The USMLE-Step 2-CK ("Clinical Knowledge") is the nine-hour-long multiple-choice portion of the second part of the United States Medical Licensure Examination. It assesses clinical knowledge through a traditional, multiple-choice examination. In contrast to the USMLE Step 1, the focus is much more on clinical application of medical knowledge. It assesses the ability to apply medical knowledge, skills, and understanding of clinical science essential for the provision of patient care under supervision. The USMLE Step 2 is generally taken during the 4th year of medical school by medical students. From January 2010, to take the exam in North America the registration fee is $580 for students attending medical colleges in the United States and $850 for medical students from other countries. There are additional charges for applicants who choose a testing region outside the United States or Canada.