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USMLE Step 2 CS Forum USMLE Step 2 CS Discussion Forum: Let's talk about anything related to USMLE Step 2 CS exam


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  #1  
Old 10-08-2012
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Arrow Sneak in for some CS tips!

This was my first USMLE test so I was quite excited !

Duration :
less than a month (first 15 days I was doing an elective so devoted about 2 -3 hours daily and then last 10 days 6-7 hours)

=> just like any other exam we need to put in quality time. Instead of doing 12 hours for 5 days I would rather like to go slow ..bit by bit. I also know people who have passed after preparing for less than a week, but trust me you dont want to be on fire by doing this!


Books :
FA was always the whole and sole of my prep. I also did few cases from UW, CSE videos (and had other sources but didnt look into them)

Method:
I had 3-4 live study partners plus 2 skype partners.
I practised all cases with one and say 5-6 with the each of the others, their feedback helped greatly . For the first reading I quickly read thw whole book :first the explanatory pages and then the cases ,the scenario and the whole questionaire and the solution behind . Second time I practised the case as I would do in the real exam.
=>Try not to memorise the case however try to pick up clues! (Some people know FA cases in and out)
=> Try to practise with 2 different people if possible because at times you need someone to point your mistakes.
Its quite possible that both of you make a common mistake and practise with the same mistake every time.
Broadening your database always helps. May be you can ask questions on the forum or to people who have already taken their exam.
I havent taken step1 , so I had to memorise the differentials and lab tests. Its not really difficult ,but there are certain obvious things from step1 ( I had no clue what Lyme disease was!) that you need to know (if you are one of those kinds who always have a 'why' )I had to look up on the internet for details of terminologies or symptomatology.
2 of my partners were done with step1 so I could take their help.
Regarding CSE videos and other similar video resources are very long say 15 min or so ,but its a good option if you watch them once just to get an idea and condense the relevant part into the 5 or 7 min that are given in the exam. My study partner and I made a standard examination for every system that could fit in the desired time .
=>Guys please imbibe the giving habit. Not speaking of Karma here but practically dont we like to hang out with people who help us back and not the ever needy ones? When someone gives you some useful information
you always think of that person when u find something from a 3rd source. Dont try to be a parasite!
You may be required to make adjustments wrt time, way of studying etc so try to find someone who suits your schedule best and who gives you a feeling that you are heading towards the right direction . Everybody has certain strengths and weaknesses. So try to pair up in such a way that you can help each other in some way or if both lack a particular ability then both can work towards it.
You may not be able to handle someone who comes to your house to practise and always has long phone conversations with his/ her
bf/gf or is so busy with his /her schedule that always tries to squeeze you in his schedule.
(I am glad I was lucky to have found them all and you know what..I am still friends with all my study partners! )
I did a massive exchange of mnemonics .I wrote them down on my copy of FA. I dont think I could have managed without them.
=> Be sure you keep the optimum number with you, dont overwhelm yourself because there is a chance you might jinx it all!
Timed sessions are a must!! For the first 20 cases I always ran out of time. I only got the hang of it after say 30 cases.
=> Also I would mention here that when you practise do it as real as possible.
Spend those few seconds washing hands and doing the draping so that you train your brain now and you do stuff at the spinal level in the real test.
I did 5 cases back to back 4-5 days before the exam and that helped.
Do not ignore Patient notes!
( I was very lazy to do the typing as I didnt enjoy it much like the acting part!! I am not good at typing but some practise helps )
=> Again for the PN, try to make a simple template which you can write down and then fill up the details as per the individual case.
Use shortforms here, it saves you a lot of time.
I donot personally know anybody who took preparatory course for step1 so I am not commenting on it.
(I have taken the exam before May 19 , when they followed a slightly different pattern, but the chunk stays the same)
  • Do's
    -Live partner(its easy to find them on such forums and if you arent lucky enough a skype partner would do)
    -timed practice
    -apply for the test in advance
    -Dress well and look calm and confident and polite
    -Be comfortable with their accent( I had never watched anything more than titanic ! I could never understand American accent and therfore was loyal to bollywood !But when I prepared myself for TOEFL I had to take this seriously and almost got over this fear. [ I scored a 29 in speaking]
    as I stayed in the US for about 2 months and having many people to talk to I became just perfect!
    -USCE helps you to be more confident. (My attending knew
    i was Doing CS soon so she let me practise the history and the examination on the real pts in the outpatient department.
    My internship in my home school gave me lots of patient exposure
    so I would be unshaken even if the patient started jumping on the examination table!)
  • donts
    -look for numerous resources.. abc notes, xyz videos ..
    -take others very seriously (many of us are afraid to face patients and hence most of us who take this test have feeling that we screwed it all up. It was just me who said it went well while others were sure they had failed which did not happen as expected)
    -dont waste days before your exam finding out which cases were encountered by your friends
(they repeat for sure however they change the minute details,


