Examinees will see an increased focus on quality improvement principles and safety science hence causing a change in current question pool of USMLE.

USMLE STEP 2 Clinical Knowledge (CK)

Examinees will see more questions about quality improvement principles; safety science; epidemiology, biostatistics, and population health; professionalism; and interpersonal and communications skills. These may be tested using item formats currently under development by USMLE. If new item types are introduced into the examination, sample materials will be made available well in advance by USMLE.

USMLE STEP 2 Clinical Skills (CS)

Further enhancements to the assessment of communications skills are being piloted by USMLE. If the pilots get appreciable results, the enhancements to Step 2 CS will be introduced into the exam no earlier than 2015, and will be announced well in advance.


In line with our previous reports, beginning November 2014;

  • Examinees will be able to schedule the exam on two non-consecutive days.
  • Applicants will NOT need to apply for Step 3 under the eligibility requirements of a specific medical licensing authority.
  • Examinees will see increased numbers of items that assess an expanded range of competency-based content, including foundational science essential for effective healthcare; biostatistics, epidemiology, and population health; literature interpretation; medical ethics; and patient safety.

The two exam days will be named Step 3 Foundations of Independent Practice (FIP) and Step 3 Advanced Clinical Medicine (ACM).