USMLE Step 2 CS
Objective Structured Clinical Exam (OSCE Exam)
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USMLE Step 2 CS OSCE Exam has 12 OSCE
stations. You will have 15 minutes for each patient encounter and 10
minutes to record each patient note. If you do not use the entire 15
minutes for the patient encounter, the remaining time will be added to
the time you have to record the patient note. This 15 minute patient
encounter includes the time to read the instruction on the station door.
The USMLE Step 2 CS OSCE Exam session
lasts approximately 8 hours, and two breaks are provided. The first
break is 30 minutes long; the second break is 15 minutes long. You may
use the restrooms before the exam and during breaks. A light meal will
be served during the first break, and there are vending machines
available for drinks.
Your USMLE Step 2 CS OSCE Exam includes a very small number of
unscored patient encounter OSCEs, which are added for pilot
testing new cases and other research purposes.
As USMLE Step 2 CS OSCEs are 15 minutes
long, most stations will require more than one task to be completed,
e.g. history taking and physical examination, or, history taking and
In USMLE Step 2 CS OSCE Exam, you will be
assessed to the same clinical skills and communications skills which are
evaluated in other Objective Structured Clinical Exams (OSCEs).
The testing area of the USMLE Step 2 CS OSCEs
clinical skills evaluation center consists of a series of examination
rooms equipped with standard examination tables, commonly used
diagnostic instruments (blood pressure cuffs, otoscopes, and
ophthalmoscopes), non-latex gloves, sinks, and paper towels. Outside
each USMLE Step 2 CS OSCE Exam room is a cubicle equipped with a
computer, where you can compose the patient note.
Before the first patient encounter in USMLE Step 2 CS OSCEs, you
will be provided a clipboard, blank paper for taking notes, and a pen.
The examinee instruction sheet gives you specific instructions and
indicates the patient's name, age, gender, and reason for visiting the
doctor. It also indicates his or her vital signs, including heart rate,
blood pressure, temperature, and respiratory rate. You may encounter
patient problems or conditions that suggest the need to confirm or
re-check the recorded vital signs and/or perform specific maneuvers in
measuring the vital signs. In USMLE Step 2 CS OSCEs, you may also
encounter a case in which the examinee instructions include the results
of a lab test.
In USMLE Step 2 CS OSCE Exam, you should
interact with the standardized patients as you would with any patients
you may see with similar problems. The only exception is that certain
parts of the physical examination must not be done: rectal, pelvic,
genitourinary, female breast, or corneal reflex examinations. If you
believe one or more of these examinations are indicated, you should
include them in your proposed diagnostic work-up.
The USMLE Step 2 CS OSCE Exam, you should
perform physical examination maneuvers correctly and expect that there
will be positive physical findings in some instances. Some may be
simulated, but you should accept them as real and factor them into your
evolving differential diagnoses. You should attend to appropriate
hygiene and to patient comfort and modesty, as you would in the care of
With regular patients in a normal clinical
setting, it is possible to obtain meaningful information during your
physical examination without being unnecessarily forceful in palpating,
percussing, or carrying out other maneuvers that involve touching. In
USMLE Step 2 CS OSCE Exam, your approach to examining standardized
patients should be no different. SPs are subjected to repeated physical
examinations during the USMLE Step 2 CS OSCEs; it is critical
that you apply no more than the amount of pressure that is appropriate
during maneuvers such as abdominal examination, examination of the ears
with an otoscope, and examination of the throat with a tongue depressor.
Immediately after each USMLE Step 2 CS OSCEs
patient encounter, you will have 10 minutes to complete a patient note.
You will be asked to handwrite or type on a computer a patient note
similar to the medical record you would compose after seeing a patient
in a clinic, office, or emergency department. You should record
pertinent medical history and physical examination findings, as well as
your initial differential diagnoses. Finally, you will list the
diagnostic studies you would order next for that particular patient. If
you think a rectal, pelvic, genitourinary, female breast, or corneal
reflex examination would have been indicated in the encounter, list it
as part of your diagnostic workup of the patient note part of USMLE
Step 2 CS OSCE Exam.
In USMLE Step 2 CS OSCE Exam:
- There is no examiner in the room. The
encounter is video monitored and taped. Thus, there will be no
questions asked in the room. However, during physical examination,
you are still required to explain to or take permission from the
patient before you start each physical contact with the patient.
- There is no bell or buzzer. Human voice
pager announcement will announce; the beginning of the patient
encounter, five minutes left fort the encounter, end of the
encounter, two minutes left for the the patient note period, and
lastly the end of the station.
- Treatment, consultations, or referrals
should not be included in your workup plan.
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