Step 2 Clinical Knowledge (Step 2 CK)

Step 2 Clinical Knowledge (Step 2 CK) consists of multiple-choice questions prepared by examination committees composed of faculty members, teachers, investigators, and clinicians with recognized prominence in their respective fields. Committee members are selected to provide broad representation from the academic, practice, and licensing communities across the United States and Canada. Test questions focus on the principles of clinical science that are deemed important for the practice of medicine under supervision in postgraduate training. The examination is constructed from an integrated content outline that organizes clinical science material along two dimensions.

Normal Conditions and Disease categories (Dimension 1) form the main axis for organizing the outline. The first section deals with normal growth and development, basic concepts, and general principles. The remaining sections deal with individual disorders.

Sections focusing on individual disorders are subdivided according to Physician Task (Dimension 2). The first set of physician tasks, Promoting Preventive Medicine and Health Maintenance, encompasses the assessment of risk factors, appreciation of epidemiologic data, and the application of primary and secondary preventive measures.

The second set of tasks, Understanding Mechanisms of Disease, encompasses etiology, pathophysiology, and effects of treatment modalities in the broadest sense.

The third set of tasks, Establishing a Diagnosis, pertains to interpretation of history and physical findings and the results of laboratory, imaging, and other studies to determine the most likely diagnosis or the most appropriate next step in diagnosis.

The fourth set of tasks, Applying Principles of Management, concerns the approach to care of patients with chronic and acute conditions in ambulatory and inpatient settings. Questions in this category will focus on the same topics covered in the diagnosis sections.

The diseases noted in the outline do not represent an all-inclusive registry of disorders about which questions may be asked. They reflect the development of a "High-Impact Disease List" that includes common problems, less common problems where early detection or treatability are important considerations, and noteworthy exemplars of pathophysiology. Questions are generally, but not exclusively, focused on the listed disorders. In addition, not all listed topics are included on each examination.

The Step 2 CK content outline is not intended as a curriculum development or study guide. It provides a flexible structure for test construction that can readily accommodate new topics, emerging content domains, and shifts in emphases. The categorizations and content coverage are subject to change. Broadly based learning that establishes a strong general foundation of understanding of concepts and principles in the clinical sciences is the best preparation for the examination.