Examinees taking Step 2 CS for the second time improve on average, and those with prior exposure to exam information do not appear to benefit unfairly from this exposure.

A decision about combining physical examination and history-taking proficiencies into one composite score, as well as the weighting of these components, should be driven by the intended use of the score. The choice of weights in combining physical examination and history taking makes a substantial difference in the precision of the resulting score.

The findings support the validity of scores for repeat examinees on their second attempt.