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Old 10-10-2012
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Smile mbbs2010 High Performance Pass in Philly; August 2012

so i took my exam in philly on the 24th of august in philadelphia
(YES, i am an IMG. and the stuff about Philly being non img friendly is BS).


passed all my components with stars (higher end)

so so thankful to god.

if anyone needs any help with anything u can post in this thread n i will try to keep updating it regularly!

good luck to everyone
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I took my exam on 16 Aug Phili and have not still received the results yet. Scary
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Congrats on being done. When are you planning for Step 3?
Can you please write about your prep and your experience of the test ( what did you miss etc) in as much detail as possible.
Thanks
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Old 10-10-2012
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Congratulations man! so proud of you
Hope you get into a kickass program and you kick the **** out of some americans hahaha (just kidding)

Ill take this exam in february the 4th, hopefully I'll also do fine, ill take it in Houston though.

Now drink get high and get laid (in that order or everything at the same time!
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Quote:
Originally Posted by Novobiocin View Post
Congrats on being done. When are you planning for Step 3?
Can you please write about your prep and your experience of the test ( what did you miss etc) in as much detail as possible.
Thanks
dividing this post into 2 parts -- what my prep was.. and what id advice.

-----MY PREP-----
i gave my step 2 Ck exam on the 3rd of august and had my CS scheduled for the 24th of august. So basically had exactly 19 days between the two. (not counting the days of the traveling etc)

KAPLAN CS COURSE
there was fortunately a Kaplan CS course starting on the 6th of august. I took it. went into the course BLANK. not even knowing what the CS was about. the course was great!

there were 5 major pros to the kaplan course -
FIRSTLY- the physical exam
a-see the deal here is that the SP is grading you for the physical and the etiquette. The SP is not an actual patient but an actor. He is taught how to recognize CERTAIN ways to perform the physical.. based on which he will grade you. Now being an actual doctor - you might be doing something right. but the SP might not recognize it.. and hence u will not get the check mark for it!!
b- they teach you recognizable ways (by the SP) of doing the PE.
and by the end of it.. you can do all the exams in less than 3 minutes on an avg.
cvs - 3 minutes
RS - 3 minutes
neuro- 4 minutes
abdomen- 2.5 minutes
musculoskeletal - <3 minutes
HEENT - <2 minutes


so basically this gives you MORE THAN ENOUGH TIME TO CLOSE your case, discuss diagnoses, work ups, counsel, hidden concerns etc etc.

SECONDLY - the CIS
the way they train you is really good specially for IMGs. you deal with SPs individually. its the SPs themselves that actually show you how to do things, what to say how to say etc etc.. how to be empathetic but not sympathetic. its more of active learning. if you are doing something that is incorrect - they stop u and u start over till u get it right. so basically very well organized stuff.

main portions in the CIS - validating patient feelings, empathizing, bringing out hidden concerns, managing difficult situations, handling abuse cases etc.

THIRDLY - an entire day dedicated to management of difficult cases and also hidden concern cases

FOURTHLY - actual simulated test with feedback
on the last day of the course there was a full scale exam with 12 SPs etc. and they gave u individual feedback on ur patient note, CIS etc. you could sit down with the Sps you had and they would tell u again how u could improve etc.

and lastly - the patient checklist
the exam is very very subjective. you are graded on 2/3 components based on how the SP feels u are doing - and for all of this the SP has a pre determined checklist that u need to meet. (btw there is no longer a history checklist - there is however a CIS one and one for SEP i think)
so i thought if someone could train you and mould you accordingly so as for you to meet the criteria on this checklist - it was great!


after the course
i took 2 days off. to recharge my batteries.

for the next6 days i teamed up with a friend and we used FA and did cases out of it.. doing upto 15-16 cases in a day.
we finished all the cases in 3 days. then went over them a second time in the next 2 days.
left 1 day to go over the physical examination and revise stuff we were not comfortable with.

then took another day off
after that spent 2-3 days going over the minicases from FA, mneumonics from the kaplan course and other notes from the course.

spent 1 whole day only reading cases from FA and then practicing the patient note - timing myself

last day - travelled to philly , took the day off, chilled in the eve, gave the test the next morning





-----WHAT I WOULD ADVISE-----

if you have the resources - go in for the kaplan course! i know its a **** load of cash --but it is really really worth it. It goes without saying - that you wouldnt want to screw up on any of the usmle steps. specially the CS. so if you can manage the resources -- GO FOR IT!


