Step Two of the United States Medical Licensing Examination measures the candidate's ability to apply medical knowledge and skills to real-life situations. This examination is sponsored by the Federation of State Medical Boards and the National Board of Medical Examiners. The content of the USMLE Step 2 is divided into two dimensions: the first dimension includes normal development and basic medical ethics; the second dimension concerns specific medical disorders. This second section contains four general types of medical service: preventive medicine and health maintenance (15 to 20% of the exam); understanding the mechanisms of disease (20 to 35%); establishing a diagnosis (25 to 40%); and applying the principles of management (15 to 25%). The categories from which questions in this second section may be derived include but are not limited to: 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; nutritional and digestive disorders; gynecological disorders; renal, urinary, and male reproductive disorders; disorders of pregnancy, childbirth, and the puerperium; disorders of the skin and subcutaneous tissue; diseases of the musculoskeletal system and connective tissue; and endocrine and metabolic disorders. In general, candidates will be presented with a medical scenario and required to give a diagnosis, prognosis, an account of the underlying reasons for the condition, and a forecast of the subsequent steps in treatment. Questions may require the candidate to incorporate information from tables, laboratory data, imaging studies, diagnostic studies, and photographs of gross and microscopic specimens. Most of the questions on the test are in a multiple-choice, best-answer format. In other words, there may be several responses that are somewhat correct, but there will be only one answer which is most correct. There are 370 questions on the exam. The number of questions answered correctly will be used to calculate the score on both three-digit and two-digit scales. Individuals who do not begin every block of the test will not receive a score. In order to pass the USMLE Step 2, individuals must receive a minimum score of 182 on the three-digit scale, and 75 on the two-digit scale. The test takes nine hours, and is administered in 8 one-hour blocks over the course of a day. The USMLE Step 2 is administered year-round by Thomson Prometric; those who wish to take this exam should register for test date and location at the Prometric website.
