USMLE Step 2 CS - Clinical Skills:

• USMLE Step 2 CS is not a computer based exam. It is a live exam with paid actors portraying patients.
• The purpose of the Step 2 CS is to test medical communication skills, English proficiency, history, physical exam and diagnostic skills.
• Step 2 CS is a one-day exam given over approximately 8 hours.
• You will be given 12 patients to examine. You will have the opportunity to interact with each patient for 15 minutes. You will then have 10 minutes to write a brief medical history, physical findings, differential diagnosis and treatment plan.
• You will be allowed a 30 minute lunch break and a 15 minute mini break.
• The fee for USMLE Step 2 CS is $1200
• At present the USMLE Step 2 CS is given in 5 test centers called Clinical Skills Evaluation Center (CSEC) at the following locations.
• Clinical Skills Evaluation Center - Los Angeles
  100 N. Sepulveda Blvd., 13 th Floor
  El Segundo, CA 90245 
• Clinical Skills Evaluation Center - Philadelphia
  3624 Market Street, 3rd Floor
  Philadelphia, PA 19104
• Clinical Skills Evaluation Center - Atlanta
  Two Crown Center
  1745 Phoenix Boulevard, Suite 500 (5th Floor)
  Atlanta, GA 30349
• Clinical Skills Evaluation Center - Chicago
  8501 West Higgins Road, 6th Floor
  Chicago, IL 60631
• Clinical Skills Evaluation Center - Houston
  400 North Sam Houston Parkway
  Suite 700
  Houston, TX 77060
• Fees: $ 695 (If taking the test outside the US and Canada, please add International test delivery surcharge)

USMLE Step 2 CS consists of three components:

• Integrated Clinical Encounter: Consisting of data gathering (History & Physical examination) and documentation (patient notes).
• Communication & Interpersonal Skills:  Questioning skills, patient counseling skills, professionalism
• Spoken English Proficiency: Clarity, pronunciation, and minimizing the need to repeat yourself.
• You must pass all three sub-components to pass USMLE Step 2 CS.

What type of patients will you get in the USMLE Step 2 CS?

• Since Step 2 CS tests your clinical and bedside skills at a basic level, you will most likely get patients with common disease conditions like Hypertension, diabetes, Myocardial infarction.
• However, their presentation to you will be “symptom based”. So your preparation should also be symptom based.
• Common symptoms that current Residents see in real life, in their medical residency clinics, include chest pain, shortness of breath, abdominal pain, diarrhea, seizure, headache, side effects of medications, vaginal bleeding, vaginal discharge, wrist pain, back pain, knee, shoulder pain, diffuse muscle pain, weakness etc.,

Retaking a USMLE Step:

• There is no limit on the number of attempts to pass each USMLE Step.
• There is a minimum wait period of 60 days between consecutive attempts and a limit of three attempts in a 12-month period.
• For USMLE Step 1 and Step 2 CK: You can retake the exam no earlier than the first day of the month that begins at least 60 days after your previous test date.
• For Step 2 CS and Step 3: Your eligibility period for the retake will begin no earlier than 60 days after the date of your prior attempt.
• For Step 3: You may not reapply sooner than 60 days after your last attempt.

USMLE General Rules that you should know:

• If you pass a Step or Step Component, you are not allowed to retake it.
• To be eligible to register for USMLE Step 3, you must have passed Step 1, Step 2 CK and Step 2 CS.
• You can take the Step 1, Step 2 CS or Step 2 CK in any order or sequence that you wish (provided you fulfill all eligibility requirements)
• Individuals who have passed Step 2 prior to the implementation of Step 2 CS are not permitted to take Step 2 CK.

USMLE Step 3 eligibility:

To be eligible to apply and register for USMLE Step 3, you must have

• Graduated from medical school and obtained a MD / DO degree (or its equivalent)
• Passed Step 1, Step 2 CK, and Step 2 CS 
• Should be ECFMG Certified.
• Fulfill other requirements as determined by the state medical licensing board to which you are applying (residency requirements etc).

Number of Attempts and Time Limits:

• There is no limit on the total number of times you can retake a USMLE Step or Step Component you have not passed.
• However, USMLE recommends to state medical licensing boards
• that the state medical boards have a time limit of 7 years within which you should have passed Step 1, Step 2, and Step 3 examinations.
• that the state medical boards allow no more than six attempts to pass each Step or Step Component
• The ultimate decision on accepting these above USMLE recommendations rests on the state medical licensing boards. This is the reason that there are so many confusing requirements from each state medical licensing authority.
• Visit residency Forum to discuss state specific medical licensing requirements. http://residencyandfellowship.com/ipw-web/bulletin/bb/ 
• Time limit for completion of all three Steps: The time period may start from the date the first Step or Step Component is passed (or in some states from the date of the first attempt – even if you didn’t pass that attempt)
• For state-specific medical licensing requirements, Visit the FSMBhttp://www.fsmb.org/