This test combines aspects of the CST and the PICSI. It assesses a candidate's ability to effectively understand and communicate through speech in both English and another language, and in addition evaluates their performance in a series of short role play scenarios with a separate scoring of included healthcare related terminology.

• English/Spanish
• English/Core languages other than Spanish (Mandarin, Cantonese, Vietnamese, French, Somali, Arabic, Portuguese, Russian, Korean, Japanese, Hindi, German, Italian, Greek, Turkish, Ukrainian, & Haitian Creole)
• English/Rare languages (All languages not listed above)