HOW TO PREPARE FOR USMLE STEP 2 CS
BEST TIPS ON HOW TO STUDY AND PASS USMLE STEP 2 CS
By Ali Feili MD, MBA
I just received my USMLE Step 2 Clinical Skills (CS) scores a few days ago and I was extremely happy since I passed. What really made me happy though; was the fact that I did really well in all three parts of the exam (the ICE, CIS and SEP). Before I received my passing score I was very confident that I had passed the USMLE step 2 CS exam simply, because of the way I studied and practiced. I would like to share my method with all of you and I hope my method would be useful to you and it can improve your performance, so you can pass the exam once and for all.
Before I explain my USMLE Step 2 CS Tips on how I practiced and passed, I would like to clarify that I am an IMG student and I went to a Caribbean medical school. English is my second language but since I’ve lived in the United States for the past 14 years, I have no difficulties speaking English, other than a very minor accent, I consider myself an average student but I do have a lot of ambition and motivation and I always try to do my best and I always put in 100% in everything that I do.
The reason I’m telling you all this is because I know many of you are also IMG students with the same qualities but, unfortunately for us IMG students everything seems harder and I believe the best way to prepare for any of the USMLE examinations is to follow other IMG students advice, who have passed the exams and have done well.
USMLE STEP 2 CS TIPS (#1): WHICH BOOK TO STUDY
There are several different books out there for this exam, but in my opinion, the ONLY book you need is First Aid for USMLE Step 2 CS. You should not need any other book, unless you are one of those people who likes over study. One thing that really stresses out most IMG students is that we always think that we don’t know enough so we try to use many different sources, which will always end up being more harmful than helpful.
You must understand, that USMLE Step 2 CS tries to test your knowledge on the most common diseases in the United States and First Aid for USMLE Step 2 CS covers pretty much all those cases.
USMLE STEP 2 CS TIPS (#2): LIVE PARTNER
The most important thing is practicing with a “live” partner. I know many other students who tried to practice on Skype or over the phone but the problem is that you do not get to actually interact face to face and in person with them and that’s what USMLE Step 2 CS is really all about. Your live partner does not have to be a medical student or even in a medical field. All you need is someone to practice with, like any of your friends or family members, which I’m sure will be more than happy to help you.
USMLE STEP 2 CS TIPS (#3): TIMER
You cannot perform well if you don’t time yourself while practicing. You might think you are going to do ok even without practicing with a timer, but in reality the day of USMLE step 2 CS exam you’ll be too nervous and stressed to even think about time. But if you have practiced all of your cases with a timer then your brain will automatically manage the time for you, therefore you will have one less problem to worry about, which will enhance your performance. This is the timer that we used (Timer).
USMLE STEP 2 CS TIPS (#4): PATIENT GOWN
Make sure to have a patient gown or something close to it so you can start getting comfortable with asking questions such as “May I please untie your gown so I can listen to your breathing sounds” or “May I please lower your gown a little bit so I can listen to your heart sounds“, “Now, I’m going to tie back your gown“… Many students forget to do these easy tasks, and lose a lot of valuable points only because they did not practice with a patient gown. This is the patient gown I purchased and it was pretty much identical to the one used on my USMLE step 2 CS exam.
USMLE STEP 2 CS TIPS (#5): NOTE CARDS
I highly recommend going through all the long cases in First Aid for USMLE Step 2 CS at least twice with a live partner.
After you have practiced all the long cases for the first time, then start making note cards for your “second” round. On each note card write patient’s name, age, chief complaint and vital signs. After you have all your note cards ready then shuffle them and have your partner pick your cases randomly.
The reason you would want to do this is because you don’t know what cases are going to show up on your actual exam and, this method will prepare you well for facing all the cases you face on the day of your USMLE step 2 CS exam. Also, if you don’t perform well in a certain case then put the corresponding note card in a different batch. I will explain to you why you should do this in the following tips.
