{'fraction_non_alphanumeric': 0.020237571491421028, 'fraction_numerical': 0.010118785745710514, 'mean_word_length': 5.080213903743315, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
The Step II Clinical Skills exam.

Beginning with the graduating class of 2005, the United States Medical Licensing Examination now includes a standardized Clinical Skills (CS) exam that all medical students must pass in order to become licensed in the United States. In addition to the traditional component of Step II in which clinical knowledge is tested using a multiple choice format, students must now pass Step IICS, an exam in which they encounter a series of standardized patients (SPs) and are graded on their ability to gather data and communicate with patients. 1,2 The Step IICS exam is administered at 5 national testing centers in Atlanta, Chicago, Philadelphia, Los Angeles, and Houston. The testing session lasts 8 hours with 2 brief breaks. Students encounter 11 or 12 (it is possible that 1 station will be nonscored and used for new case development) SPs who have been trained to present cases that run the gamut of standard complaints and conditions seen in medical practice. Each visit lasts 15 minutes, during which time students are expected to demonstrate their competency in conducting a history and physical exam, collecting sufficient information to develop a preliminary differential diagnosis and a plan for diagnostic workup. After each station, students have an additional 10 minutes to write (by hand or via computer) a patient note that summarizes findings from the history and physical exam, possible diagnoses, and plans for further diagnostic workup. The students’ performance during the interviews is scored by the SP using carefully developed checklists, and physicians read and grade the patient notes. The scoring involves 3 separate subcomponents: 1) Integrated Clinical Encounter, which is a combination of data gathering during the interview and documentation based on the postnote; 2) Communication and Interpersonal Skills, which is based on questioning skills, information sharing skills, and ability to establish rapport as graded by the SP; and 3) Spoken English Proficiency, which is graded by the SP based on the amount of effort needed to understand the speech of the student. Students must pass each of the 3 components to pass the exam. Those who pass will not be told their scores, nor will they receive any additional