Icky feeling after Step 2 CS

[fistulitis]

I walked out of the Step 2 CS and I feel like I totally could have failed it. 15 minutes is just not enough time to be super duper comprehensive with many lines of questioning for a wide DDx, lots of physical exam, and counseling at the end, all while being ridiculously courteous throughout.

For anyone willing to admit they failed it the first time, how bad did you do?

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[IronheadJake]

I thought the same thing when I came out of the test. You really have no idea what specific things they are looking for and whether the SP's will remember what you acutally asked them to check off on their list. There were atleast 2 cases where I had no idea how to direct my questions. Despite all these doubts I still passed. I think what most people say about being somewhat coherent and being able to speak english fluently really is more than half the battle.

 

[Medical123]

I walked out of the Step 2 CS and I feel like I totally could have failed it. 15 minutes is just not enough time to be super duper comprehensive with many lines of questioning for a wide DDx, lots of physical exam, and counseling at the end, all while being ridiculously courteous throughout.

For anyone willing to admit they failed it the first time, how bad did you do?

I walked out of Step 2 CS feeling like crap last week. I totally agree that 15 minutes is not long enough to do a good History and Physical exam, especially when the patient has multiple complaints involving several organ systems. I wish there was a clock in the room. On my first case, I just had finished the history when the 5 minute announcement sounded. There was not time to do my exam and it was a complicated case. I just put in my plan to do a full "XXXXXX exam" and told the patient that I would be in to do this. Whether it works or not, I don't know. The guy did look kind of shocked himself when the 5 minute announcement was called. Another standardized patient was a similar case, involving a lot of organ systems and a lot of complaints. However, he was almost impossible to get information from. He answered all questions with "yes" or "no" answers. When I would try to go to a more open ended question, I would get "What do you mean? Why are you asking that?" When I asked him if there were any medical problems that were in his family, he said "no." I then asked if his parents were alive. He told me that they were dead. When I asked what they died of, they had quite a significant medical history. In other words, he was being difficult and wasted a lot of my time. When we were waiting for rides and shuttles back to the hotel, several people were discussing this particular individual. He did two or three different scenarios that day (it was the same person because he had some very distinguishing features) and he acted like that in all of them. I also had trouble with timing on some of my patient notes. If you type the notes, you can only put a certain amount of characters in each space. If your patient has a lot of complaints, you may run out of space while typing your HPI! What do you cut out? All of this was relevant to the case! As far as the cases themselves went, they weren't bad. However, timing was definitely a factor for me. If I did fail it, I am sure it is going to be because I didn't have the time to do all all of the necessary physical manuevers or adequate counseling. I am totally disgusted. I have always done well on standardized patient exams and excelled clinically. However, I don't have a good feeling about my performance on this exam. I am disgusted. I spent over $1500 by the time I paid for the test, travelled across the country, and paid for a night in the hotel. For me, this is rent and groceries for the month. I may have to do this over again. Plus, I had to take time off from a clerkship that I will have to make up. I can't wait for the results.