Eliminate Step 2 CS for US Medical Graduates

In 2004, the US Medical Licensing Exam (USMLE) was expanded to include a clinical skills assessment -- Step 2 CS. A similar exam had previously been administered only to foreign medical graduates, but since the change all graduates of US medical schools are required to pass the exam prior to obtaining a medical license.  We strongly believe eliminating the national clinical skills exam for US medical graduates reduces unnecessary costs in the education process without negatively affecting patient care.


The exam fee alone currently costs $1,275, and most students pay hundreds of dollars more to travel and stay near one of five national testing centers. Nationally, the test fee alone costs students $36 million annually. Over 95% of US medical students pass on their first attempt.


Despite 11 years of data since the exam was broadened to include US medical graduates, there are no data to support a causal link between Step 2 CS and improved patient outcomes. The Step 2 CS exam aims to assure that all licensed physicians have basic clinical competencies and can communicate effectively with patients. These skills can be more efficiently evaluated by individual medical schools, the vast majority of which already conduct their own clinical skills exams. While Step 2 CS provides students only a pass/fail grade, exams by individual schools can provide students with a more comprehensive assessment as well as targeted feedback to help students to improve their skills in communication, history taking, physical examination, and clinical reasoning.


Currently, it costs over $1 million to catch a single student who fails the Step 2 CS on back-to-back attempts. Step 2 CS adds no provable benefit to US medical education or patient safety at an enormous cost. The exam should not be required for licensing of US medical school graduates.

Current Signature Count

Please sign your name below to support the movement to end Step 2 CS as a required exam for graduates of US medical schools.

This petition was written by a group of fourth year students at Harvard Medical School. We are building a national coalition to convince NBME to eliminate Step 2 CS, and we promise not to share your contact information with anyone.

What is your current level of training? *
Please select the US medical school you currently attend or graduated from.
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