USMLE Step 2 CS (Currently Suspended)

USMLE (United States Medical Licensing Examination) is a three-step long examination taken to become a licensed physician in the USA. The second step of USMLE is divided into two components, namely the USMLE Step 2 CK (Clinical Knowledge) &USMLE Step 2 CS (Clinical Skills). USMLE Step 2 checks your capability of application of medical knowledge, skills and understanding of clinical science essentials for the provisions of patients. Emphasis is further given to health promotion and disease prevention. The primary aim of USMLE step 2 CS is to devote attention to principles of clinical sciences and your basic skills centered toward patients.

The USMLE Step 2 CS is governed by CSEC and can be taken at any of the 5 test centers of United States. The duration of the USMLE Step 2 CS Exam is not more than a day. The exam is based on analyzing the practical skills of the examinee by confronting many standardized patients and the examinee is expected to take a note of their history, perform physical examinations, determine differential diagnosis and finally write down a note based on their determination. The exercises are usually performed in emergency wards, clinics, etc. while the concerned fields are gynaecology, paediatrics, internal medicine, obstetrics, surgeries, etc. The examinees are further required to look over the patient’s illness together with acquiring a thorough analysis of patient’s medical history of the past, allergies, environmental history, history of its family, etc. followed by a physical examination. Usually, there are more than one USMLE Step 2CScase formats. For instance, there is one where the examinee is able to communicate with the Standardized patient by means of a telephone.


Good news is that USMLE Step 2 CS is an exam that should be qualified by the examinee and there are no such criteria of a good rank. Either you pass or you fail. Speaking of the length of exam, the duration is approximately 8 hours. While taking the USMLE Step 2 CS, you need to see 12 standardized patients who simulate various medical conditions. You are given a break for 50 minutes in these 8 hours (which are again split into 2 breaks of 10 minutes each and a 30 minutes lunch break). The direct patient examination lasts for 15 minutes where you are supposed to take a note of the past medications, do physical examinations and counsel the patients. Moreover, you are given 10 minutes to prepare the USMLE Step 2 CS patient note where you provide the documentation of the patient’s history and physical examination information collected during your patient encounter.

There are also a handful of special case formats where the examinee’s other instincts are challenged. These comprise of telephone encounters, tablet scenarios, skill demonstrations, caregiving activities, etc.

  • Telephone Encounters- You will be asked to counsel the standardized patient on a phone call. Moreover, the counseling involves assessment of patient’s medical history, assistance in decision making, etc. However, there is no way for a physical examination of the patient, but the examinee must not leave the physical examination column in the USMLE Step 2 CS patient note
  • Tablet Scenarios- The examinee is provided with a digital image which he is supposed to understand and then elaborate to the standardized patient.
  • Skills demonstration- This involves your skill analysis while you perform physical operations on a dummy figures.
  • Caregiving activities- In these formats, the patient is generally a child or an elderly person and the examinee is expected to counsel them along with taking a note of their medical history and assistance in decision making.


The USMLE Step2 CS is a qualifying exam and the USMLE Step 2 CS results will be reported as either pass or fail.Your USMLE Step 2 CS results will be concerned with 3 areas which are needed to be passed by the examinee for obtaining a qualifying designation.
  • Integrated Clinical Encounter (or ICE) - This consists of Data interpretation and gathering of the patient and the patient’s note. The grade is determined by the scores given from the patients for the physical examination, and experienced trainers for the USMLE Step 2 CS patient note.
  • Communication and interpersonal skills (or CIS) – This grade incorporates a faithful relationship of a Doctor and a patient in a professional manner together with communication and counseling skills. Further, the grade is wholly in the hands of standardized patient.
  • Spoken English Proficiency (or SEP) – Here, the examinee is asked to interpret the patient’s pronunciation and the choice of words. This grade again remains in the hands of the standardized patient.
In case the examinee could not qualify the exam, he will be handed over a report of his performance data so as to guide them where the improvisation is needed. Also, the examinees are required to wait mandatorily for 60 days to retake the USMLE Step 2 CS and they can appear in the exam for not more than thrice in a year.
The USMLE Step 2 CS Results are released after 4-5 weeks with respect to each testing period. On the basis of the date when USMLE Step 2 CS was taken, the USMLE Step 2 CS Results can be reported 13 weeks after the date when test was taken.


