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  #1  
Old 10-18-2013
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Thumbs Up Passed Step 2 CS - My experience + Advice

Took my Step 2 CS in July. Received my score last week and I passed!

Just wanted to share my experience and give everyone a few tips/advice on how to prepare for Step 2 CS. Before I begin, I'd like to make clarify a statement that I heard a lot of during my preparation. A lot of my colleagues told me that Step 2 CS is EASY as long as you know English and can communicate easily. That was a big RELIEF for me but DO NOT UNDERESTIMATE this exam. Just because you can communicate doesn't mean you got this under your belt. Of course, communication is a BIG and probably the most important factor when it comes to grading this exam but none the less, do not take it lightly and prepare thoroughly. Anyways, here it goes -

Materials used -
  • First Aid (Third Edition) for Step 2 CS
  • Youtube videos
  • This forum for mnemonics
  • A good study partner

Method of preparation and for how long did I study for?
Approximately 2 months.

Went over the main cases in First Aid about 3 times and then did some HY cases a 4th time. Cases I considered HY included abdo pain, chest pain, SOB, dizziness, hearing loss, fatigue, and whatever I considered was outside of my comfort zone (all the obgyn, neuro, and child cases). I did all the main cases with a study partner and used proper equipment; drape, gown, stethoscope, hammers, gloves etc.

Also read the mini-cases 3 times; once before I started the main cases, then after I finished the main cases twice, and a last time in the days leading up to my exam. I also wrote the mini cases out by hand.

I watched youtube videos multiple times for all the physical exam techniques especially for "special" tests such as rovsing's, psoas, obturator, rinne, webber, anterior drawer sign, etc etc. Make sure that you know how to perform the special tests. The more you practice, the faster and more comfortable you'll be. <-- that statement will be repeated multiple times because its the key to passing this exam.

The Patient Note
I generally don't have a problem with writing since I like to write (as you can tell by the number of posts I have lol). Patient notes are easy for me but a lot of ppl find this difficult especially given the time restraint. I used both, the bullet format and the narrative format, for my patient notes depending on what type of case it was and how much space I thought I would require. I would suggest you go to the Step 2 CS website on usmle.org and look at the demo note provided under the practice materials. I wrote notes for all the main cases only once and that was sufficient for me. If you have a hard time with patient notes or usually run out of time then you need to practice. The more you practice, the faster and more comfortable you'll be.

History/ PE, and Closure
Okay, everything in this section is what suited me well and what I felt comfortable doing. I had a script of how I would enter and introduce myself. I did that in every practice case during my prep and kept it the same during my exam. Believe it or not, I walked into a phone case by knocking and saying "Hello..." only to realize no one was there. After I introduce myself, I would get right into the HPI. My mnemonics included -
  • P - Past Medical Hx
  • A - Allergies
  • M - Medications
  • H - Hospitalizations
  • U - Urinary Problems *
  • G - GI Problems *
  • S - Surgical History
  • F - Family History
  • O - Occupation
  • O - Obgyn History *
  • S - Social History
  • S - Sexual History
  • W - Weight
  • A - Appetite
  • D - Diet
  • E - Excercise
  • S - Sleep
  • LIQORAAAPP for pain

* I wrote these on the side when I wrote my mnemonic because these did not fit in too well and would disrupt the flow of history taking. But these are important and should not be forgotten.

For the physical exam, I always started with the focused PE. For example, if a pt has abdo pain then I started with examining the abdomen and if time permits, then I would do further PE. For almost all cases, I had enough time to listen to their heart and lungs. It's not necessary for neuro cases in my opinion.

For the closure, first aid has excellent samples of how to close a case. Just make sure you leave some time for closure in EVERY case. Even if you are running out of time, this is the most crucial part of your exam. Forget the PE, just make sure you close!!!

Lastly, not every case I went into was a perfect case. I had a lot of mistakes. I always used Gloves to save time and that's is OKAY. You don't have to wash your hands. SP's don't care what you do as long as you do either one. Some of my mistakes included not performing a special test to rule out a ddx, forgetting about key closure components such as quitting smoking advice, asking about social hx and drug abuse etc. Nothing big but just don't let it affect you after you realize you made a mistake. This will affect your performance in the next case. The more you practice, the faster and more comfortable you'll be.
Exam Day
I was nervous. I booked my exam for the morning. I took it in Chicago. I had very poor sleep the night before because of anxiety. I went to bed at 10 PM and couldn't sleep till almost 4 AM. Then I woke up at 6 AM to get ready lol So I had about 2 hours of sleep. But once I got to the exam centre, the adrenaline and a big cup of coffee kicked in. The registration and orientation take quite some time and become a bit of a drag. Nothing you can do about it except just prepare yourself. Once it starts though, its GO GO GO. For my first two cases, I was a nervous train wreck but I held it together and did a decent job. Not going to discuss what specific cases I got but I did mention some HY cases above that you should familiarize yourself with. I would encourage you to bring some snacks as not everyone would like their lunch. Also, snacks are good during the 15 minute breaks you get. Other than that, I don't have much advice to give about the exam day. It's pretty straight forward. Watch the orientation video on the usmle.org website.

