USMLE Step 2 CS December 13th 2017 score release

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Ughhh it's killing me. 9/11 and score report is still there. Is it normal for them to disappear all the way up until Wednesday or is Sunday or nothing?
 
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Wanted to jot down some words of encouragement for those of you who are waiting on scores or haven't taken the exam yet. I got my passing score (!) last week after waiting an interminable 2.5 months for my result. I took my exam in September at the Chicago testing center.

This was easily the worst I've ever felt at the end of an exam. I went into the exam feeling like it was a formality (although I took my preparation seriously beforehand) and came out thinking that there was a real possibility that I had failed it. I was seriously bummed out for several weeks afterward, feeling like my trajectory toward residency had just been stopped cold. There were several reasons for this. First, I didn't feel like I had a good diagnosis on 2/3 of the cases. They were too vague and non-specific to narrow down. I felt like I must have missed something really big (my school's CSE had much more clearly defined cases). In hindsight, I think this is just how many of the cases are designed for this exam. They want to see how you approach an ambiguous complaint. Secondly, I had very few actual physical exam findings. I assumed I must have missed something big (my school's CSE focused on PE findings much more heavily). It's clear (from my exam and talking with lots of others at my school and on the interview train) that the actual exam just had fewer of these. Finally, I had heard stories about friendly SPs essentially volunteering information if you were nice to them. This was not my experience. My SPs were all about short answers and did not generally volunteer information or give me long answers to questions (even open-ended ones). I felt like I must have really botched my communications to get such difficult SPs. I think that the style of individual SPs and testing centers varies quite widely.

All of this added up to a lot of unnecessary angst and heart-ache in the days after the exam. In the end, I passed comfortably, with my ICE score touching the high performance border and my CIS comfortably inside the passing range. I think the reason I did well despite feeling awful is that I didn't significantly change the way I did anything during the test. I stuck to my guns with my question style and physical exam format. I showed empathy and made sure I closed every encounter. I didn't let myself get thrown off my game because of how awful the exam felt to me.

If you are currently feeling awful, like I did, try to let yourself off the hook for now (at least until the score comes out). I know that's easier said than done, but I hope my experience helps someone feel a little bit better.

Recommendations for those yet to take the exam:
  • Prepare beforehand, even if it's just reading through First Aid. This helps with peace of mind during and after the test.
  • Develop a system that you use for every encounter (how you introduce yourself, what open-ended questions you start with, what elements of the H&P you want to be sure to get hit, how you transition between parts of the encounter, what physical exam maneuvers you do for each area/system, and how you close/summarize). Stick to it on every encounter.
  • Practice your system so it's easy to remember, even if it's just in your head.
  • Don't question yourself during the exam. Put faith in your system and stick to it. Set aside the second-guessing until after the exam. Trust me, you'll have plenty of time for it later.
 
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madod said:
... This was easily the worst I've ever felt at the end of an exam. I went into the exam feeling like it was a formality (although I took my preparation seriously beforehand) and came out thinking that there was a real possibility that I had failed it. I was seriously bummed out for several weeks afterward, feeling like my trajectory toward residency had just been stopped cold. There were several reasons for this. First, I didn't feel like I had a good diagnosis on 2/3 of the cases. They were too vague and non-specific to narrow down. I felt like I must have missed something really big (my school's CSE had much more clearly defined cases). In hindsight, I think this is just how many of the cases are designed for this exam. They want to see how you approach an ambiguous complaint. Secondly, I had very few actual physical exam findings. I assumed I must have missed something big (my school's CSE focused on PE findings much more heavily). It's clear (from my exam and talking with lots of others at my school and on the interview train) that the actual exam just had fewer of these. Finally, I had heard stories about friendly SPs essentially volunteering information if you were nice to them. This was not my experience. My SPs were all about short answers and did not generally volunteer information or give me long answers to questions (even open-ended ones). I felt like I must have really botched my communications to get such difficult SPs. I think that the style of individual SPs and testing centers varies quite widely. ...
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I feel like many of these experiences I hear are why I'm just as nervous about my score coming back. I had the same issues on the exam like missing diagnoses. There were times where I missed stuff that should have been clear based on the patient's chief complaint and the setting (i.e. emergency dept. vs. clinic.) And like your school, my OSCE had very easy chief complaints (E.g. chest pain) along with stations that were much less like the real CS. At the very least, my SPs seemed to be very polite, but they were also short with their answers. I felt like after asking just one open-ended question, I had to start using specific questions, and I ended up wasting a lot of time as a result.

I also had a standard format coming in, where I'd start with open-ended questions and then do stuff in the order of such mnemonics as OLD CARTS, PAMHUGSFOSS, etc., and had my scrap paper with headings to reflect that. However, I felt like my notes were all over the place, as sometimes I would do bullet points and other times I would use sentences. Again, I think I had way too many occasions where I would ask if there was anything else the patient was concerned about, and all they would say was no.

