<P> US medical students take Step 1 at the end of the Basic Sciences portion of the curriculum, usually after the second year of medical school . The Step 1 score is frequently used in medical residency applications as a measure of a candidate's likelihood to succeed in that particular residency (and on that specialty's board exams), and it has been cited by residency program directors as their most important criterion in selecting graduating medical students for their residency program . Average USMLE Step 1 scores for various residencies are available in Charting Outcomes in the Match . </P> <P> If the student passes the exam, he or she may not repeat it to achieve a higher score, and any failed attempt is permanently recorded . This "one - time deal" situation is the reason the Step 1 is unanimously viewed as the most arduous and paramount examination a medical student will ever sit during his or her entire career . It has substantial bearing on the specialties and location a residency applicant is competitive for . </P> <P> USMLE Step 2 is designed to assess whether medical school students or graduates can apply medical knowledge, skills and understanding of clinical science essential for provision of patient care under supervision . US medical students typically take Step 2 during the fourth year of medical school . Step 2 is further divided into two separate exams: </P> <P> USMLE Step 2 Clinical Knowledge assesses whether medical school students or graduates can apply medical knowledge, skills, and understanding of clinical science essential for the provision of patient care under supervision and includes emphasis on health promotion and disease prevention . Step 2 ensures that due attention is devoted to principles of clinical sciences and basic patient - centered skills that provide the foundation for the safe and competent practice of medicine . </P>

When do medical students take step 2 of the usmle