Step 2 CS - Helpful Tips (Page 2)
Tip #5 Use hand washing time productively
When washing hands before the physical exam, avoid engaging the patient in useless “small talk”. This is also NOT the appropriate time for asking history questions. Instead, make better use of this precious time by planning and mentally preparing for your entire focused physical exam before approaching the patient. Doing so will allow for a more deliberate and methodical demonstration of your PE skills, and minimize the tentativeness and uncertainty which can detract from your “professional manner” score.
Tip #6 “Treat the person, not just the problem”
In short, if your entire focus is only on finding the correct differential, and not on the comfort, concerns and behavior of the patient in front of you, you stand a very good chance of failing CIS.! Standardized patients are trained to have very specific “agendas” in many cases which, if not addressed appropriately, can reflect negatively on the communication skills component of your score. Remember that EVERYTHING that a patient does or says during an encounter is specifically intended to be part of that presentation – even if it doesn’t relate directly to finding the diagnosis. Finally, don’t forget to inquire and empathize about any impact that chronic complaints have on life activities – it’s required!
Tip #7 Practice! Practice! Practice
For many medical graduates (and most IMGs), the Step 2 cs exam is the most difficult hurdle of all the USMLE licensing requirements. In my experience, the number one reason for failure is inadequate practice. But remember that your preparation for the step 2 cs exam requires that you have someone else to practice with. After all, you can’t perform a physical exam without a body! Ideally, you should try to partner with another medical graduate who is also preparing to take the exam and has some understanding of exam criteria. If your budget allows, you may also want to consider taking an affordable review course. Without the benefit of accurate, objective evaluation, it is sometimes impossible to be aware of many of the subtle communication skills deficits which so often are responsible for cs failures. Before choosing a course, find out how long it has been established, and be sure to ask about the background of the instructors as well as the standardized patients who will be evaluating you. Pick one that offers full case practice and personalized feedback from experienced experts who can identify specific problem areas and provide the right solutions.