CPX Info and FAQs

The Clinical Performance Examination (CPX) is a standardized patient-based examination administered to all medical students in the state of California, to be taken at or towards the end of the core clerkships. 

The main purposes of this exam are:

  • To evaluate your current level of competency in clinical and interpersonal skill
  • To provide individual feedback on these skills in preparation for your residency training
  • To prepare you for your residency and medical practice 


The CPX is designed by a consortium of clinicians and medical educators from ten California medical schools to assess clinical skills essential to the practice of medicine regardless of specialty. Over 1,000 students take this exam each year. During the exam, you will see eight patients with a broad range of problems, which may encompass subject material from any core clerkship. You will be expected to perform a focused history and focused physical examination as well. You will also be expected to communicate your thinking and preliminary plans to the patients. After each patient encounter, you will complete an inter-station designed to assess your clinical reasoning.

Passing the CPX is a requirement for graduation. Students who do not attain an overall passing score on the exam will be required to successfully complete a remediation program and clinical skills re-assessment examination.  In the event that you need to take this exam, we will help you develop the skills necessary for improvement.

The exam will involve one five-hour block of time in the Immersive Learning Center in the LKSC. Your course directors will be notified so that you may be excused from your scheduled rotation. Bear in mind that successful completion of the CPX examination is a graduation requirement.

Frequently Asked Questions about the CPX

When should I take the CPX?

The CPX is typically administered during the final two weeks of Period 1 and the first week of Period 2 in the summer. You are eligible and encouraged to take the CPX after you’ve completed your first clinical year. The latest you can take it is the summer before the year before you plan to graduate.

How do I prepare for the CPX?

You do not need to study any specific material for the CPX.  However, you can prepare for the examination by:

  • Knowing differential diagnoses for common clinical problems and clinical scenarios
  • Reflecting on how these differential diagnoses may affect the approach you will take in your focused history and physical
  • Reviewing your physical examination skills and the appropriate techniques by which to perform them
  • Observing basic fundamentals of physical examination behavior, such as proper introductions, hand washing, and measures to keep the patient’s comfort and perspective in mind

Where is the CPX held?

We are located in the Goodman Immersive Learning Center, on the ground floor of the Li Ka Shing Center for Learning and Knowledge on the Stanford University School of Medicine campus.

What do I need to bring to the CPX?

All you need is: (1) professional dress, including white coat; (2) a stethoscope; and (3) yourself.  All other medical supplies will be provided in the examination rooms. You will not be permitted to bring pocket guides or other “cheat sheets” into the exam. You will not be permitted to bring cell phones or other electronic devices into the exam.

How am I being evaluated?

Generally, students are evaluated in several skill areas. These include, but are not limited to: history taking, physical examination skills (not just whether you perform a certain maneuver but also if it is done correctly), the ability to communicate information to patients, and interpersonal skills. Following each patient encounter, you will be assessed on your knowledge and clinical reasoning.

These are just actors, right?

Not necessarily. For some exercises/exams, we hire professional actors for cases that involve simulations of exam findings or emotionally charged scenarios. Sometimes, however, we use real patients with real histories and physical exam findings. Remember that all standardized patients are people – and you should treat them as your patients, not as actors.

Will I get feedback on the CPX?

Yes. After the entire class has completed the CPX, you will receive detailed feedback from the patient encounters and a set of scores with comparison standards.

What happens if I don’t pass the CPX?

Successful completion of the CPX is a requirement for graduation. Students who do not attain an overall passing score on the exam will be required to undergo remediation and successfully complete a re-assessment clinical skills examination, which is administered in January. In the event that you need to take this exam, we will help you develop the skills necessary for improvement with the Student Guidance Program (SGP): https://med.stanford.edu/md/academic-support/stanford-student-guidance-program.html

What if I can’t make any of the CPX dates?

The CPX is offered at ten California medical schools. Although most students do, in fact, take the exam at their own school, on occasion there may be an extenuating circumstance that necessitates taking the exam at another location. If due to an extenuating circumstance you will be unable to commit to an exam date at Stanford, please complete the form to petition for an alternative exam date at another California institution. You may also contact the CPX administration team at cpx_administration@stanford.edu

Can I switch the date of my CPX?

You cannot change the date of your examination once registration for the CPX has closed, nor can you switch with another student. If there are extenuating circumstances, please contact the CPX administration team at cpx_administration@stanford.edu.  


Elias Escobedo
Standardized Patient Program Trainer

Center for Immersive and Simulation-based Learning
Li Ka Shing Center for Learning and Knowledge
291 Campus Drive, LK019
Stanford, CA 94305-5134