FA for the CS -- this book is GOLD!! but only if u rip out the first half of the book and use it ONLY AND ONLY for the minicases and the cases after that. (would strongly recommend AGAINST using it as a resource for patient counsellings or any of the CIS components)

team up with a friend - on the first run one person does the odd numbered cases n the other person does the even numbered cases. For the second run - you guys switch.
(tip-- instead of 15 minutes like on the actual test - time urself for 13-14 minutes. this will speed u up. and on the actual test u will be about 1 minute ahead of time.. which goes a LONG way on the CS)

quiz ur partner on the minicases - these help primarily in working up a differential diagnosis on the actual test.


for the CIS -- borrow a kaplan book for the cs from someone (the newest edition) and photostat the chapter on communication skills. It is worded according to the checklist the patients have, will give u a ball park view of how ur supposed to do things.

on the actual test ===== this is the MOST important part as there is no longer a history questions checklist. Make sure you really connect with the patient as a doctor. make sure you counsel, discuss and close EVERY SINGLE CASE!! even if it means cutting short ur physical examination.


for the patient note
- type type type!! practice practice practice

on the actual test ============donot leave any segment blank. write the history, physical findings, tests to order, then the differential diagnosis - and for the justifications use the copy paste function of the computer --TRUST ME IT WILL SAVE ALOT OF TIME and will make ur patient note more complete.


the actual test
pace urself well over the 15 minutes

1 minute - at the door - right the patients name (you WILL FORGET LATER), age and CC. roughly what Physical exam u think u will do. 2-3 differentials. the mneumonic. any irregular vitals.

knock-- TAKE A DEEP BREATH---go in

(total 14 minutes remaining)

next 5-6 minutes : history taking + first part of CIS stuff - bonding with the patient, validating feelings, reassuring, remaining calm etc.

(total 7-8 minutes remaining)

next 3-4 minutes : wear gloves, do a quick FOCUSED physical exam.

WHEN THE 5 MINUTE WARNING BELL RINGS YOU MUST HAVE ALREADY BEEN IN THE MIDDLE OF UR PHYSICAL EXAM. IF YOU Are still taking the history at this time --- STOP EVERYTHING YOU ARE DOING AND START YOUR PHYSICAL EXAMINATION.

(total 3-4 minutes remaining)
Final 3-4 minutes -- save it for discussion with the patients. YOu MUST DO THIS on atleast 10/12 patients. this counts alot towards the CIS component.

when they say "THIS PATIENT ENCOUNTER IS NOW OVER" -- leave right then. you are not graded for anything once this announcement is made. so even if said something brilliant to the SP you wont be graded for it. besides you will lose time from ur patient note if you stay back to stay stuff.


patient note:10 minutes -- starts IMMEDIATELY after the announcement "this patient encounter is now over" - so walk out fast!!

write it as discussed earlier in the post.
use the copy paste function.

one big tip -- while practicing the patient note at home - practice using 8-9 minutes as the cut off.
during the test day you WILL lose about 1 minute of time for the patient note mainly -- walking out of the room after the encounter, computer freezes, blanking out ,typing on a desktop computer rather than a laptop (if ur using one- this also slows u down)etc etc


so practice with about 8-9 minute deadlines at home. so that you can do it within 10 minutes on the test



**** REMEMBER****

1- the test is DO-ABLE!!
2- The SP is there to help you pass! if you ask the right questions they HAVE to give u the info - its what they are hired for!
3- if you strike the right chord with the SP -- they will lead u to ur diagnoses.
4- treat the entire encounter as if you are treating an ACTUAL PATIENT.
DONT TREAT IT LIKE A TEST... cos if you do.. the chemistry with the patient will not set in.. and the CIS component will get screwed.




if there are any other specific questions -- feel free to ask in this post. will keep updating.
good luck

