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

The Clinical Skills Exam is scored simply as a pass/fail grade, but the individual must pass both the Clinical Skills Exam and the Clinical Knowledge Exam in order to pass Step II of the USMLE. The individual will receive the pass/fail grade based on the individual's patient examinations, patient notes, and diagnoses. The current registration fee for the Step II - CS is $1,005, which will be raised to $1,025 in 2008.