Failed Step 2 CS

[freakingoutStep2CS]

I just found out I failed step 2 cs. I am a US grad with otherwise good step scores, decent grades who is applying to a very competitive residency. What the f$($# do I do now? Am I totally toast? i took my own school's version of the CS two days prior and did fine, and I thought this one went okay. I struggled a little on one of the cases but I really didn't think I was going to fail. I failed the ICE portion, and I am thinking it was the SP portion since my notes were okay.
The only thing I thought was weird was there weren't many simulated physical exam findings as far as I could tell. I had one patient with labored breathing and one with limited range of motion but that was pretty much it.
I am just so upset and frustrated. What can I even do about this? I had already uploaded my Step 2 CK and step 1 scores to ERAS so nobody has to see my score before interviews. But I still need to pass this thing, as well as figure out how to explain this. I just wish I had a better idea of what I did wrong. I looked at the example patient notes, and I think mine are pretty similar. Maybe it was the differential diagnosis? The SP checklists? I just don't know.

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[rd31]

Don't release it now. Retake ASAP and pass it. If programs require it for ranking, only release the score after you pass it (assuming you pass it prior to rank lists are due). If programs require it only prior to your start date and not for ranking, then keep quiet until after the match. I think you'll be fine, especially since you already released both step 1 and 2CK. But if programs ask you about CS on interviews (I think few would) you should be honest. Otherwise don't volunteer the info if possible.

 

[freakingoutStep2CS]

Thanks man. Can anybody tell me exactly when schools will have to see the rest of the scores? Will it be after the match or what? I can't even find any openings to retake it soon...

 

[RingTailedDoc]

It's program specific whether they require your scores prior to ranking. I would check into it on their websites, at least for your top program choices. I believe you need to provide scores prior to ranking for most CA programs, but this might be specialty specific.

Use check4change plug-in for Firefox to find an open date (basically you leave the webpage open and it just refreshes it repeatedly and alerts you when there's a difference). Most SDN users find one within a couple hours using it, so you should be able to easily find a date that will allow you to get a pass before schools start ranking (usually around Feb, so make sure your score reporting falls in the right timeframe)

 

[saudades]

I agree, from what I understand most places require it for ranking but check with each if you can. As far as the physical exam findings, I felt the same way--I remember maybe 2 patients that had actual physical findings I could report. (I passed). If you think it was the checklist portion you had trouble with, you're probably right. I just asked as many questions as I could (including stupid ones), summarized frequently and asked if they understood a bunch of times. I also listed more tests to order than I think most people would in real life to cover my butt--not sure if that helped or hurt, but I figured better safe than sorry. And if it makes you feel any better, 6 people in the class of 2014 at my school failed (including one AOA person) and all matched. Good luck.

 

[takeuponeidea]

I just found out I failed step 2 cs. I am a US grad with otherwise good step scores, decent grades who is applying to a very competitive residency. What the f$($# do I do now? Am I totally toast? i took my own school's version of the CS two days prior and did fine, and I thought this one went okay. I struggled a little on one of the cases but I really didn't think I was going to fail. I failed the ICE portion, and I am thinking it was the SP portion since my notes were okay.
The only thing I thought was weird was there weren't many simulated physical exam findings as far as I could tell. I had one patient with labored breathing and one with limited range of motion but that was pretty much it.
I am just so upset and frustrated. What can I even do about this? I had already uploaded my Step 2 CK and step 1 scores to ERAS so nobody has to see my score before interviews. But I still need to pass this thing, as well as figure out how to explain this. I just wish I had a better idea of what I did wrong. I looked at the example patient notes, and I think mine are pretty similar. Maybe it was the differential diagnosis? The SP checklists? I just don't know.

I think in your step 2 cs score report , they just report ICE but not sub-components (PN and Physical Examination) as these new cs format still need more statistics to report split components like in old format score report.

Regarding ICE, SP only have check list for PE findings and History thing is now clubbed together in PN and which will be rated based on Rating scale by physician.