Last edited by mbbs2010; 10-10-2012 at 06:49 PM.
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Quote:
Originally Posted by Pinky
I really appreciate.I really have 1 more question in ROS question do we have to ask question from each system that is neuro,cardio, resp,abdo , etc. in all cases or only case related questions;as I have watched cse videos and in those videos they ask almost every question from each system in all cases.Do we have enough time for all those questions in real exam. And also 1 more doubt did you do PE of all system?eg: doing cvs and rs in abdo case also?And for patient note do you have any idea about wpm speed good enough for the exam.and did you write in each line. or did you write continously like after writing HPI ,put a period and start with RS as people say if we press enter it will take away lot of space.and did you type everything in capital. is that ok as i'm doing practice only with caps lock on.
1- there is no longer a history checklist.
so NO . you donot need to ask any questions from other systems unless it is relevant to your diagnoses/differential that u are thinking of.

however 3 things u would always ask for --
- any change in bowel movements?
- Sleep changes
- weight changes /skin changes
cos these go under depression and thyroid dysfunction which are differentials in ALOT of cases.


2-DO PE ONLY of system u think is involved after chief complaint and history.
for eg - if u are doing RS -- while auscultating the front of the chest.. you can always listen to the heart - that will give u the extra point.
simultaneously for the CVS - can always auscultate the lungs -- that will give u extra point.


ALWAYS check for pallor + clubbing + peripheral pulses -- cos u only need to look at the wrists and nails for all 3 (saves time) --- will save time and give u 3 extra points in the patient note for mentioning

always palpate the legs for edema. --- just touching once will give u the point and u will hv extra stuff for the patient note.


Patient note
i typed in all CAPS. saved alot of time

typed stuff on a new line for every heading.
(the practice software on the usmle website had a problem where if u pressed enter ur word limit would get filled automatically but this problem is NOT there on the actual test. so you can press enter and type on different lines.
its jsut more organized and easier to read.)

also use medical abbreviations ALOT in the patient note - cos it makes it seem more professional.
for eg :

PERRLA - pupils equal round reactive to light and accomodation (for HEENT)
BS + 4 Q = bowel sounds positive in four quadrants (for abdomen)
(-)m,r,g === NO murmurs, rubs or gallops (for cvs)



while ordering tests on the patient note

never write - LFT, KFT, TFT etc

write in detail

for eg:
LFT = AST, ALT, Bilirubin - total/direct/indirect, prothrombin time etc
TFT - total t3, t4, FT3, FT4, TSH, TBIG, anti thyroidperoxidase ab.
so on and so forth.. will get u extra points.
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Congrats

Do you know about live online course of kaplan ,its cheaper -700$
Is it good
I read the online course is the live feed of the same online course ,so do u think it will be good ?
you did the live prep right ? which city ?
Is it in Chicago because I will be in Chicago .Can one take live prep course on B1B2 visa ?
sorry for many questions
Thank you so much and your experience is very very helpful
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Thank you for your feedback. Did you specifically note that number of characters is not an issue at all on the test? I mean are we totally cool with starting every sentence after hitting enter (Like FA bullet style PN samples)?
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Old 10-11-2012
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@mbbs2010:

TONS of thanks!!! I've been looking for feedback on the kaplan step 2 CS course all over the internet for months now and this is the BEST REVIEW there is. I love the detailed approach you took in writing your experience! It gave me peace of mind that taking the course would be worth the price.

You're absolutely amazing! I can't thank you enough.

By the way, where did you take your kaplan step 2 CS course? In New Jersey or in Chicago?
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congrats man!! And thanks for sharing your experience, its helpful for all of us!!
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Thank you very much for the much needed guidance. Thank you for your time and effort to help everyone here preparing for CS exam.
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Congrats

thank you so much




Do you know about live online course of kaplan ,its cheaper -700$
Is it good I read the online course is the live feed of the same online course ,so do u think it will be good ?
i donot know about the live online course - yes the teaching part will be the same -- but how will u interact with the SP and receive feedback?
also about the visa issue i have no idea. sorry,.
the best thing to do will be to pick up the phone n call the kaplan helpline.. or go to their website and chat with a med advisor, cos they will give u the best and most accurate answers.



