USMLE Step 2 Clinical Skills

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Physician education and training in the United States


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Step 2 Clinical Skills (Step 2 CS) of the United States Medical Licensing Examination (USMLE) is an exam that is currently administered to all medical students/ graduate who wish to become licensed physicians in the U.S..

Contents

[edit] Exam Structure

The USMLE Step 2CS exam consists of a series of patient encounters in which the examinee must see the simulated patient or SPs, take a history and do a physical examination, determine differential diagnoses, then write a patient note based on his/her determinations. The topics covered are common outpatient or Emergency Room visits which are encountered in the fields of internal medicine, surgery, psychiatry, pediatrics, and OB/Gyn. Examinees are expected to investigate the SP's chief complaint, as well as obtain a thorough assessment of the SP's past medical history, medications, allergies, social history (including alcohol, tobacco, drug use, and sexual practices), and family history.

The examinee is allowed 15 minutes to complete each encounter and 10 minutes for the patient note for a single patient encounter. The patient note is slightly different than a standard SOAP note. For the exam note, the examinee will document the pertinent facts relating to the history of present illness as well as elements of the past medical history, medication history, allergies, social history, family history, and physical exam. Then the examinee will then state up to 5 differential diagnoses relating to the SP's symptoms, and up to 5 tests or procedures to investigate the SP's complaints; the examinee will not recommend any specific treatments in the note in contrast to a true clinic SOAP note (IE, IV fluids, antibiotics, or other medications). Over the course of an 8-hour exam day, the examinee completes 12 such encounters.

USMLE Step 2 CS replaced the former ECFMG Clinical Skills Assessment (CSA) effective June 14, 2004. The last administration of the ECFMG Clinical Skills Assessment (CSA) took place on April 16, 2004.

[edit] Grading

The test is graded on a straight pass/fail basis, without any numerical score associated with it (as opposed to the other parts of the USMLE series). In order to pass, one must achieve a grade of "pass" in each of the three sub-components of the exam. [1]

  • Integrated Clinical Encounter (ICE) - This component includes the ability of the examinee to collect pertinent clinical information from the SP, and to write an appropriate patient note with differential after the clinical encounter. The former part is graded by the SP, and the latter by a practicing physician.
  • Communication and Interpersonal Skills (CIS) - This component includes evaluating the examinee's question asking skills (asking open ended questions, avoiding repetition and medical jargon), information sharing skills (acknowledging patient concerns, providing counseling and information about what will happen in the future), and professionalism / rapport (asking about feelings and concerns, showing consideration for patient comfort, proper hygiene during examinations, providing empathy and respect for the SP).
  • Spoken English Proficiency (SEP) - This component includes clarity of spoken English communication in the context of pronunciation, word choice, and minimizing the need to repeat questions or statements.

[edit] Exam centers

The exam can be taken only in the USA. Currently there are 5 testing centers called the Clinical Skills Evaluation Center (CSEC) throughout the USA:



[edit] See also

[edit] References

  1. ^ USMLE™ : Test Content & Practice Materials

[edit] External links