My Step 2CS tips
I studied less than 2 weeks for CS and passed with very good performance. So I would like to give you some tips. I hope it will help you
First of all, First Aid and Youtube videos about physical examination are enough for this exam. For the First Aid, read everything! (of course not the part with the hotels, flight etc ☺) And for youtube videos, I recommend the ones by this author
There are things that you will do exactly the same for each encounter.
>>Lets start with opening. Write down your speech for the opening and memorize it. An example
“Hi Mr./Ms. xxx! I am Dr. xxx, I am the attending physician today. I would like to ask you some questions and examine you…… Are you comfortable in the room? Let me put this drape on you./That’s good you are draped. …….Do you mind if I sit down and take some notes? …..Okay Mr./Ms. xxx, what brought you today?”
For the phone encounter
““Hi Mr./Ms. xxx! I am Dr. xxx, I am the attending physician today. How may I help you today?”
>>Next thing, write down what you would say when you do the counseling! An example
“Have you ever tried quitting smoking?
--Yes but I couldn’t!
--Smoking is a risk for your health. I understand that it is difficult but I am here to help you. We have a great smoking cessation center here. If you want, I would be more than happy to arrange an appointment for you.
--Would you like to quit?
-- That’s good to hear. As your physician I am here to help you. We have a great smoking cessation center here. If you want, I would be more than happy to arrange an appointment for you.
--Would you like to quit?
-- Smoking is a risk for your health. I understand that you don’t want to quit smoking right now. But if you ever decide, I just want you to know I am here to help you.
This is just an example. You may do your own.
And do the same for alcohol and recreational drug too. I tried to counsel everyone who drinks alcohol regardless of their CAGE!
>> For the closing part again write down a format. An example
“Thank you for answering my questions and letting me examine you today Mr./Ms. xxx. Your xxxx (the symptom) may be due to xxxxx or xxxx. In order to better understand what is going on I would like to run some test. I would like to do some blood work to see your xxxx and xxx (like hormones etc) and x-ray/MRI/CT scan an imaging test to see your xxx(kidney, liver etc) in details. Do you have any questions? Is there anything else that concerns you?
Okay Mr./Ms. xxx, lets meet when we have your results back. It was very nice to meeting you. Thank you.”
For this part you should of course change according to your diagnosis and work up. But at least know how to say!
>>For each case don’t forget to summarize. I did the summary after taking the history! And say something like
"Do you have anything else to add?" They might say something important you forgot to ask!
>> Do the counseling right away, if you leave it to the end, you will forget.
>> Spend up to 1 min at the door, and make a plan about what you will ask!
>>Always help the patient while they are lying down, standing etc. And tell them what you are doing. Like..
“I would like to listen your lungs now. Do you mind if I untie your gown?”
“Let me help you”
>>Close the lights while you are doing the fundoscopic exam.
>>For vibration use 128-Hz tuning fork and for Rinne-Weber use 512-Hz tuning fork.
>>Wait for full inspiration and expiration while you are listening the lung. Do not pull your stethoscope early!
>>For heart listen at least 4 focus and for lung 3x2 total 6.
>> If they are coughing offer tissue. If they have tissue, ask them to show you and check for blood. You can also offer water.
>>Be confident! Or at least look confident!
>>And of course PRACTICE PRACTICE AND PRACTICE!!!Do the first aid cases twice!
For now that’s all in my mind. If I remember anything else, I will add ☺ Good luck!
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