maqsur
Forum Junior
Topics: 5
Posts: 78
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Hi all,
Well, once again, I just wanted to share the good news, and give a big good luck to everyone else out there as well. OASIS finally updated with my score report date, and when I attempted to reregister, I was told in those beautiful sexy red letters: "Our records indicate that you have already passed Step 2 CS..."!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Al-hamdulillah (praise to God) for this victory! May you all experience the same relief and endorphin kick that I am feeling right now! Gotta get ready for work, take care!!!!
___________________
Hasan
MS-4, St. George's University
Aspiring Peds Resident
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| rhonda
Forum Senior
Topics: 9
Posts: 122
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That's so great maqsur! You're really starting off the year with good fortunes! You deserve it!  Congrats!
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| Gina
Forum Junior
Topics: 9
Posts: 50
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Congratulations!!!
Wish you the best of luck for your future.
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| sar
Forum Guru
Topics: 22
Posts: 639
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Congratulations to you Maqsur!
Thats great, i can imagine how one feels when he gets those "red letters of success"
Now you are done with all these steps. Best of luck for your residency!
Share your cs experience with us!
Sar.
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| maqsur
Forum Junior
Topics: 5
Posts: 78
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Hi all,
Thanks for the accolades, I appreciate it. My experience... well, let me attempt to summarize my day back in November.
First off, I did my exam in Atlanta. I stayed in Country Inn on Pheonix Blvd. The testing center is right next to the hotel. You can walk across the parking lot and you're there.
The test center was nice and clean. You walk in and a lady checks your ID and ticket. If I recall correctly, you basically can't bring anything with you except your ID and your white coat/stethoscope. You then procede to a room where the other test takers are and sign in. They give you a badge with a number to wear on your coat. They also give you something to cover up any identifying symbol for your school. After everyone has shown up (around 8:30 am), they herd us to a conference room where they give a little intro to the test and its rules. They also play a video to orient you with the exam, the rooms, how to use the equipment. Then there was a small break for people to use the restroom. Then they split is into two lines, and we entered the test area where each station was set up. There was a station next to the door for each exam room, and the station had a computer there. Oh, and they give you a clipboard and scrap paper and a pen to use for the day (one sheet of paper per room).
I don't want to give too much more detail on these little technical aspects, because you can watch the video available on the USMLE website, which will show you visually how the exam is conducted. Now, from what I read (and they tell you this during the test orientation), we cannot discuss the specific cases because that is considered irregular behaviour, so you'll forgive me for being paranoid and not wanting to take a chance.
However, I will say generally that the cases are testing common medical problems; things you would see in a primary care office. I approached each patient the same way. After the signal to start was given, you read the paper on the door to get the synopsis of the patient (vitals, chief complaint; instructions). I write down a couple of the things that I think are important. Then you knock on the door (always do this before entering), and once you go in, introduce yourself to the patient, smile, and then begin your history. Ask for present history, and any pertinent family history or social history. Remember that you don't have all day for the encounter (you have 15 minutes from the start signal). After I would get the history from the patient, I would let them know that I wanted to do a physical exam and that I needed to wash my hands first. The reason I told them I was washing my hands is so that I would not forget, and also they would know that I was thinking about cleanliness. Now, each case will have slightly different exams to do, but on EVERYONE i did a heart and lungs exam. I think this is good form, because while the patient may not give a specific cardiovascular complaint, you may find something unknown to the patient (this is mainly general advice, but also applies even to testing purposes - it signifies completeness). Once I did my pertinent exam (only lasting a few mins usually, i was quick on most patients), I would tell the patient that I want to do further testing (and tell them which testing I wanted to do), and that based on this further testing we could figure out what the problem was. In other words, I was vague because a lot of the time, I could not say exactly what was wrong just based on h and p (unless it was something obvious), and I would tell everyone that I wanted to get x test and y test to try to get to the right diagnosis. I always asked at the end (and also while washing my hands before physical) if they had questions and concerns. Most of the patients will need some reassurance when you ask this question, because they will voice some sort of concern. Remember, they are also testing your interpersonal skills on this exam.
After my 12 patient encounters (yes, 12), they collected our clipboards, we signed out, and got a paper confirming we had taken the exam, and that was it. There were 2 10-15 minute breaks, and one 30 minute lunch break (some foods was provided - sandwiches, salad, cookies, soda).
