I agree with the above posters that the testing site does not matter. I am using myself as an example because I too failed the ICE portion, but it had nothing to do with the testing center. I took it in Philly again the second time, even though some folks told me to avoid it. There is a lot of anxiety when it comes to testing in general. I chose to just battle against my fears because I knew I would come out stronger from this if I did. It is your personal choice at the end of the day because you want to do what's best for you psychologically on test day.
In regards to improving on the ICE portion, there are several important factors. First and foremost, get the latest edition of FA Step 2 CS prep. Yes, the cases are similar, but when I retook the exam last year, I had noticed the new edition had actual examples of how to formulate the questions to write a detailed HPI. Use the PNs in the book as an example of how your note should be outlined. Starting from Day 1 of my prep for the exam the second time around, I immediately starting using the online software as part of my patient encounter. By that, I mean I had a live partner that would place a white board with the basic information as it would on test day. Next, I would go in, ask all the pertinent questions and do the PE, along with counseling if needed etc. After the completion of the encounter, I would go to my desk, where I had the software opened up already and I started typing in my notes as I would on test day. Remember, all of this is timed. So as you may already predict, I made a lot of errors or did not write a proficient note in the beginning. In addition, I would sometimes not get the inital dx correct. This showed me why I failed the first time I took my exam.
Here is the site I used to type my notes:
Patient Note Grader - Gold USMLE Review Houston, Atlanta & New York
Another component I wanted to brush up on was the physical exam. Without attaining a proper physical exam, you cannot write supportive findings or write a sufficient PN. I personally watched Geeky Medics videos on youtube and they have their own website too. It goes into more detail than you need to know for the exam, but it will prep you really well in terms of having the PE down like muscle memory. This is not to say that you don't already know all the correct PEs, but this is more so to brush up on ones you felt weak in. I watched these videos over the course of the week and jotted down notes on what I needed to work on. At the end, I had PEs down for each system, where I can properly utilize them in an instance without second thought. This is important because as you know, you are limited in time. The CS exam is about proficiency, so you want to do only the pertinent PEs.
Here is the Geeky Medics sites to brush up on PEs:
Clinical Skills OSCE Guides | Examination | Procedures | Geeky Medics
Also, make sure you know the correct abbreviations. The USMLE website outlines the abbreviations that are acceptable to use on test day. If it is not listed on there, do not abbreviate it. Develop your own systematic way to tackle this exam. I had to fight through anxiety and angst with this too. I just want to let you folks know that this is not a deal breaker for your future. This was a great learning experience for me. I used this momentum to tackle CK also, and I did very well. Use it as fire to keep your train going. At the end of the day, you want to know you gave it your all. You made it this far in school, so do not give up. If you have further questions, send me a PM and I will be more than happy to answer them.
Best of luck!
I had originally taken it in Philadelphia and after talking to some people it seems that Philly is the most difficult location. Since Im scheduling it far in advance & Ill be using the Step 2 CS Carrd service I can pretty much choose any location I want. Does anybody know if certain spots are actually better than others or have any recommendations as to which CS location is most IMG friendly?