ICE: PE ( Checklist) and PN ( rating Scale)===> ICE Score bar

Can i know your score bar....Is it close to border line? your low ICE can be bcs of PN or PE because we don't know split score as of now. PN should make sense for physician raters and they rate it on global scale. Unfortunately Step 2 CS is different than step 1 and step 2 ck....

Work hard and All the best friend.

 

[deleted542263]

Hi all... didn't realize I made an account here so long ago.... but here goes...

IMG student, English first language and no problems in this portion, passed CIS portion only a little more than marginally, failed ICE. Step 1 230s and Step 2 CK 230s from last year and this year... trying to apply to IM.

Right now there is no sub-heading for ICE portion or CIS, so I don't even have any feedback on which portion I did wrong. I failed ICE though.

Honestly I don't understand what happened. I've been reading here that some passed and did not finish this or that aspect, or didn't close, or didn't finish the pt interview portion..... none of those things happened to me and I still failed so now I feel completely worthless....... >.>

I felt actually not that bad coming out of it and now I see that CS scoring people see it MUCH differently than I did.... so now I feel like an idiot loser who can't do a proper HPI or get a differential anymore >.>

My physical exam skills are not poor, but not great, I would say weak maybe. And I think this was my weakest portion.... so now I'm doubting everything I did so I can't even understand what I did right or wrong on PE, or did they just hate my patient notes?? I took the CS practice from Kaplan and I thought I got a good impression on how they wanted patient notes.... so I did it pretty much how they asked me to in the Kaplan course after they gave feedback.....

I never ran out of time. I feel like I got a great HPI on all patients but my last one..... I don't even.... >.>

I missed questions here and there on patient interview... I tried to ask as many pertinent ones as possible... I always repeated the history they gave me back to me, always washed hands before PE, always did ROS, always got medical history, always closed, and counselled on all except one guy.... I felt I was being nice but apparently I'm a big idiot for thinking that because my CIS wasn't that good anyway >.>

One time I forgot to counsel with a *healthy* smoker who had a cough, and I realized as soon as I left that station, but I'm pretty sure I did everything else for that guy, would counselling harm me so badly there? For almost all the patients I felt I did a reasonable job, at least enough to pass.... except the last patient.....

The last patient I met I didn't understand well and it made me scared during the process... her CC was "feeling tired" and every question I asked related to thyroid and depression and everything I asked was "no no no no." So like I didn't get any HPI from her. So now I feel like I suck at HPI and have to fear that every program is going to look at me the same like I'm a ******.... I even asked her like 3 times "is there anything else you would like to talk about?" and I got nada every time.... so what I am supposed to do in that situation I don't understand...... >.>

Like.... I don't even know how I failed. I don't know what I could've done so awful that made me fail? The only other glaring mistake I can remember is one note I barely finished..... but enough to fail....? I don't know....

I've been so afraid and depressed of what this is going to do or is already doing to my applications that I've missed this whole week of rotations... I've been having such an awesome time in 4th year, having a great time talking to patients and helping out my residents on electives, and now after I got the score I feel like I ran into a brick wall..... I don't know what to do. I've already applied to get a CS permit the day I found out but what else am I supposed to do?

P.S.

I have a question about draping.... every patient I saw already had a drape on them, all 12 patients, it was already on their laps. Was I supposed to do something that accounts for ICE portion here? Put another drape on them? Am I supposed to open the drape, it seemed already open to me and covering them..... I don't know what I was supposed to do..... >.>

Anyway I wrote in philly and I just don't know.... if the CS goal was to make CS fails feel inadequate and useless.... goal achieved. Not only I get to fail.... I lose some interviews I guess and now I owe another $1500, thanks UMSLE!!!!

 

[takeuponeidea]

Hi all... didn't realize I made an account here so long ago.... but here goes...

IMG student, English first language and no problems in this portion, passed CIS portion only a little more than marginally, failed ICE. Step 1 230s and Step 2 CK 230s from last year and this year... trying to apply to IM.

Right now there is no sub-heading for ICE portion or CIS, so I don't even have any feedback on which portion I did wrong. I failed ICE though.

