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 My CS Success formula  

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I had exactly 10 days to prepare for CS and a lot of help from good friends like Chemamr and I'll tell u my success story hoping it'll help someone else.

In such a short time, making an organized plan is key to preparing for your CS. I would recommend starting with watching the USMLE cd u get in the mail, and I 'm sure most of us having done step 1 and 2 first would already have a copy of this. The cd gives you an exact idea of what is going to happen on exam day, step by step. Plus, they show it to you again in the examination hall, so it's a comfortable piece of information to be familiar with. After watching the cd, I starting hacking "First Aid for CS". I made que cards for all the differential diagnosis's and their concerned investigations given in the back of the First Aid for CS. I spent about 3 days just memorizing these and took these cards EVERYWHERE I went, be it the mall, the gym..even to parties. Trust me, memorizing as much of these as u can cuts down more then half the work. In the next few days I read over the cases and counselling problems given in the first part of First aid, paying special attention to what questions to ask in each case for history. Know LIQOR AAA and PAM HUG FOSS like the back of your hand, plus make que cards for other handy mnemonics for pead's cases, depression, erectile dysfunction and abuse. They really help on exam day when u read that white sheet and draw a blank in ur mind as to what to ask when in da room. <?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />

The last few days I watched a brief physical examination cd I had and I practiced with a phone partner, with my mom, dad, cousins, stuffed animals and any other willing person as many cases out of first aid as I could. When I ran out of cases in first aid, I went to "Mastering the USMLE step 2 CS/OSCE" book which was another excellent source. I did NOT eat, drink, breathe CSA cases, but did practice whenever I could and felt up to it.

Exam Day:

Make sure you get a good night's sleep before. I was trying to sleep in a hot LA apartment, so u can imagine with noise of traffic, unfamiliarity of place plus exam nervousness how much sleep I must have gotten, but somehow I managed to perk up with a cold shower and a good breakfast in the morning (don't have too many carbs..ul b jumpin before u enter the hall). Make sure u also have all ur necessary equip. layed out from the night before like ur lab coat, stethoscope, photo id and exam permit. The staff and SP's are super as soon as u walk in u feel right at home. They'll let u keep ur id and cash in ur lab coat pockets but also have a room they keep locked up all day for any other belongings u may have. Before walking into every room, I always wrote down the patient's name, PAM HUG FOSS and 3 differentials on my white sheet, this helped keep me organized with what to do. Make sure u ask a relavent history but don't go into too much detail, or repeat what the SP's already told u. Try to start ur examination a few minutes before the 5 min me 5 mins r never enough to examine. U don't have to examine complete systems (eg. CNS) but do try to auscultate the heart and lungs in every case. The food they offer u is well balanced in quality and quantity...and don't forget to grab some extra cookies and juice (or whatever u center's got) for the second break they give after lunch. The exam finishes pretty quickly, and everyone is bound to forget to ask or examine something or another..we're all human.

After having passed now on what little prep I had, I can only say that it's ur history and communication skills which win u the most marks. I can say that for a fact because I didn't know how to examine 4 of my patients and probably didn't do enough, or the right examination for the's my weakness. But, I was always empathetic to the patient, always washed my hands, greeted them with a wide and warm smile and always shook hands with them when leaving and asked if they had any other concerns or questions. Remember little things like warming ur hands, pulling out the leg rest, helping the patient sit up or lie down... with one sick female, I even helped cover her with a blanket and handed her back her pillow when done examing her. I ran out of time on almost every don't worry if the staff have to knock, or even open the door for u..still say goodbye with a smile, tell the SP ul b in touch with them and show them WHO'S Da BOSS!


Good luck and keep up the optimistic attitude. Thanks for sharing!..


its not blanket..its drape


thanks for sharing ur experience.even i have just 12 days to prepare for cs.did u use usmleworld or just firt aid?


U have to re-drape every pt. but if they have a blanket on in addition to the drape, putting it back on them will earn u some more points!


