examination every three to four years.

For the 2017 Step 2 Clinical Skills (CS) review, information from multiple sources will be considered, including:

  • Results of content-based standard setting exercises conducted with three groups of physicians who have not previously participated in USMLE test committees;
  • Results of surveys of various groups (e.g., samples of examinees, state licensing representatives, medical school faculty) concerning the appropriateness of current pass/fail standards for Step examinations;
  • Trends in examinee performance;
  • Score precision and its effect on the pass/fail outcome.

The USMLE Management Committee is scheduled to review the minimum passing requirements for the USMLE Step 2 CS examination at its July 29 - August 1 meeting (originally scheduled for May 2017).

If the Committee determines that a change is appropriate, the new recommended minimum passing requirements will become effective for all examinees who take a Step 2 CS examination on or after September 10, 2017 (originally July 16, 2017.)

The decision of the Committee will be posted on the USMLE website immediately following the July 29 - August 1 meeting.


Step 2 CS cases – common presenting signs and symptoms

Posted: September 10, 2017

A list of common presenting signs and symptoms that Step 2 Clinical Skills (CS) examinees may expect to see during their examination has been posted to the USMLE website. These are examples only, and the list does not represent all possible presenting signs and symptoms that may be encountered.

The Step 2 Clinical Skills Content Description and General Information booklet has been revised to include this list.

Examinees will encounter a broad spectrum of cases reflecting common and important symptoms and diagnoses, as well as patients with a variety of backgrounds. The criteria used to create individual examinations focus primarily on presenting symptoms and conditions. On any examination day, the set of cases will differ from the combination presented the day before or the following day, but each set of cases has a comparable degree of difficulty.

Presentation categories include, but are not limited to, cardiovascular, constitutional, gastrointestinal, genitourinary, musculoskeletal, neurological, psychiatric, respiratory, and women's health. Examinees will see cases from some, but not all, of these categories. The selection of cases is also guided by specifications relating to acuity, age, gender, and type of physical findings.

The USMLE program continually reviews its examinations to ensure their content is relevant to the practice of medicine. As practice guidelines evolve or are introduced, the content on USMLE is reviewed and modified as needed.


Updated Step 2 Clinical Skills orientation video and information booklet

Posted: September 10, 2017

An updated Step 2 CS orientation video is available. The video includes information about two user-adjustable display features in the patient note program used by Step 2 CS examinees, text magnification and color inversion.

An updated Step 2 Clinical Skills (CS) Content Description and General Information booklet is available. The updated booklet includes a list of common presenting symptoms and signs that examinees may expect to see.


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