Honestly I don't understand what happened. I've been reading here that some passed and did not finish this or that aspect, or didn't close, or didn't finish the pt interview portion..... none of those things happened to me and I still failed so now I feel completely worthless....... >.>

I felt actually not that bad coming out of it and now I see that CS scoring people see it MUCH differently than I did.... so now I feel like an idiot loser who can't do a proper HPI or get a differential anymore >.>

My physical exam skills are not poor, but not great, I would say weak maybe. And I think this was my weakest portion.... so now I'm doubting everything I did so I can't even understand what I did right or wrong on PE, or did they just hate my patient notes?? I took the CS practice from Kaplan and I thought I got a good impression on how they wanted patient notes.... so I did it pretty much how they asked me to in the Kaplan course after they gave feedback.....

I never ran out of time. I feel like I got a great HPI on all patients but my last one..... I don't even.... >.>

I missed questions here and there on patient interview... I tried to ask as many pertinent ones as possible... I always repeated the history they gave me back to me, always washed hands before PE, always did ROS, always got medical history, always closed, and counselled on all except one guy.... I felt I was being nice but apparently I'm a big idiot for thinking that because my CIS wasn't that good anyway >.>

One time I forgot to counsel with a *healthy* smoker who had a cough, and I realized as soon as I left that station, but I'm pretty sure I did everything else for that guy, would counselling harm me so badly there? For almost all the patients I felt I did a reasonable job, at least enough to pass.... except the last patient.....

The last patient I met I didn't understand well and it made me scared during the process... her CC was "feeling tired" and every question I asked related to thyroid and depression and everything I asked was "no no no no." So like I didn't get any HPI from her. So now I feel like I suck at HPI and have to fear that every program is going to look at me the same like I'm a ******.... I even asked her like 3 times "is there anything else you would like to talk about?" and I got nada every time.... so what I am supposed to do in that situation I don't understand...... >.>

Like.... I don't even know how I failed. I don't know what I could've done so awful that made me fail? The only other glaring mistake I can remember is one note I barely finished..... but enough to fail....? I don't know....

I've been so afraid and depressed of what this is going to do or is already doing to my applications that I've missed this whole week of rotations... I've been having such an awesome time in 4th year, having a great time talking to patients and helping out my residents on electives, and now after I got the score I feel like I ran into a brick wall..... I don't know what to do. I've already applied to get a CS permit the day I found out but what else am I supposed to do?

P.S.

I have a question about draping.... every patient I saw already had a drape on them, all 12 patients, it was already on their laps. Was I supposed to do something that accounts for ICE portion here? Put another drape on them? Am I supposed to open the drape, it seemed already open to me and covering them..... I don't know what I was supposed to do..... >.>

Anyway I wrote in philly and I just don't know.... if the CS goal was to make CS fails feel inadequate and useless.... goal achieved. Not only I get to fail.... I lose some interviews I guess and now I owe another $1500, thanks UMSLE!!!!

Sorry to know about your result.....there is no doubt that step 2 cs is complete useless exam which fail to asses our clinical skills in just 10min.....it is unfair but the system is like that.....it is subjective exam and need luck as well....i wish usmle remove cs exam or else ignore attempts.

Atleast PD's should ignore cs attempts and just accept pass score....there is a meaning when someone consider step 1 . ck and step 3 attempts but not for step 2 cs.....it is useless exam as far as to assess medical student clinical skills.....i heard many students who were excellent in clinical skills and communication/English failed cs...

Few months back CIS was based on rating scale and now it is based on checklist...my question is, how can one compare old and new format....i think that is the reason why they have increased CIS passing grade compared to old format because checklist for CIS relatively easy for student to pass compared to CIS rating scale grading.

However CS exam is not uniform.......NBME need to rethink of CS ( atleast regarding attempts)....All the best my friend

 

[Phloston]

Anyway I wrote in philly and I just don't know.... if the CS goal was to make CS fails feel inadequate and useless.... goal achieved. Not only I get to fail.... I lose some interviews I guess and now I owe another $1500, thanks UMSLE!!!!

