USMLE Step 2 - Clinical Knowledge Exam
The USMLE Step 2 Clinical Knowledge Exam is part of the second test of the three-part United States Medical Licensing Examination that is required in order to receive a license to practice medicine within the United States. The USMLE Step II Clinical Knowledge Exam is a computerized examination that consists of 368 multiple-choice questions that cover a variety of different topics related to the medical field. The USMLE Step 2 Clinical Knowledge Exam, also known as the Step II CK, is split into 8 sections that are not separated by topic, but rather are 46 randomly distributed questions related to disease mechanisms, differential diagnosis, emergency medicine, neurology, patient care management principles, preventative medicine, radiology, and surgical subspecialties. These questions include information specifically related to human development, conditions and disorders occurring during pregnancy, childbirth, and the perinatal period, congenital abnormalities, disorders of the puerperium, diseases of the blood and blood-manufacturing organs, diseases of the musculoskeletal system, nervous system, respiratory system, and infectious and parasitic diseases. It also includes information related to cardiovascular disorders, endocrine and metabolic disorders, gynecologic disorders, immunologic disorders, mental disorders, nutritional and digestive disorders, skin disorders, neoplasms, the renal system, the male reproductive system, and questions related to symptoms, signs, and ill-defined conditions.
The Clinical Knowledge Exam is scored based on the number of correct responses and then scaled so that the individual will receive a three-digit score and a two-digit score. Scores for the three-digit scale usually fall between 140 and 260 with 184 set as the minimum score considered as passing for the exam. The two-digit scale is not actually an exact percentage score, but still ranges from 0 - 100 with 75 representing the minimum score necessary to pass the exam. The individual must pass both the Clinical Knowledge Exam and the Clinical Skills Exam in order to pass Step II of the USMLE. The current registration fee for the Step II - CK is $470, which will be raised to $480 in 2008.
USMLE Step II CK Exam - Diseases and Disorders
The USMLE Step II CK Exam, in addition to covering information related to the general principles of practicing medicine, covers a wide range of information related to the various diseases and disorders that could potentially be affecting a patient. The types of diseases and disorders covered on the exam include:- Infectious and Parasitic Diseases
- Neoplasms
- Immunologic Disorders
- Diseases of the Blood and Blood-forming Organs
- Mental Disorders
- Diseases of the Nervous System and Diseases that Affect the Senses
- Cardiovascular Diseases and Disorders
- Diseases of the Respiratory System
- Nutritional and Digestive Disorders
- Gynecologic Disorders
- Renal, Urinary, and Male Reproductive Infections, Disorders, and Diseases
- Disorders associated with Pregnancy, Childbirth, and Puerperium
- Diseases and Disorders of the Skin and Subcutaneous Tissues
- Diseases of the Musculoskeletal System and Connected Tissue
- Metabolic Disorders and Disorders of the Endocrine System
USMLE Step II - Clinical Skills Exam
The USMLE Step II Clinical Skills Exam is part of the second test of the three-part United States Medical Licensing Examination that is required in order to receive a license to practice medicine within the United States. The USMLE Step II Clinical Skills Exam is designed to prove whether or not an individual has the skills, knowledge, and general ability necessary to physically examine a variety of patients with common diseases, disorders, and/or other problems. The exam takes approximately eight hours to complete in total, which includes a 30 minute break and a 15 minute break. The exam-taker will spend the entire period of the exam examining patients, diagnosing each patient's condition, communicating with patients, and writing out patient notes. The exact amount of time it will take to examine each patient varies, but the exam-taker is only allowed a maximum of 15 minutes to evaluate each patient and 10 minutes to write out the patient note after the evaluation. For certain parts of the test, the individual taking the exam will not be presented with a patient to examine, but instead will be placed in a room with a phone and will be able to receive a call from a patient. The individual must then gather all of the necessary information from the patient in order to make a diagnosis. During portions of the exam where there is a patient physically present, the exam-taker will be required to conduct a physical examination of the patient in order to make a diagnosis. The exam-taker is expected to carry out the examination in a careful and professional manner and to check the patient for signs of diseases or conditions that might explain the problems the patient is experiencing.However, the exam-taker is only expected to check for signs that may be relevant to the situation and there are certain types of physical examinations that the exam-taker cannot perform. The physical examinations that are prohibited during the exam are:
- Rectal Examinations
- Pelvic Examinations
- Genitourinary Examinations
- Female Breast Examinations
- Corneal Reflex Examinations
- Throat Cultures and Other Throat Swab Tests
USMLE Step II CS - Scoring Format
USMLE Step II CS - Scoring Format: The USMLE Step II CS is scored using a pass/fail system, but the exam is actually split into three separate categories of skills. In order for an individual to pass the exam, the individual must show that they are competent in all three areas by receiving a passing score in each category. The three categories covered on the exam, which are referred to as subcomponents, are Communication and Interpersonal Skills (CIS), Integrated Clinical Encounter (ICE), and Spoken English Proficiency (SEP).For the communication and interpersonal skills portion of the examination, the individual will be scored based on his or her information-sharing skills, questioning skills, and the individual's ability to work with the patient in a professional and respectful manner. The exam-taker will actually receive his or her score for this area of the exam from the patients that he or she treats during the examination as each patient will be asked to rate the individual's performance in these specific areas. The integrated clinical encounter portion of the exam will assess the individual's ability to gather thorough information about the patient and document that information correctly. This portion of the exam is scored based on a checklist that each patient has to fill out regarding the specific questions and evaluations that the exam-taker performed during the examination and how much information about the patient's condition and treatment the exam-taker shared with the patient. The spoken English proficiency portion of the exam assesses an individual's ability to speak English clearly and the individual's ability to effectively convey important information to the patient. The exam-taker will actually receive his or her score for this area of the exam from the patients that he or she treats during the examination as each patient will be asked to rate the individual based on the number of pronunciation problems the individual has, word-choice errors the individual makes, and how much difficulty the patient has understanding the exam-taker.