The United States Medical Licensing Examination Step 2 Test, or USMLE Step 2, is a challenging assessment for men and women who want to enter the rewarding field of medical science. This exam has two parts: a Clinical Knowledge (CK) section, which consists of 352 multiple-choice questions administered in eight one-hour blocks, and a Clinical Skills section, which consists of 12 patient cases lasting approximately 25 minutes each. The content of the USMLE Step 2 can be broken down in a few different ways.
Topically, the questions in the CK component relate to specific areas, including internal medicine, obstetrics and gynecology, pediatrics, preventive medicine, psychiatry, surgery, and other subjects relevant to the provision of care under supervision. Questions in this section require one of the following conclusions: a diagnosis; a prognosis; an indication of the underlying mechanisms of disease; or the future course of treatment, including preventive measures.
Another way to look at the CK component is as a combination of questions about normal growth and development and questions about individual organ systems or types of disorders. The conditions covered by this component of the USMLE Step 2 test include immunologic disorders, diseases of the blood and blood-forming organs, mental disorders, diseases of the nervous system and special senses, cardiovascular disorders, diseases of the respiratory system, and nutritional and digestive disorders. The CK portion also covers gynecologic disorders; renal, urinary, and male reproductive systems; disorders of pregnancy, childbirth, and the puerperium; disorders of the skin and subcutaneous tissue; diseases of the musculoskeletal system and the connective tissue; and endocrine and metabolic disorders.
The CK section of the USMLE Step 2 exam can also be approached by physician task. There are four types: promoting preventive medicine and health maintenance (15 to 20 percent of the exam); understanding the mechanisms of disease (20 to 35 percent); establishing a diagnosis (25 to 40 percent); and applying the principles of management (15 to 25 percent).
The Clinical Skills component of the USMLE Step 2 test, on the other hand, has only three subcomponents: an Integrated Clinical Encounter (ICE), requiring data gathering and documentation; Communication and Interpersonal Skills (CIS), including assessment of the candidates ability to ask questions, share information, and maintain a professional manner and rapport; and Spoken English Proficiency (SEP), which assesses the candidates spoken English communication within the context of the doctor-patient encounter.
The raw score (the number of questions answered correctly) for the CK section is placed on both a three-digit and two-digit scale because different jurisdictions require different scaled scores. Most three-digit scaled scores are between 140 and 260, and the typical minimum passing score on the two-digit scale is 75. No numerical score is given for the Clinical Skills section of the USMLE Step 2; instead, candidates are either passed or failed by an expert team of physician raters.