What's actually really interesting about this is that I was emailed by a friend about 6 months ago after he failed the 2CS, and he gave me two pieces of advice.

The first was fair enough: follow everything exactly by the book (i.e., just do everything exactly their way).

The second was: don't write the exam in Philadelphia. He said something along the lines of, "I know that sounds like a very odd piece of advice, but don't write it in Philadelphia. I was doing a 2CS training course (IMG), and the only people who failed were the ones who took it in Philly. The kids who took it in Atlanta and Houston passed."

 

[takeuponeidea]

What's actually really interesting about this is that I was emailed by a friend about 6 months ago after he failed the 2CS, and he gave me two pieces of advice.

The first was fair enough: follow everything exactly by the book (i.e., just do everything exactly their way).

The second was: don't write the exam in Philadelphia. He said something along the lines of, "I know that sounds like a very odd piece of advice, but don't write it in Philadelphia. I was doing a 2CS training course (IMG), and the only people who failed were the ones who took it in Philly. The kids who took it in Atlanta and Houston passed."

I do not agree with your friend about test centers relation with cs pass/fail outcome. I know few of my friends who were not well prepared ( accepted by themselves ) and some with low SEP levels passed from Philly with high pass grade and some with great skills failed from Houston and Atlanta.

Good thing to do is: Practice Practice Practice with LIVE SP using FA and Kaplan CS Core cases......Nothing is needed except bit of luck.....manage time with PN and try to be less nervous on exam day (easy to say)

 

[597622]

I disagree. I have several IMG friends who took it in Philly and had no issues passing. The FA CS book is all I used. Read over it casually for 4-5 weeks and studied everyday for 2 weeks and practiced with a partner during those 2 weeks. The actual exam I could see how it would be easy to fail if you don't practice. You need to have confidence and it's hard when dealing with complete strangers who are grading you. If you read the CS bookx3 and do the casesx2 and are intelligent on CK and Step 1 material I don't see how someone could fail this unless nerves got in the way and they panicked. My lowest score was in the clinical score but was still far away from borderline. English fluency must also be an issue for those not lucky enough to call english their 2nd language. Can't imagine doing USMLE exams not just CS in non-native language.

 

[spik]

OP, most residencies do not require Step 2 CS for ranking; however, they usually require a passing score by the time you start your residency. Furthermore, check you medical school graduation requirements since many medical schools require it for graduation. Since you have already released your Step 1 and Step 2 CK, I think you are in a good shape; most residencies want both of them for ranking. I would not release your Step 2 CS failing score prior to the match. Yes, some residencies will not rank you; however, many more will not rank or rank you lower with a failing Step 2 CS.

Retake your Step 2 CS and don't fail it again. I am sorry for your difficulties, and I agree that Step 2 CS is a completely useless test for AMGs. Good luck!

 

[Sileni]

Calm down, What's your email, you need my help before you make another mistake, these ppl can't help

ROFL, are you really mass replying to threads related to failing CS to promote yourself/business.

 

[rain77]

Hi guys Cs is like cat on the wall kinda exam. Dont know which way it goes. Practice is key. Practicing the right way also counts. Ofcourse being calm on the exam day matters.

 

[outsider29]

Calm down, What's your email, you need my help before you make another mistake, these ppl can't help

does anybody know if they repeat the cases?

 

[Jorje286]

.

 

[D1stant]

Random question: to pass, do you need most stars right to the left or right border of the borderline region?

 

[D1stant]

If 5 or more stars out of 9 stars are in the borderline section, you'll pass in that component.
If 5/9 are in the lower performance, then its a Failure.

 

[JiniInBottle]

Don't release it now. Retake ASAP and pass it. If programs require it for ranking, only release the score after you pass it (assuming you pass it prior to rank lists are due). If programs require it only prior to your start date and not for ranking, then keep quiet until after the match. I think you'll be fine, especially since you already released both step 1 and 2CK. But if programs ask you about CS on interviews (I think few would) you should be honest. Otherwise don't volunteer the info if possible.

how do you opt to not release the score? Also, if you have already put it that the medical school can receive the score? Wouldn't they see it as well?