So I don't really know which to worry about more now, my ICE performance or whatever I did for CIS (Which included getting the real patient concern, e.g. "Will I be able to go back to work?", some counseling, checking for patient understanding of diagnosis and plan, etc.) All I can do now is just hope for the best I guess.
 
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I was so dissappointed last week when my score didn’t come out. Hoping it will this wednesday. So anxious it’s killing me! Took exam 7th oct, LA
 
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I just passed! Score came out 11:00 AM today!

ICE w/ 6 "x" in borderline, 9 above. CIS/SEP safely to the right.

AMG, read First Aid, but didn't practice pacing/timing for the exam, let alone read over the mini-cases.

This may be no longer just a test of English -- make sure you know differential diagnoses for common complaints and have the correct medical terms for them.
 
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Passed!!! Email notification sent after score was already available online. Touching borderline of ICE, others at far right side! This is such a bs test which generated waaaay too much unnecessary anxiety! I'm AMG, prepared the test for <2 days, didn't skim through even once of first aid, but we have osce at school. Again that showed how redundant this money-making test is!
 
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:love:Passed! Happy ending to a horror story test day. In short, I missed at least 4 primary diagnoses (no where in my note). I know this for sure because I took good enough histories but I brain-farted when coming up with unifying diagnoses or recalling pathognomonic features on test day due to panic. I also wrote 2 diagnoses on the same line if they were related. Lastly, the order of my differentials was not always most likely to least because I would run out of time rearranging my note. There are more mistakes.

I passed ICE with 3 XXX in lower performance. CIS and SEP were asterisks in high performance. For those still waiting - hang in there and try your hardest to stay off SDN until you get the result. I just lived through 3 months of hell that I wouldn't wish on anyone else. Be well :)
 
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AMG taken on 10/6 at Philly. PASSED :) Comfortably to the right for CIS, Star for SEP and 6 stars in Borderline for ICE.

I only prepped on the 2 hour plane ride to Philly by reading the first part of the First Aid book and skimming through a couple cases.

I would say that I could have made the wait less anxiety provoking for myself if I actually took a week to go through First Aid, and probably would have done better on ICE instead of being borderline. Why take the risk like I did.

All in all, just happy to have put this $1200 exam that I believe is totally unnecessary for AMG's behind me.
 
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Yassomed said:
I'd like to know the same thing, I wonder if it's from the OASIS website where we download and print the permit from.
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Yes, because iF that's the permit, Mine disappeared immediately after my exam
 
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To all those who passed. For ROS did you just write "negative except as above" or did you fill it in. This is all over FA but i heard it could hurt your ICE grade. i was thinking of putting pertinent negatives in that column. Would that work? and congrats! must be a great feeling to be done with this nonsense
 
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EazyE1907 said:
To all those who passed. For ROS did you just write "negative except as above" or did you fill it in. This is all over FA but i heard it could hurt your ICE grade. i was thinking of putting pertinent negatives in that column. Would that work? and congrats! must be a great feeling to be done with this nonsense
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It's a pass and fail exam... Everyone that I have talked to put that.
 
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Mine was released today, permit disappeared yesterday, passed despite my fair share of errors and ridiculousness.
 
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passed!!!!! worst 3 months ever.

and yeah my permit disappeared yesterday as well.
 
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Is there anyone else on SDN from this reporting period besides me who hasn't received their grade yet?
 
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Me also. Mine should be coming in tomorrow though as my permit disappeared this morning. Does the the inability to register for another test date mean that I passed?
 
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I passed!!!! It was the worst wait. I took it 10/12 and was freaking out about matching! Everyone else should think about scheduling this test super early!
 
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Got my score today FINALLY! I took it late September. Very happy to have passed. I am so glad the wait is over. My permit disappeared sometime between Sunday and Tuesday night.
 
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hlancaster said:
Got my score today FINALLY! I took it late September. Very happy to have passed. I am so glad the wait is over. My permit disappeared sometime between Sunday and Tuesday night.
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Yeah!!! Happy your wait is over!
 
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DOEs anyone know how I can set it up so that I can know when a date open so up on the step 2 cs website? I need a date in August and everything is booked up! Please help I’m freakinf out
 
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ReginaBing said:
Just wanting to see how your score worked out because my permit disappeared right after my exam and I have not seen many people saying the same.
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What do you mean by your permit disappeared exactly? Do you mean the link to click on the permit? If yes, I have the same thing.
 
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blueforest said:
What do you mean by your permit disappeared exactly? Do you mean the link to click on the permit? If yes, I have the same thing.
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When I go to OASIS on the ECFMG website, I do not see anything about my permit for STEP 2CS, unless I am supposed to be checking somewhere else?
 
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Bully Ball said:
Passed!