When to book your exam ?
This depends on when you wish to apply for Residency. For example, if you're applying for residency in September 2014 for the 2015 Residency Match, then look at the scoring schedule for step 2 cs on usmle.org and book accordingly. I've seen way too many people mess this up.

If I remember anything else, I will add that in. Also, I will write up my CK experience once I get my score!

Anyways, if you guys have ANY questions or feedback, please ask away. GOOD LUCK!
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The above post was thanked by:
anestikologist (08-10-2016), Ayesha omer (03-14-2016), currentofinjury (10-23-2013), Doctor Ali (11-07-2013), dr mumble (11-02-2013), dr rookie (10-20-2013), Dr.Tiger (10-24-2013), dr.Zh (10-18-2013), drbhandarkar (02-06-2014), fati (11-30-2013), happyboo (10-04-2015), kagman (11-21-2013), lizard (4 Weeks Ago), MEDICINE DOC (10-20-2013), neelmed (10-20-2013), Neutrino (10-21-2013), pp06060 (12-05-2013), samren17 (10-24-2013), sumedha (10-19-2013), USMLEClark (10-18-2013), val7 (11-16-2013)




  #2  
Old 10-18-2013
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Thanks and congrats!
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  #3  
Old 10-20-2013
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Quote:
Originally Posted by Hope2Pass View Post
Took my Step 2 CS in July. Received my score last week and I passed!

Just wanted to share my experience and give everyone a few tips/advice on how to prepare for Step 2 CS. Before I begin, I'd like to make clarify a statement that I heard a lot of during my preparation. A lot of my colleagues told me that Step 2 CS is EASY as long as you know English and can communicate easily. That was a big RELIEF for me but DO NOT UNDERESTIMATE this exam. Just because you can communicate doesn't mean you got this under your belt. Of course, communication is a BIG and probably the most important factor when it comes to grading this exam but none the less, do not take it lightly and prepare thoroughly. Anyways, here it goes -

Materials used -
  • First Aid (Third Edition) for Step 2 CS
  • Youtube videos
  • This forum for mnemonics
  • A good study partner

Method of preparation and for how long did I study for?
Approximately 2 months.

Went over the main cases in First Aid about 3 times and then did some HY cases a 4th time. Cases I considered HY included abdo pain, chest pain, SOB, dizziness, hearing loss, fatigue, and whatever I considered was outside of my comfort zone (all the obgyn, neuro, and child cases). I did all the main cases with a study partner and used proper equipment; drape, gown, stethoscope, hammers, gloves etc.

Also read the mini-cases 3 times; once before I started the main cases, then after I finished the main cases twice, and a last time in the days leading up to my exam. I also wrote the mini cases out by hand.

I watched youtube videos multiple times for all the physical exam techniques especially for "special" tests such as rovsing's, psoas, obturator, rinne, webber, anterior drawer sign, etc etc. Make sure that you know how to perform the special tests. The more you practice, the faster and more comfortable you'll be. <-- that statement will be repeated multiple times because its the key to passing this exam.

The Patient Note
I generally don't have a problem with writing since I like to write (as you can tell by the number of posts I have lol). Patient notes are easy for me but a lot of ppl find this difficult especially given the time restraint. I used both, the bullet format and the narrative format, for my patient notes depending on what type of case it was and how much space I thought I would require. I would suggest you go to the Step 2 CS website on usmle.org and look at the demo note provided under the practice materials. I wrote notes for all the main cases only once and that was sufficient for me. If you have a hard time with patient notes or usually run out of time then you need to practice. The more you practice, the faster and more comfortable you'll be.

History/ PE, and Closure
Okay, everything in this section is what suited me well and what I felt comfortable doing. I had a script of how I would enter and introduce myself. I did that in every practice case during my prep and kept it the same during my exam. Believe it or not, I walked into a phone case by knocking and saying "Hello..." only to realize no one was there. After I introduce myself, I would get right into the HPI. My mnemonics included -
  • P - Past Medical Hx
  • A - Allergies
  • M - Medications
  • H - Hospitalizations
  • U - Urinary Problems *
  • G - GI Problems *
  • S - Surgical History
  • F - Family History
  • O - Occupation
  • O - Obgyn History *
  • S - Social History
  • S - Sexual History
  • W - Weight
  • A - Appetite
  • D - Diet
  • E - Excercise
  • S - Sleep
  • LIQORAAAPP for pain

* I wrote these on the side when I wrote my mnemonic because these did not fit in too well and would disrupt the flow of history taking. But these are important and should not be forgotten.

For the physical exam, I always started with the focused PE. For example, if a pt has abdo pain then I started with examining the abdomen and if time permits, then I would do further PE. For almost all cases, I had enough time to listen to their heart and lungs. It's not necessary for neuro cases in my opinion.

For the closure, first aid has excellent samples of how to close a case. Just make sure you leave some time for closure in EVERY case. Even if you are running out of time, this is the most crucial part of your exam. Forget the PE, just make sure you close!!!