so there is always a chance that you presume something to be the same but in reality its not !)
-sound robotic
-be anxious and panic
-switch dates(there are people all over the globe waiting for them.
I have monitored my ecfmg page 24x7 however I couldnt get the desired slot as somebody took it a few milliseconds before me.. yes it happens!)
=> For taking the dates , Mozilla firefox has this addon Check for change which alarms you as soon as a slot is vacant
Dont travel all the way to Houston with the belief that passing rates differ with locations!

Exam Day:
Day before I was expecting to skim through FA once.
I was so stressed that I read 1/10 th of the book till late evening and did the rest of it the next day.
In my case, I felt I was prepared enough , so I could have easily watched a movie the day before and skipped FA totally.
My centre was in the same city and an hour away and I had already seen it the day before.
My friend drove me in her Mercedes to the exam centre . I was the first to reach there.
They dont let you in before 15 min. So I was waiting outside . Its good to take some time and freshen up and be comfortable with the place.
=> Please watch the orientation video atleast twice because the real exam is pretty close to what you see there.
=> Listen to their instructions carefully and follow them. And please do not try to outsmart them!!

What you need to carry is your food or medicine and make up material
and keep the necessary stuff on the table outside while the rest is locked in a room .They serve food and tea/coffee there and I liked every bit of the chocolate brownie so much that I almost forgot why I had been in the hall in the first place!
You are given papers (12) and pens(2). And also a writing board for support.
The SPs are friendly and are great actors! Stick to your mnemonics and they always answer you well!
Dont panic if you are not answered as expected, it is because they are instructed to do so
and that is generally a clue that something is wrong.
For example, if you see the pt is not responding to you and looks sad it could be a case of depression.
Dont forget to summarise and at the end of the hx ask if they wish to add something.
Most of the times they tell you what you might have missed or even reemphasize the possible diagnosis!
Be nice to them.
I asked the patient if I could sit down and take notes while taking the Hx. I am never able to stand for long so sitting was a better option although I seemed to be at a lower level when it came to eye contact.
Dont forget to wash hands.
=> Wash hands and turn the tap off with your elbow or tissue.
(It makes no sense touching the tap after you wash your hands!
They closely watch you or even hear you! Let me tell you.. I thought that because my SP is not facing me I could wash hands and turn the tap off with the washed and then wipe them . But later on I realised that the room was so quiet that he could have easily guessed the sequence of events going on and he knew someone was trying to act smart!)