For those of you who didn't want to read through my extremely long 'summary,' here are some quick tips which I feel are good to keep in mind.
1. Knock before entering!
2. Introduce yourself each time!
3. Time is limited, ask important questions and don't get involved in minutiae.
4. WASH YOUR HANDS BEFORE EVERY PHYSICAL EXAM.
5. Cover the patients legs and lower body to protect modesty. Only expose what you need to examine.
6. Do a heart and lung exam on everyone, even if they are complaining about their big toe.
7. Always ask if the patient has questions or concerns!
8. Make eye contact, and keep it at their level (i.e. sit your butt down so you are not looking down towards them - I did this by mistake with one lady, and then caught myself and sat down).
9. Reassure the patient at the end of each encounter, and let them know you want to run whatever test, and that you will go from there and see what happens. Be kind!!!
10. Now, this last piece of advice (at least for this message post) might not be for you, but, TYPE YOUR PATIENT NOTE. My hand cramps from writing quickly, and I always make mistakes and have to cross stuff out. It's easier to type and correct yourself with the backspace button. Besides, I can type fast, and I don't cramp up while typing.
11. This did not apply to me, BUT, if you have an accent, practice your English skills and pronounciation. Speaking clearly is key. Oh, and don't use big medical words; speak in common terms, as you do not want to confuse the patient.
I had no phone cases. All cases were patients except one, in which there was no patient (just talking basically). Remember, if you finish your h and p early, you can use that extra time for your patient note. Don't be afraid to finish an encounter early, if you feel you got everything you need. No doubt, I forgot things here and there. I'm human like everyone else, and I felt stupid for forgetting. However, remember, this is not a natural environment; we are under stress and being watched.
Lastly, and sorry for taking so long, remember that the STANDARDIZED PATIENT is the one who grades you on this exam (each of the 3 components). So BE NICE TO THE PATIENT. Okay, I can't think of anything else to type. I will be happy to answer questions you all may have, but please don't ask about the specific cases, as we are not allowed to discuss them (at least not publically)! :P
___________________
Hasan
MS-4, St. George's University
Aspiring Peds Resident
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| maqsur
Forum Junior
Topics: 5
Posts: 78
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By the way, I know that several folks out there practice before the CS. I did not do any practice or studying beforehand, because I felt it was unnecessary. I truly felt that my clinical rotations gave me ample knowledge and skill in history taking and physical examination. Interpersonal skills are something you develop simply by talking to people anytime anywhere.
Now, having said all that, it is not a bad idea to practice if you feel unsure of your skills. As I said, practice your speaking (in terms of pronounciation and word selection). Let me repeat myself yet again: BE NICE TO THE PATIENTS! They are the ones grading you!
___________________
Hasan
MS-4, St. George's University
Aspiring Peds Resident
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| FAT_GOITER
Forum Senior
Topics: 18
Posts: 110
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Congrats Maqsur!
I took my exam in Atlanta and stayed in Country inn too just like you and the best news is that I have also passed the exam as updated on OASIS.
Wish you good luck in residency .
Fat Goiter
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| uspinoydoc
Forum Junior
Topics: 1
Posts: 91
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Congratulations ! and nice post..i'm sure it will help many in this forum..
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| maqsur
Forum Junior
Topics: 5
Posts: 78
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thanks guys, congrats to you too
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Hasan
MS-4, St. George's University
Aspiring Peds Resident
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| sar
Forum Guru
Topics: 22
Posts: 639
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Thanks Maqsur for such a detailed post. Those tiny details that you have mentioned are also very imp, in order to fully aware of the environment and the real exam day.
In usmle CD, they says you can bring your own food, if i dont bring it would that food ( that they will provide) be ok?
Where do we put our IDs?? and other accessories like my purse??? 
How was the temp inside?? bearable or cold or warm enuf??
Sorry for the stupid questions 
thanks again
Sar.
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| maqsur
Forum Junior
Topics: 5
Posts: 78
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Temp was okay for me. As ups has mentioned in his own post, there is a place where you store all your belongings. I kept my ID in my white coat pocket if I recall correctly.
The food they had was fine. It was salad, sandwiches, and cookies. I didn't eat lunch except for a piece of bread (I can't eat when I'm on the spot or during events like CS or interviews - I don't trust my stomach!). I had some water as well.
___________________
Hasan
MS-4, St. George's University
Aspiring Peds Resident
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| sar
Forum Guru
Topics: 22
Posts: 639
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Thank you maqsur!
