Step 2 CS Frustration

[je355804]

So my wife and I are practicing for our upcoming step 2 cs, and we are currently using first aid for step 2 cs.

The problem we are running into is definitely that of time, especially when attempting to get as many check marks as possible in their "sample" cases. I am wondering how important it is to get 100% of these questions asked + perform every physical exam they recommend + have enough time for closure.

It seems as though as we are practicing we're getting most of the questions asked, however this is coming at the cost of time... my HPI/ROS/PMH/FH/OBH/etc is taking me about 10 minutes to complete which is leaving only 5 minutes for Physical and Closing/Counseling...

I could easily make the diagnosis and DDx by only spending 7 or so minutes on the HPI etc however this comes at the cost of missing more questions in first aid.

The question is, how big of an issue is missing some of these questions (in order to facilitate proper PE/Closure)... btw the missed questions are never missed due to social hx or that sort of question, they're questions like "did you have any foreign body inserted into your ear" for a man with hearing loss, for example.

Thanks for the help!

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[NewYorkDoctors]

Not big at all

Passed by big margins by doing a FOCUSED H&P based on a VERY CLEAR CUT scenario

No bizarre pain, joint pain, stroke in a young patient vasculitis

Straight up common and easy cases. Just be concise and you'll do great

 

[Stellar Clouds]

Not big at all

Passed by big margins by doing a FOCUSED H&P based on a VERY CLEAR CUT scenario

No bizarre pain, joint pain, stroke in a young patient vasculitis

Straight up common and easy cases. Just be concise and you'll do great

+1

FA is overkill. You need to be extremely focused and to the point.

 

[NewYorkDoctors]

Ever been in a primary care office setting and see how fast and to the point the attending is? Something like that will do (though gloss over the cases to ensure your cases aren't missing the hot points, like be warned about a female smoker over 35 with OCP use)

 

[K31]

FA is overkill. You need to be extremely focused and to the point.

Concur. My H&P wasn't anything difference than what I'd do with a real patient--was just more careful about the show of it (draping, asking permission, etc) than I would be normally. I'm doing EM though, so the focused H&P is something I've had quite a bit of time to practice (I'd just finished my FM rotation a week before too).

 

[je355804]

Concur. My H&P wasn't anything difference than what I'd do with a real patient--was just more careful about the show of it (draping, asking permission, etc) than I would be normally. I'm doing EM though, so the focused H&P is something I've had quite a bit of time to practice (I'd just finished my FM rotation a week before too).

Alright thanks for the advice... I hate the "show" we have to put on for this damn test. It's also annoying not knowing exactly what's expected.

 

[EaglesAllDay]

thanks for this thread, had many of the same questions.

 

[survivordo]

Sounds like you're a going a bit overboard (not a bad thing!). You could both probably pass with flying colors at this point from the time you have already put in. Just be sure not to lose easy points by not draping, washing your hands etc. Otherwise, go have a date night instead of studying!!

Survivor DO