Since I didn't have much time I didn't think it was worth it for me to spend money on usmleworld...I just used First Aid and Mastering Step2 CS


Thanks Carmen and rn..any other questions are welcomed.


hi nisha i live in india and have started preparing for my step1 ...have finished my dvds and have started studying preparing to give my exam feb 2007 is 6 months enough?......and also tell me what were ur scores on both the steps.....i plan to give my cs in april 2007.....will 1 month be sufficient for studying ?? and how many days before the exam do we need to stay near the exam centre....i plan to give my cs in chicago...


docahmer, 6 months is enough for both steps and 1 month is enough for CS, especially if u are able to communicate effectively in English. I stayed near the exam center only the night before the exam


thanks for your kind words nisha. wink


thanks for ur reply nisha,i have a few questions

how do we start questioning an alcholic patient?shud we straight away start with questions like from when u drink ?how to approach?

can we straight away ask if they have std or hiv or ivdrugs?

shud we offer pain killers for pts in pain?

do we need detailed menstrual history for females esp with pain abdomen or just LMP

can we write on pt notes and tell pts they require hosp admission?i watched in the usmle cds,they have mentioned not to write admission but its mentioned in usmleworld.

smiling facesmiling face


hi Nisha, i wanted to know, at the LA center, are they good abt lending stets? do they hv plenty....or is it better if i carry my own?

thanks in advance


hi nisha thanks fr sharing ur exp
im planning to gv my cs in nov lot f time but no dates available is there any possibility f getting dates


rn: ok for your alcoholic pt. start by asking
  1. do you consume alcohol
  2. how much and how often do you drink? if they say occasional, ask what they mean by that
  3. ask if they've felt the need to cut down? feel annoyed by the criticism about their drinking, feel guilty about drinking, or ever need a drink in the morning to lay off a hangover? (CAGE)
  4. u can ask about support systems, stresses, anxieties which may be leading to the problem
  5. u can ask about any s/o alcoholic liver disease, any hematamasis, ulcer pain, wasting, gynaecomastia, pigmentations on chest/hands
  6. how this is affecting their relationships at work, with their spouse and kids?
  7. any problems with fertility?
  8. then most imp: COUNSEL THIS PT. talk about Alcoholic's anonymous, and Al-non, talk about providing support, Disulfiram/Naltrexone

For STD's, straight up ask them if they've ever been diagnosed with an STD, and if they ask what it is, ask if they've ever noticed any vesicles, or other lesions/growths on their genitalia, any urethral discharge, or if any of their partner's have had such a problem.

If a pt. is in acute pain, and u are pretty sure u know the diagnosis, eg. musculoskeletal pain, u can say my nurse can give u a painkiller right now if this pain is disabling, but I would prefer to give you proper and adequate treatment once I run some diagnostic tests on you and confirm what u've got.

For a female with abd pain: take a detailed menstrual history, that incl ur age of menarche, how many day cycle, volume of flow, # pads changed, clots, pain, LMP, etc. Remb. it cud be like an ectopic rupture, or u wanna rule out everything.

On ur pt. note, don't write anything about sending the pt. to the hospital, or getting a referral...stick to investigations, and that can include: BP, DRE, pelvic and inguinal exams


drk1980: In my group no one needed a steth...everyone brought their own..I think it's a good idea to carry ur own, the SP may fake some findings, and everyone is usually atuned to their own steth


kishan_dr: the best way to find a date opening is to check on the ecfmg website day and night, dates usually become available 2-3 days before an exam as ppl cancel last minute, if ur flexible and well prepared u can give it spur of the moment. Tell ur parents, friends, siblings to keep checking for u when u can't reach the net. Alternatively..u can mention that ur looking for a date switch on different CS forums and websites like


thanks a lot Nisha !!
My exam center is in LA too, plz tell me which hotel you stayed in? & how far it is from the center?
thanks again.


I stayed at my cousin's place, but I've heard a lot of good things about the Hacienda Hotel, and it's only supposed to be a 10 minute walk from the exam center, u can check it out. Good Luck!


thanks fr the info


old post but good

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