Is a tie necessary for step 2 CS?

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I took my CS in November (still awaiting scores). I don't remember any of the guys wearing ties. Good luck!
 
The USMLE website recommends it, so might as well wear one if you can. While almost no one actually wears a tie in the hospital, they are still common in outpt clinics which is what step 2 CS is supposed to mimic (i guess).
 
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