Step 2 CS Secrets

USMLE Step 2 CS analyzes a student’s ability to independently communicate, investigate, perform physical examination, diagnose, and counsel a patient within the given time. The exam is composed of 12 simulated patient encounters in one day. 15 minutes are given for each patient encounter. A warning announcement is made when five minutes are remaining. 10 minutes are given to complete patient notes. We have a few secret tips and tricks which will help you in passing Step 2 CS on the first attempt.

Step 2 CS Exam Secret # 1: Effective Time Management

The most important exam day tip is effective time management. You can roughly divide the given 15 min into four sections in the following manner:
4 min: Introduction and Handwashing
4 min: Clinical Investigation
4 min: Physical Examination P/E
3 min: Conclusion

Step 2 CS Exam Trick # 2: Organize your Blue Sheet

The most crucial minute is the first minute before you enter the room. Once you enter the room, you must focus on establishing communication and reaching the diagnosis in a stressed environment. Therefore, a secret tip to a successful patient encounter is to make a blue sheet blueprint before even you knock on the door.

Step 2 CS Tip # 3: Things you should say after entering the room

A few things you need to say to show respect towards your patient include:

  • Take a deep breath, relax, and then knock on the door.
  • Enter the room with a smile. Say Hello, Mr./Ms ______, I am Dr ______. Introduce yourself.
  • Maintain eye contact and shake hands.
  • Ask the patient about the chief complaint, then say, “I am sorry to hear that” with genuine empathy.
  • Sit down with the patient’s permission and ask, “How can I help you?”

Secret # 4 Know where to stop

Ask only relevant questions. Be specific about your diagnosis. But also investigate about some other related systems. A comprehensive investigation is essential to gain passing status.

Secret # 5: General Examination

General examination might reveal some important clues for your diagnosis, which are missing from the patient history. It includes observation of the mouth and throat, examination of neck for any nodes and checking skin for rashes or dryness, including a check-up of hands and feet.

Secret # 6: Essentials of Physical Examination

You have four minutes to conduct the physical examination including the one specific and two other associated ones. Certain mistakes in this step will definitely lead you to failure. It is important to inform the patient about how you are going to conduct the physical examination. Use the words “Please” and “Thank You” along with a proper eye contact to make the patient feel comfortable with you.

Secret # 7: Closure

Don’t skip this step; even you can cut short the P/E if you are running short of time. The closure must include summary and counseling. Tell the patient about the diagnosis and the investigations you require for further diagnosis in simple terms that the patient can understand.

Secret # 8: Lots of Practice

No matter how proficient your learning is, practice is must. Without practice students aren’t able to manage time efficiently. Practicing live with a friend or a family member helps you in proper communication, physical examination and reaching differential diagnosis. Thorough practice of typing is also necessary to complete patient notes within ten minutes.

Secret # 9: Be Confident

Our last tip to pass your step 2 CS Exam is to believe in yourself as a doctor. No matter how much clinical knowledge you have, anxiety will soon take over if you enter the room without confidence and make you skip the important things to pass the exam.

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