I oscillated between extreme nervousness remembering my mistakes in the hours and first week after taking the exam then completely forgetting about it for a couple weeks, only to randomly remember something I messed up on or question whether I did the PE or wrote the correct diagnosis throughout the months

SEP: *
CIS: xxx*
ICE: 3x's in borderline, rest above

In my opinion, the new standards/tougher grading just mean passing got a little tougher, not the difficulty of the exam. In reality, the only thing they can objectively grade harder is the note/workup/diagnosis so work on your ICE portion. I'm a USIMG. I think the main reason for my ICE scores were the differential/workup section. My HPI was solid. Physical exam note could have been a little better; I didn't write what I should have for every single normal abdominal exam (non-tender/non-distended/etc). I didn't write any negatives in the physical section of my diagnosis justification. I rarely wrote shorthand except for HPI/ROS/PMH/PSH/FH/SH/HEENT/wnl. I wrote in paragraph form. I wrote to the limit on almost every patient note. Pretty sure my graders were pissed at the amount of work I gave them compared to others.

CIS Advice:

Not everything the patient does is scripted. Joke around with your patients if appropriate. One of my patients had a husband with a similar job as my father. We joked about the work and what comes with it. I forgot to ask a couple of key questions and guess what, she volunteered that information without me even asking. Another example, a patient had something where he had to act in a lot of pain, he made a quip about how he should have listened to his wife, I commented back that I've yet to meet a husband that listens to his wife enough. He laughed and stopped acting for the rest of the encounter. I forgot to wash my hands before the physical and remembered midway through. As I left the room I apologized again, he said don't worry about it, you'll be fine.

If the patient had a major milestone, say congratulations (anniversary/graduation/promotion in Eagle Scouts). It goes a long way towards developing rapport, making them feel comfortable and it's free points

Leave your politics/religion/personal experiences at the door. Patients can be LGBTQ or drug abusers, don't give them a dirty look or anything worse

ICE Advice:

This was by far my lowest section so I'm not sure what advice to give other than to list some of the mistakes I made and tell you to not do them.

Support your diagnosis with pertinent negatives. This is weird for me for some reason so I never did it in practice and it definitely could have been useful in the exam for grading purposes. I know why I picked a diagnosis, because the patient had a negative *** physical exam and I wrote that in the physical exam section, but I never wrote it in the diagnosis support section. Could have costed me a chunk of points

You can totally screw up an entire case and be fine. Patient had a problem. Even if I was acting, I'd hate to repeat that I have that problem 12 times a day. They were one of my last encounters and the patient was rude and disinterested and I don't think they were told to act that way. I asked if they were on any meds, they said no, I thought it was weird so I asked again, they said no. Finish the HPI/ROS/etc and start to summarize when I say you're not taking any meds. Patient looks at me angrily with a look that reads "da fuq?" and quickly rattles off 5 medications with doses. I didn't get every single dosage and I wasn't going to ask him to repeat it. Due to the nature of the problem, I fumbled around with what to do for a physical exam. I forgot to order the most crucial labs. I only had one diagnosis and another diagnosis not directly related to the chief complaint. I had difficult patients before but it was clear they were acting. This person should not have been a standardized patient. They threw me off my game during the entire encounter and my note suffered. If this happens to you and it only happens once. You'll be fine

Also, practice typing on a windows based platform. I used a mac for all my practicing and when I started typing my note I couldn't copy and paste and thought the computer was acting up or they decided we weren't allowed to use it anymore. Nope, I just kept pressing command+c instead of control+c. I was always the last one out of the room and I'm a fast typer, but I could have done a better job with the note.

For one encounter, I only had one differential. The tests I ordered were justified, but the most obvious test that everyone else probably ordered, I didn't because I read not to in Uworld guidelines but I should have if I followed FA guidelines.

I probably messed up on a few diagnosis or at least the order they should have gone and I should have supported all of them with more justifications. People always say there are no physical exam findings and that's true. Put the negative exam findings instead. So glad this is over. Hope this helps someone. Good luck!
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Thanks for your post, very helpful.
When you say UWorld guidelines, are you referring to UWorld qbank for CK or UWorld 70 cases for CS?
 
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Reperfused said:
Thanks for your post, very helpful.
When you say UWorld guidelines, are you referring to UWorld qbank for CK or UWorld 70 cases for CS?
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Glad it helped someone! I was referring to the guidelines in UWorld CS. Studying for CK concurrently could help your ICE component in regards to forming differentials or knowing what tests to order. Just remember to treat it like a clinic/urgent care/ER. Common things are common and start with the cheapest/least invasive tests when listing them in the diagnostic workup section. Good luck!
 
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Merely said:
DOEs anyone know how I can set it up so that I can know when a date open so up on the step 2 cs website? I need a date in August and everything is booked up! Please help I’m freakinf out
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I used this website: step2scheduling (google it since it won't let me post a URL here) honestly it was a life saver! I needed a date in a months time and it found it for me. You will pay in advance and you get a refund if they don't find your date but trust me you will get the date you want. Register on it, write the date and location you want and forget about it, you'll get an email in the coming days telling you they found and booked your desired date.
 
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