If like me, you are having a rough time trying to remember all the questions you should be asking your standardized patient, then try using mnemonics. With the help of some students we created really easy to remember mnemonics for basically all the long cases in First Aid for USMLE Step 2 CS book, which definitely helped me remember things during my actual exam. I have also included list of physical examinations along with differential diagnosis and diagnostic work-up for each case. You’re welcome! 🙂
USMLE STEP 2 CS TIPS (#6): BLUE SHEET
Imagine you are suffering from an anaphylactic shock a.k.a. (USMLE Step 2 CS) so obviously your only way of survival is your EpiPen a.k.a. (Blue sheet). I cannot emphasize how important the blue sheet really is. Without a good and organized blue sheet you will definitely perform poorly on your exam. Try making yourself a really nice and organized blue sheet template and practice with it in every single case.
If you don’t want to make your own then I highly recommend using this USMLE Step 2 CS Blue Sheet Mnemonic.
USMLE STEP 2 CS TIPS (#7): TYPING
Apparently the typing part of the exam is where most students have been failing recently. This is because most of us think we can type fast, which I’m sure is true in many cases but how fast and accurate can you type under a lot of pressure and stress? The day of exam is very stressful and you have tons of information on your blue sheet that you need to transfer and type up within 10 minutes.
Now if you have not really practiced then this will become the hardest and the most stressful part of your day and will alter your performance. So I highly recommend timing yourself and typing accurately, right after you do each case just like in the real exam.
USMLE STEP 2 CS TIPS (#8): SIMULATE THE ACTUAL USMLE STEP 2 CS EXAM
A few days (about 3-4 days) before the actual USMLE step 2 CS exam you should try to simulate the actual exam day by practicing twelve (12) of those hard cases that you were originally having problem with (as I mentioned earlier). You definitely want to practice these cases a few days before the exam so they can stay fresh in your mind. Also simulating the actual exam will give you a really good idea of how rough the exam day is going to be. This will also, allows your brain and your body to adjust and make you more ready and energetic on the day of your exam.
USMLE STEP 2 CS TIPS (#9): MINI CASES
I recommend reading all the mini cases from First Aid for USMLE Step 2 CS, as many times as you can. Most students over-look these mini cases, but they will actually help you tremendously with your differential diagnosis, which are very important. Sometimes, your patient might not have what you originally thought they had, so now the only thing that can help you stay in control of the situation is coming up with new questions to ask based on the mini cases/differential diagnosis.
Like I’ve mentioned you should study these mini cases from day one of your preparation but a day or two before the USMLE step 2 CS exam you should take an entire day and go through all the mini cases to keep them fresh in your mind.
This is pretty much all I did in order to prepare for my USMLE step 2 CS.
I do not think there is anything extra you need to do as long as you can master everything I have mentioned in this post.
USMLE STEP 2 CS TIPS (#10): THE BIG DAY
On the day of your USMLE step 2 CS exam you should have a good breakfast. Try to stay calm and remind yourself that these patients are only actors and they are not really sick. Physical examination is important but most people including myself only did the focused physical examination to save time for the closer and have enough time to answer any questions that the patient might have at the end of your interaction.
I took my exam in Chicago and every single patient was super nice and actually very helpful. One trick that actually helped me in a few of my cases was that before I started doing the physical examinations, I would ask “Now if it’s ok with you I would like to do a few physical examinations to help me narrow down my diagnosis, but before I proceed is there anything that you feel might be important that you would like to mention?”.
Some of my patients gave me a few hints but some didn’t, which was totally fine because this question only takes a few seconds to ask and it can really help you if you have somehow missed asking something very important.
USMLE STEP 2 CS TIPS (#11): FORM A BOND
Try to be super nice to your patients but don’t be fake. It is really important to form a doctor patient relationship, this is why eye contact and smiling are essential. I also found it very useful to ask one or two non-medical related questions during some of my patient encounters. For example if your patient is a retired music teacher asked her what type of musical instruments he/she plays or which instrument is his/her favorite. Just by asking these simple questions your patient will feel much more comfortable for the rest of your encounter and they might even give you a few hints here and there.
USMLE STEP 2 CS TIPS (#12): FINAL TIP
My last and the most important advice that I can truly give you is PRACTICE, PRACTICE and PRACTICE. You may know every little detail in your book, which are worthless if you cannot perform well. So please make sure not to rush and take as much time necessary to practice a few times before you actually schedule your exam and remember that the result of your test could make or break your chance of getting into a residency program here in U.S., so make sure you’re 100% ready.
Summary Step 2 Clinical Skills of the United States Medical Licensing Examination was an exam administered to medical students/graduates who wish to become licensed physicians in the U.S.