Wednesday, 28 November 2012

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USMLE Step 2 Clinical Skills (CS) changes and modifications. USMLE Step 2 CS Modifications.

As most of you know--and if you don't you'll find out soon enough!--in December 2011, announced a number of changes that would be installed on the USMLE Step 2 CS as of mid-year 2012. 

These changes were implemented to further enhance the testing methods employed on the CS. Most of my fellow students feared the changes, but frankly, they turned out to be OK--not more difficult and a bit more useful--. By this they meant, with further conversation, that the changes installed were more helpful to them, in the sense that it "mimics more a live patient encounter" and it is "more useful to you as a professional".

This opinion may vary among those who already took the CS with the new changes. If you disagree with this opinion, please do leave your comment in the section bellow.

At any rate, the changes are the following:

"Changes to the assessment of Communication and Interpersonal Skills *CIS*"

This assessment will now focus on 5 functions:

1. Fostering the relationship
2. Gathering information
3. Providing information
4. Making decisions: basic
5. Supporting emotions: basic 
6. *a sixth function was added*: Enabling Behaviors

Here's a table comparing the old version of CIS with the new, enhanced version of CIS:


Here's a list of the functions and subfunctions provided by 


Changes to the Patient Note:

As with the previous version of the Patient Note, the examinee is required to fill out the patient note after the patient encounter. You will be continued to ask to detail relevant history and to mention diagnostic studies to be ordered. *Examinees will also be asked to to create a reasoned, focused differential (maximum of three diagnoses) listed in order of likelihood and to list the evidence obtained from the history and physical examination that supports each differential.


So basically, you will encounter a more focused method of testing you. Is this worse? I don't think so. It's so well organized that I think it promotes simplicity. More accuracy permits you to focus your efforts. It also helps you organize the information you gathered, so you can pinpoint the differential diagnoses, why you thought about the given differential, and what test(s) you're going to order to rule in or out your potential diagnoses. 

In the end, this will make of you a better professional. So learn to cope with the new set of rules and UTTERLY defeat the USMLE Step 2 CS.

Comments? Thoughts? Ideas? Leave your thoughts behind!

If you wish to read the articles whence this information was gathered in full, here are the links to the source:


If you are taking the 2 CS soon, you should consider reading:

The USMLE Step 2 CS Booklet, provided by

If you need practice materials, you should also check out's material:

Practice Material:

1.) Step 2 CS Content Description and General Information Booklet view online
2.) Onsite Orientation for Step 2 CS (Video) download 90 Mb
3.) Patient Note Interactive (simulation of program for writing patient notes)view online
4.) Sample Patient Notes view online

Study hard and remember, Step 2 CS is all about practice!!

Step 2 CS Tuts Video #4 is coming soon, so stay tuned.

It'll be about how to fill out adequately and efficiently the patient note in less than 5 minutes, the allotted time to fill out the patient note.

Check out my YouTube channel and subscribe to get the latest videos.