You all have given a good help! It will be helpful for many.
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| chivasregal
Forum Elite
Topics: 10
Posts: 285
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congrats dude..ur experience will help many..good luck for match n residency
___________________
It's good to be a Resident finally!!
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| p4cs
Forum Newbie
Topics: 6
Posts: 7
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Could you please tell me how all the breaks are laid out? Is the lunch break between the 2 additional breaks? If so, how many cases before the first break? How many between the first & lunch break? How many between the lunch & second break?
Thank you very much and good luck!
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| dacis
Forum Junior
Topics: 1
Posts: 75
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When I took exam we had the lunch break after the first 5 patients , then we had 4 more Pt after the lunch and then the short break , and after thet the last 3 patients .
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| maqsur
Forum Junior
Topics: 5
Posts: 78
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Yeah, those break times sound accurate for my test as well.
___________________
Hasan
MS-4, St. George's University
Aspiring Peds Resident
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| lucky
Forum Guru
Topics: 23
Posts: 505
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congrats maqsur. ur thru. good luck for the future.
i have a q i hope u can help me.
i am an img, i want to take prep courses before i take cs , can u guide me about the prep courses. i'll be taking the exam in houston if i get the visa.
p.s this q is for all people reading this post.
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| maqsur
Forum Junior
Topics: 5
Posts: 78
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I can't help with prep courses, because I did not take one for CS. In fact, I did not study at all for the exam, because I don't think one needs to. Unless, of course, if you have not been in a hospital lately. In that case, practice your basic exam techniques, and even more important (in my opinion), your interpersonal skills. I have heard of several people failing this exam, despite their command of English and their H&P skills, because they just can't communicate properly. By communication, I mean speaking clearly (especially true if you have an accent), using common language and not big medical words, showing empathy, making eye contact, smiling when appropriate, etc. Never talk down to the patient, and always be nice, even if they are being nasty. Remember, we are professionals, and thus we have to maintain our professionalism, even when dealing with a nasty patient. Please read my earlier super-long post if you want more insight into how my exam was.
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Hasan
MS-4, St. George's University
Aspiring Peds Resident
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| maqsur
Forum Junior
Topics: 5
Posts: 78
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By the way, I got the offical score report in the mail yesterday (2 days after it was reported), and it confirmed my passing. I notice that they do not give you any feedback on your performance. They tell you if you overall pass/fail, and then give you a pass/fail for each subcomponent. All 3 were passes of course, because if you fail one component, then you fail the exam altogether.
It would be nice to see some feedback on what I did well and what I did crappy, even though I passed overall. I think it can only help in the future.
___________________
Hasan
MS-4, St. George's University
Aspiring Peds Resident
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| dacis
Forum Junior
Topics: 1
Posts: 75
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I am also an IMG , " old graduate" with 4 years away from medicine and 2 small children . Did not take any Step2CS prep courses - just read the practice cases . If I was able to pass almost anybody should . Those prep courses are very expensive . Better practice the cases yourself and practice your English . And be very considerate and nice to the SPs .
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| lucky
Forum Guru
Topics: 23
Posts: 505
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thank u very much for answering my post. however i don't think i can pass cs without a prep course as i have been away from a hospital for about 2 years now and i have absolutely no idea how the exam goes.
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| maqsur
Forum Junior
Topics: 5
Posts: 78
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Watch the CS video (available online from the USMLE website) to get an idea of what to expect. Other than that, as dacis has said, just practice. If you have a wife, a friend, whoever, just practice taking a history from them and then doing a directed physical exam (i.e. related to their problem). I think you should be able to do fine without paying hundreds of dollars. However, you know yourself best, and you should do what makes you feel content.
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Hasan
MS-4, St. George's University
Aspiring Peds Resident
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| dacis
Forum Junior
Topics: 1
Posts: 75
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If you live in USA I can send you CD which has very good video on how to examine patient - all the systems .
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| uspinoydoc
Forum Junior
Topics: 1
Posts: 91
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I found a free website that has PE videos used in an american medical school for teaching purposes. It has all the systems.
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| elina
Forum Newbie
Topics: 3
Posts: 13
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Lucky, if you really feel that you want to take a course (I know i did) you can try taking DrSwartz workshops in New York. They are really good and less expensive than other courses. If you want I can forward to you an email from this program. You can write to me -- etsyvkin@mail.ru and I will send you that email.
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