Also sometimes the Sp might hand over a pan after coughing out sputum
=>Please look at it and comment depending on the situation! And if this happens after you wash your hands you are expected to rewash
before doing the examination! If he passes over his mobile phone to you ..rewash before you resume the examination. Needless to say do not touch your hair or scratch your face after washing hands!
My hands were always cold so I apologised for it before every patient.
Being nervous is alright, its almost impossible to complete all of the patient encounter as given in FA .
=>So try to do as much as you can starting from the stuff that seems most important and obvious.
I gave atleast 2-3 minutes for the closure giving the probable diagnosis,tests and treatment option(atleast one)
followed by assurance and then counselling if not done during the Hx.
Almost every patient had a challenging question which really isnt challenging at all.
Usually its a Will-I-be-alright or do-you-think-this-might-have caused-that !
I was almost prepared beforehand for every possible question as my study partner always added her own questions during our practice . Many of the times people dont know what is pertinent /relevant in the given case.
I did not come over any answer to this.
=> try to do things that seem most important first . Its better to start with the relevant system first . For eg in a case of pain in adbo :start with abdo examination and then go to gen exam and other systems if you have time. Its better than doing only gen exam and ausculataing for CVS'RS and totally skipping the abdo part due to time shortage. If you feel you are blank.. in the Hx go back to the mnemonics and ask whatever is next. If you dont have any idea about the examination part atleast do a general examination, auscultation for CVS and RS and then if you are able to figure out by now go for inspection ,palpation of the system thats apparently symptomatic.
Instruct and explain to the patient . Dont look rushed. If you get stuck up , jump to the next part .
(things come back to you after the nervous phase passes off. Its very normal!)
By the end of it I really felt exhausted but I was so so happy that it was over.
I almost knew I was through because one of my study partners who did the exam before me had passed and I knew I was at a relatively better postion in my preparation and performance!
I thank God for being there with me all the time and all those who contributed to my preparation.
If you have any particular question I would be happy to answer them here.

Last edited by wenskyrose; 10-08-2012 at 10:48 PM.
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  #2  
Old 10-09-2012
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Really great post, thank you. My exam is in 9 days.

What do you suggest are the best or most useful mnemonics for this exam?

How much time do you think you spent on each part of the patient encounter (history, exam, closure)?
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  #3  
Old 10-09-2012
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I had planned to give about 5-7 min for Hx, 5-7 min for examination, 3-4 min for closure. I finished every case few seconds to a minute before the time was over but found that all the others were already doing the PN!
For the mnemonics ,I picked some mnemonics from the pool. I have attached the files. There is a file named template which is exactly how I took notes in the real test.
Its completely upto you, whichever mnemonic seems easy and appealing to you can be memorised.

My favorites were LIQORAA, PAMHUGSFOSS, DIABETIC, LMPTCVSPAP, DEATHSHAFT, SAFEGUARD, SIGEMCAPS, We PASS THAT CS, FEVERCUDS.

I hope you find your favorite ones too!
Attached Files
File Type: pdf CS-Paper-Template.pdf (7.8 KB)
File Type: pdf CS-Physical-Exam.pdf (398.6 KB)
File Type: pdf CS-Mnemonics.pdf (110.1 KB)
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  #4  
Old 12-03-2012
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I really appreciate you for such a great post,,,,, for sharing with us your experience in details!!!!
It is very helpful!!!

God bless you!!
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  #5  
Old 12-06-2012
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Hi,

Great tips, thanks.

Just wanted to ask whether the scrap papers are given beforehand & could I write on it (put down the mneumonics & stuff) before the patient encounter starts...?

Thanks:-)
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  #6  
Old 12-07-2012
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Quote:
Originally Posted by Cassiopeia View Post
Hi,

Great tips, thanks.

Just wanted to ask whether the scrap papers are given beforehand & could I write on it (put down the mneumonics & stuff) before the patient encounter starts...?

Thanks:-)
They gave 12 scrap papers at once before the test with 2 pens.. However they ask you not to write anything until they instruct you.. You may write only after they let you slide open the doorway information.
Wish you all the best !
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  #7  
Old 12-09-2012
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Default Thank you it was great post

Dear friend thank you and appreciate your help
I had quick question,between your mnemonics there were DIABETIC and WE PASS THAT CS and unfortunately i could not find any info about them would you please complete them for us.
thanks and god bless you
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  #8  
Old 12-10-2012
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Quote:
Originally Posted by amirhagigi View Post
Dear friend thank you and appreciate your help
I had quick question,between your mnemonics there were DIABETIC and WE PASS THAT CS and unfortunately i could not find any info about them would you please complete them for us.
thanks and god bless you
Sorry I should have looked into it ..
This attachment has few more mnemonics.. Hope that helps..
Attached Files
File Type: pdf USMLE CS_WORD(2)(2).pdf (169.4 KB)
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