you did the live prep right ? which city ?
Is it in Chicago because I will be in Chicago .
i did mine in NJ. but its basically the same course no matter where u take it. i think its in pasadena, chicago and NJ.

sorry for many questions
Thank you so much and your experience is very very helpful
no problem at all! good luck for ur test

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Quote:
Originally Posted by Lotsahope View Post
Thank you for your feedback. Did you specifically note that number of characters is not an issue at all on the test? I mean are we totally cool with starting every sentence after hitting enter (Like FA bullet style PN samples)?

the character limit was still in place, for every box.


when u look at the prep note up on the usmle website - there is a small bar below every box to type in. everytime u hit enter the bar would go much ahead and the character limit would be over before u actually used up all the characters (this was a problem when i was practicing back in august )

however on the actual test this did not happen. so yes there was a TOTAL LIMIT on how much u cud type.. but hitting the enter button didnt make it go crazy.

again i didnt say start EVERY SENTENCE on a new line.
i said start ever HEADING on a new line.
for eg:

HPI, PMhx, Pshx, FHx etc.


if u start every bullet on a new line - there are chances u will run out of space. i donot know for sure.. but i did use up all my space in 3-4 of my cases and i wasnt using bullet form but sentences.
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Quote:
Originally Posted by d_wiqed View Post
@mbbs2010:

TONS of thanks!!! I've been looking for feedback on the kaplan step 2 CS course all over the internet for months now and this is the BEST REVIEW there is. I love the detailed approach you took in writing your experience! It gave me peace of mind that taking the course would be worth the price.

You're absolutely amazing! I can't thank you enough.

By the way, where did you take your kaplan step 2 CS course? In New Jersey or in Chicago?
well yes the course is pretty great - specially for the CIS part.
also u can take the course n then take the test within the next 2 weeks and u are done. so it helps if u hv a time constraint.
i took it in NJ.- but i guess its the same everywhere.
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Quote:
Originally Posted by mbbs2010 View Post
so i took my exam in philly on the 24th of august in philadelphia
(YES, i am an IMG. and the stuff about Philly being non img friendly is BS).


passed all my components with stars (higher end)

so so thankful to god.

if anyone needs any help with anything u can post in this thread n i will try to keep updating it regularly!

good luck to everyone
Congrats MBBS2010!

Would you like to post your performance profile? That would be great

Thanks a lot
sanluis
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Thank you for answering all our questions. You are being very helpful.
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Wow...........that's a GREAT post mbbs2010 and deserve to be made into a sticky
Are you listening Mods?
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Quote:
Originally Posted by Sanluis View Post
Congrats MBBS2010!

Would you like to post your performance profile? That would be great

Thanks a lot
sanluis
whats that? the detailed stuff for how u did on every component?

i dont know how things are going to be for the next score reporting period.. but since this was the first reporting period after the new changes and change in exam pattern - the only thing in the report was 3 headings CIS, SEP and ICE.
NO OTHER DETAILS.


this was the message posted on the usmle website -
"Individuals who tested on or after June 17, 2012 will see less detailed feedback on their graphical performance profiles than has been provided to examinees in the past."
http://usmle.org/step-2-cs/#reporting


hope that helps!~
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Old 10-15-2012
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congrats & thanks for such a wonderful review

can you please clear some questions about kaplan

how many students are there in each class?
does 5 day course includes practice test or we have to pay $999 separately for the test?
how we enter the PN in practice test i.e. does they have computer like real exam or not?
how close their practice exam is to the real thing?
are their sps as trained as the one in real exam?
lastly, i would have only 3 days after their course for the exam, do you think 3 days are sufficient (considering i have already read first aid before the starting of the course)?
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Old 10-15-2012
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some more questions......

are they able to give individual attention to each student?
do you know the passing rate of kaplan students?
where did you stay during the course & what was your means of conveyance? (i'm also planning to do course in newark)

I know these are a lot of question but I'm really confused at this moment. your answers will really help.
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Old 10-16-2012
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Quote:
Originally Posted by imgaspirant View Post
some more questions......

