Step 2 CS - Helpful Tips
Below are some helpful tips that International Medical Graduates (IMG) preparing for the USMLE Step 2CS Exam can use. If you have other questions that are not on this page, please feel free to contact us.
Tip #1 Have some ideas before you enter the room.
How wisely you spend the time outside the room, before you meet the patient, can make the difference between success and failure. A little “critical thinking” here will go a long way when you’re actually in the throws of the patient encounter! After jotting down your mnemonic letters (see Tip #2), write up to 5 differentials on your scrap paper which can be based solely on the doorway information. During history taking, be sure to ask about at least 2 symptoms associated with each of these possibilities. These questions will most likely be included on the SP’s data gathering checklist, and will help determine what physical exam should be performed.
Tip #2 MNEMONICS are your best friend
Utilizing a mnemonic guide for history taking will not only insure that you don’t miss important data, it will provide a "security blanket" if you lose your way! Unfortunately, many test takers feel compelled to rush into the room to save time only to find that they are disorganized and without focus. Find a mnemonic guide (I like LIQORAAA – PAMHUGSFOSS) that covers the basic data for every case, BUT keep in mind that each presentation will require additional investigation specific to that particular complaint (see Tip #1). A good mnemonic guide will also organize your findings on the scrap paper, allowing for easy transfer of data to your patient note.
Tip #3 Don’t forget to follow up!
When taking a history, keep in mind that ANY positive response from the patient usually requires a follow up question or two (sometimes more!). For example, when told about a prescription med, be sure to ask what it’s for, when the diagnosis was made, if the patient is compliant, and if it is managing the problem. Failure to follow up on positive findings will often be the reason for missed data.
Tip #4 Employ a Time Management Strategy
Running out of time before completing your “closing” for a case will seriously compromise the communication skills score for that encounter. When practicing for your step 2 cs exam, it’s advisable to divide the patient encounter into the following 4 segments: 1. Scrap paper preparation & introduction, 2. Focused history, 3. Focused physical exam, 4.Closing and counseling. Assign the appropriate amount of time for each segment and make sure that you don’t exceed 15 minutes total. Also, be sure to use a timer in your preparation to insure that you are adhering to your time management structure.