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Old 06-19-2014
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Steps History: 1+CK+CS
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Post My Step 2 CS experience,Atlanta

Hey guys,i am finally done with 1 more exam and this is my experience of the whole process.

From the off i was very sure i didn't know what was required to pass this exam so i was looking to enroll myself in a course,a friend of mine recommended XiMedus (Port Charlotte,FL) which is what i ended up going for and im glad i did.
A little about the course - its a very nice family feel sort of course,they never take an overload of people(usually about 8-10) so you have plenty of individualized time to learn the PE and stuff.Dr.Rowley knows her stuff and gives good advice on the 1-1 sessions.
After the course i followed their mnemonics,style of asking the questions,performing the PE and writing the PN.I practiced the FA cases with a live study partner,i did the Uworld cases online with a Skype partner.
The key to getting this exam right is finding out what you need to know and then getting thorough with the info and not panicking on the exam day.Break the exam down find out what you are going to do for the


2)History (whatever mnemonic works for you - just see that its relevant to the case that is being given to you) - when doing the history ask the relevant questions for example once you have + chronic coughing, + sputum and + fever you have 1 Dx of Bronchitis,now move to the next Dx which you might suspect(outside the room - FA minicases helps here) like TB then ask occupation and if + as nurse then you have 2 Dx TB...this way you are asking relevant questions(data gathering) getting supporting history for PN.

3) PE - this you should more or less have figured out which system (atleast 1-2 systems) you are going to do after you read the c/o,you will know what part of the system to focus on once you are done with your History.

4) Closing - give them 2 Dx and 2 tests you would order.

5) Counseling - smoking,drinking,drugs,exercise,diet -- if there is nothing you can find to counsel on(like i did on the exam) just say " i see that you eat healthy and exercise regularly(provided you asked about it in the history) and i'm glad you follow a healthy lifestyle" - basically just a causal statement about you recognizing their "area of counsel-able things" so you get points for that section.

6)PN - Find your way of doing it,be it from FA,kaplan,Ximedus or any other source - the key is practice typing with a timer...i honestly did all the FA cases and uworld cases and few cases that the Ximedus course gave me so that is about 100 PN - was it necessary - i don't think so - am i glad i did it - definitely cause i believe that's what helped me pass.

7)Anxiety - it can get to you for sure and i understand that,but just try and stay calm and i think this is a big factor cause think of it this way,if you were the SP and you were grading a doctor,its very easy to see if he/she is nervous in their way of going about the case and that would obviously point to a lesser mark - cause exams like this aren't subjective so no ones is going to feel sad for anyone,its objective so the SP's are looking to see if you are capable of being calm under stressful situations,but of course you can make an SP like you which can favor you in some situations.
My strategy was (i obviously learned all these components only from the Ximedus course) to make sure i did all of them in every case - even if i missed important questions or didn't pick up on clues or missed a system in PE or missed parts of my PN i made sure i did/asked/typed something in all sections - cause end of the day you only need 75% in all parts to pass, so even if you perfect the History taking and get 100% but miss the PE and get 0% i think that will end up as a failed result,
but getting a 85% in history and 65% in PE will give you a 75% on average - so my message to anyone who is preparing make sure you do everything even if not done perfectly - a good doctor can manage to do everything in time constraints in a clam fashion which is what i think is being tested.

For the Dx,PE and DxTests - the FA mini cases and really good,do each and every case and literally think through the process of the PE and what you would do outside the room...and of course time everything,even if you mess up and get stuck during practicing,continue the case and see how long it took you overall and then work on it backwards.
There are really good mnemonics on the forum,i honestly don't think your medical knowledge is tested a lot - the ICE part does but FA+Uworld covers most of your differential and Dxtests so if you learn those well your good.

I have the CK exam left in my USMLE journey...this exam is very doable,its a little different method of studying that is required.Good Luck
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deariederaa (03-24-2015), dr rookie (07-02-2014), seniortaker (06-19-2014)


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