Lastly, not every case I went into was a perfect case. I had a lot of mistakes. I always used Gloves to save time and that's is OKAY. You don't have to wash your hands. SP's don't care what you do as long as you do either one. Some of my mistakes included not performing a special test to rule out a ddx, forgetting about key closure components such as quitting smoking advice, asking about social hx and drug abuse etc. Nothing big but just don't let it affect you after you realize you made a mistake. This will affect your performance in the next case. The more you practice, the faster and more comfortable you'll be.
Exam Day
I was nervous. I booked my exam for the morning. I took it in Chicago. I had very poor sleep the night before because of anxiety. I went to bed at 10 PM and couldn't sleep till almost 4 AM. Then I woke up at 6 AM to get ready lol So I had about 2 hours of sleep. But once I got to the exam centre, the adrenaline and a big cup of coffee kicked in. The registration and orientation take quite some time and become a bit of a drag. Nothing you can do about it except just prepare yourself. Once it starts though, its GO GO GO. For my first two cases, I was a nervous train wreck but I held it together and did a decent job. Not going to discuss what specific cases I got but I did mention some HY cases above that you should familiarize yourself with. I would encourage you to bring some snacks as not everyone would like their lunch. Also, snacks are good during the 15 minute breaks you get. Other than that, I don't have much advice to give about the exam day. It's pretty straight forward. Watch the orientation video on the usmle.org website.

When to book your exam ?
This depends on when you wish to apply for Residency. For example, if you're applying for residency in September 2014 for the 2015 Residency Match, then look at the scoring schedule for step 2 cs on usmle.org and book accordingly. I've seen way too many people mess this up.

If I remember anything else, I will add that in. Also, I will write up my CK experience once I get my score!

Anyways, if you guys have ANY questions or feedback, please ask away. GOOD LUCK!
Congratulations mate! I am going to US to do electives. I will take my CS after that. How much can elective rotations at US hospital help my preparation?
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  #4  
Old 10-20-2013
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Originally Posted by neelmed View Post
Congratulations mate! I am going to US to do electives. I will take my CS after that. How much can elective rotations at US hospital help my preparation?
It will help tremendously. It will give you good experience in the terminology used and the way the standardized patients will talk.
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  #5  
Old 10-20-2013
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Originally Posted by Hope2Pass View Post
It will help tremendously. It will give you good experience in the terminology used and the way the standardized patients will talk.

A quick question - Now you can only give three differential diagnoses. In a leg weakness case, I might want to exclude myasthenia gravis even though it is not in the 3 DDs. Should I still list Tensilon test in the diagnostic tests?
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  #6  
Old 10-20-2013
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Can u plz tell me ,did u find it easy to do CS before CK?,how did u do it? I mean do u have any clinical experience in US??
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  #7  
Old 10-21-2013
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Originally Posted by USMLEClark View Post
A quick question - Now you can only give three differential diagnoses. In a leg weakness case, I might want to exclude myasthenia gravis even though it is not in the 3 DDs. Should I still list Tensilon test in the diagnostic tests?
If it's not in the top three diagnosis, then you don't have to add in the Tensilon test BUT if you have space in the work-up and are highly suspecting myasthenia but doesn't fit the top three, then you can still add in the Tensilon test in the work up. That will give the physician (whose marking your patient note) an idea of what you're thinking and what test you need to do to exclude it. (I did that for 2 cases I think).
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  #8  
Old 10-21-2013
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Originally Posted by MEDICINE DOC View Post
Can u plz tell me ,did u find it easy to do CS before CK?,how did u do it? I mean do u have any clinical experience in US??
I don't know if it matters whether you do CS or CK first. I am sure if you do CK first then you have more knowledge on the diagnostic tests etc but First Aid covers everything that you need to know! I did all my clinical rotations in the US and found it easy to communicate with the sp's although some of them really make you nervous and are amazing actors. One of them even got mad at me but I had to keep my cool. As long as you stick to First Aid, do everything it says in there, and don't take this exam lightly, you should be good!
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  #9  
Old 10-22-2013
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Originally Posted by Hope2Pass View Post
If it's not in the top three diagnosis, then you don't have to add in the Tensilon test BUT if you have space in the work-up and are highly suspecting myasthenia but doesn't fit the top three, then you can still add in the Tensilon test in the work up. That will give the physician (whose marking your patient note) an idea of what you're thinking and what test you need to do to exclude it. (I did that for 2 cases I think).
Thanks for the clarification!
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  #10  
Old 10-23-2013
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Such great advice! Hey, did you pass on high perf or borderline?
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  #11  
Old 11-01-2013
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Default congrats

Pls i had problem in ICE in my exam.can u pls help me in ICE.should i write the patient note in exam to be exactly like first aid.i don't know where i had problem in my last cs not to pass ICE.maybe Patient note or maybe physical exam.so if u are willing to help me so i can write my patient note and send to u to correct me since u have passed the exam.pls reply.thanks
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  #12  
Old 11-12-2013
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thanks for the encouragement thank you
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