are they able to give individual attention to each student?
do you know the passing rate of kaplan students?
during the teaching when they are telling u what to do -- u sit down as a class.
while u practice with the SPs and the other facilitators who teach u physical examination ----- u are broken down into groups of 3, and then each of u 3 students are given time to practice with the SP individually.
u also get to see what n how the other 2 students are doing things... and hence get to actively learn from their mistakes too.


the pass rate is over 85% or 90% last i heard.

good luck
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Old 10-16-2012
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Quote:
Originally Posted by imgaspirant View Post
some more questions......


where did you stay during the course & what was your means of conveyance? (i'm also planning to do course in newark)
The course is in the building next to penn station newark.

penn station is a big big hub for the New Jersey transit.

so no matter where u find a place in New Jersey or new york.. there will be PLENTY of travel options (bus/train/light rail/ path trains) to Penn station.
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Old 10-16-2012
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thanks dude.

how many students are there in each class?
does 5 day course includes practice test or we have to pay $999 separately for the test?
how we enter the PN in practice test i.e. does they have computer like real exam or not?
how close their practice exam is to the real thing?
are their sps as trained as the one in real exam?
lastly, i would have only 3 days after their course for the exam, do you think 3 days are sufficient (considering i have already read first aid before the starting of the course)?
can you suggest a cheap place near the center?
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Old 10-16-2012
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how many students are there in each class?
how does that matter? u will get ur moneys worth in the course.. irrespective of how many people there are.


does 5 day course includes practice test or we have to pay $999 separately for the test?
Yes it does include a practice test on the Friday. If you want u can take another one on Saturday for 999 $ ( will have diff cases)

how we enter the PN in practice test i.e. does they have computer like real exam or not?how close their practice exam is to the real thing?
are their sps as trained as the one in real exam?
yes it is EXACTLY LIKE THE REAL THING. they have the proper set up and the computers/timings etc...
their SPs are good too. sometimes even more difficult than the actual test.. so YES they prepare u well



lastly, i would have only 3 days after their course for the exam, do you think 3 days are sufficient (considering i have already read first aid before the starting of the course)?
Only you can answer that question!

can you suggest a cheap place near the center?
sorry mate.. no idea about that one.
maybe u can call the kaplan center and they can tell you... ( dunno for sure) they do have ALOT of IMGs living close by that come down to the center.. so you might find some kind of assistance.
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  #25  
Old 10-16-2012
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thanks a lot
you are really very helpful
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  #26  
Old 12-03-2012
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Thank you sooooo much for great post!!!!!
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  #27  
Old 01-06-2013
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Search Thanks mbbs2010,2 more questions

Did you have American accent to spoken English?You seem to have done a good deal of analysis on CS.So you feel philly is ok,not to be scared by non -img friendly tag
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  #28  
Old 01-07-2013
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Quote:
Originally Posted by hakuna matata View Post
You seem to have done a good deal of analysis on CS.So you feel philly is ok,not to be scared by non -img friendly tag
I think its a wise idea to be absolutely aware of what you are up against. So yeah.. i tried my best to be well informed about the CS before i took it.

also going thru step 1 -- 2ck and 2 cs-- something i know for sure is that the usmle exams are pretty standardized. hence chose not to increase unnecessary anxiety.
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  #29  
Old 04-06-2013
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my exam is in few days .... PLZ PLZ LET ME KNOW IF IT'S OK TO TYPE IN ALL CAPS ???/ I AM V CONFUSED ABOUT THAT... WANT TO TYPE ALL CAPS CUZ IT SAVES TIME BUT NOT SURE.....PLZZZZ HELP ME
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  #30  
Old 04-06-2013
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Quote:
Originally Posted by IMTAHIRA View Post
my exam is in few days .... PLZ PLZ LET ME KNOW IF IT'S OK TO TYPE IN ALL CAPS ???/ I AM V CONFUSED ABOUT THAT... WANT TO TYPE ALL CAPS CUZ IT SAVES TIME BUT NOT SURE.....PLZZZZ HELP ME
i did type in all caps. didnt seem to create a problem.
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  #31  
Old 04-06-2013
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thnx a lotttttttttt
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