The initial step you will be taking to register yourself for the USMLE Step 2 CS will be to apply for an exam USMLE Step 2 CS scheduling permit. The permit holds validity for a period of 12 months. So it would be advisable to play safe and apply early. Your registration will be done with ECFMG (Medical student outside of USA and Canada). Afterwards, you need to select a test center for yourself where you can reach comfortably. You can select among these 5 USMLE Step 2 CS locations-
  • Atlanta, Georgia
  • Chicago, Illinois
  • Houston, Texas
  • Los Angeles, California
  • Philadelphia, Pennsylvania
(NOTE- The registration in these following USMLE Step 2 CS locations is subject to availability.)

The next step would be to book an appointment. The appointment can be booked once yourUSMLE Step 2 CS scheduling permit is available with you. The dates for appointment can be booked for as long as 6 months in advance. So make sure you book your desired date of exam 6 months prior so that it would be reserved. In case you can’t present yourself on the said date, then rescheduling of the date can also be done without paying any additional amount. However, the rescheduling must be done 15 days prior to the reserved date for USMLE Step 2 CS exam.


Being an exam involving different encounters, you need to examine different patients carrying different symptoms and act accordingly. So here are some simple hacks which will help you keep a positive impact during the exam and ensure your qualification in the USMLE Step 2 CS.
  • First and foremost, try out the simplest trick, BREATHE! Encountering the patient is easier said than done, but if you will calm yourself down before you walk through that door and center yourself to each encounter, it would be of great help.
  • Next advice would be to maintain a healthy relationship with the patient and not just focusing on assessing a perfect diagnosis. Maintain a comfortable eye contact with the patient and make sure you knock on the door before entering. This signifies your respect toward them.
  • During those 15 minutes, your focus should be on patients and not on the time. It shows your concern toward them and likewise your grade will be determined on how empathic you were to them. The concern can be communicated in a number of ways. Speaking of physical terms, you must ask them if there’s anything you can do for them if they are in pain. Or if they seem to be emotionally unstable, you can be supportive to them by asking them to share their problems.
  • Make sure you check all your remarks (medical history, physical diagnosis, etc.) in theUSMLE Step 2 CS patient’s note so that you can add something you have missed while writing them down.
  • While taking the exam, your outfit should be professional and you should feel comfortable while wearing it. For men, a formal shirt and pair pants along with formal shoes would be advisable. While women can wear a formal blouse with either a formal pair of pants or formal skirt along with formal shoes.


There are certain things which you are obliged to bring along with yourself to the USMLE Step 2 CS locations-
  • You are expected to bring the schedule permit you have received when you registered for the exam.
  • Photo ID and sign proof provided by the government. (For identification purposes)
  • A confirmation notice
  • A lab coat and a stethoscope
  • A lunch box (It is an 8 hours long journey!)
There are also some articles that are prohibited in the USMLE Step 2 CS locations such as-
  • Jewelry (Exception for wedding ornaments and engagement rings)
  • Hair accessories should not be worn by any candidate while taking the exams. These accessories include hairbands, hairclips, combs, etc.
  • Luggage is too prohibited in the exam centers and you won’t be even allowed to store it in the exam centers.


Once you’ve arrived at the test center, keep your exam permit, USMLE Step 2 CS scheduling notice and verification IDs ready to check-in. After this, you will be assigned a number to be put on each side of the shoulder part of your lab coat. Moreover, any details present on your lab coat that display your information or that of your university would be covered with white stickers. Once all the candidates have checked in, they are escorted to the orientation room where you can keep all the essentials that you can access during the break time. While the personal items are locked up and are returned to you at the end of the session.


USMLE® is a joint program of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). None of the trademark holders are affiliated with MOKSH or this website.

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The ECFMG® is a registered trademark of the Educational Commission for Foreign Medical Graduates.

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Electronic Residency Application Service (ERAS®) is a program of the Association of American Medical Colleges and is not affiliated with MOKSH.

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