Step 2 CS-- thoughts??

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
U

USMLE0423

Full Member
10+ Year Member
Joined
Oct 30, 2011
Messages
53
Reaction score
7
Hi all,
I'm sure this question has probably been asked a thousand times, but I cant seem to find a thread for it. But anyway, for those of you who have already taken CS, did you guys feel like you did terrible? (i took it a couple of weeks ago but scores dont come out till oct:() I mean I barely got through any of my PN completely. Didn't really have time to write out relevant findings from hx and PE for each dx, never did more than CV, lung, abd exam bc always ran out of time for that part too. I didn't have these problems when I was practicing with a partner so I wasn't really expecting to run into these problems on the real test. I'm not sure how to feel about the test. Any help is appreciated!!!
Members don't see this ad.
 
Sort by date Sort by votes
hi. i did the exam yesterday at chicago. im feeling the same way as u r... i ended up writing things that i did not do like HEENT for all patient notes. im wondering if its gonna cost me a lot..!
 
Upvote 0 Downvote
I feel your pain... I did a whole physical exam on the Right side when the complaint was on the left! I missed out on many main d/d as well. I think i had a handful of good cases where i didnt completely mess up but in the end we tend to remember all the things we did not do, not the things we did. I even forgot to counsel a patient and urge him to stop multiple hard drugs which was the cause for his medical problem!
 
Upvote 0 Downvote
Members don't see this ad :)
hi all....me too in the same boat gave my exam at chicago...so confused i did what all i can do and can think of doing then during exam but still not satisfied with the exam. I was so good while doing with study partner. very much tensed about the result. hope everything goes well.
 
Upvote 0 Downvote
Well I missed a few things here and there, but I felt like I got the majority of the H&P. I believe I got extra points on empathy as the patients looked totally surprised (pleasantly) at some of my actions. (e.g. warming stethoscope and using the word please)

My grades are not out yet, but I felt I did well.

There was one very nice patient who helped me out. Without giving overt spoilers, it was just a OBGYN case in which you have to ensure this person of a certain age is not doing something in the social hx that may interfere with a medication she wishes to be prescribed which may cause certain complications
(Think the most high yield thing you can)

I totally forgot to mention that, but the patient was kind enough to bring it up to me and then I promptly went into advice mode.
 
Upvote 0 Downvote
hi.. do u know if writing things like HEENT in patient notes for some cases whr u didnt perform matters a lot?
 
Upvote 0 Downvote
nailbiter said:
hi.. do u know if writing things like HEENT in patient notes for some cases whr u didnt perform matters a lot?
Click to expand...
Dont want to freak you, but i've seen people getting screwed royally for writing something they didn't do because SP's checkmark what you've done, and what you haven't.

So if the two don't match, then its a big red flag.
 
Upvote 0 Downvote
question -- for hte patient note, do you need ALL 5 ddx and ALL 5 w/u???
that seems a bit ridiculous? if you have 3 ddx and 3-4 w/u is that sufficient? thanks!
 
Upvote 0 Downvote
I took it, felt terrible, sure I missed several vital things (e.g., misdiagnosis a stroke a brachial plexopathy). Got my score back and did fine.

Diagnosis is only 1 part of the scoring. As long as you wash your hands and were empathic + made sure the patient understood your plan you will be ok!

The making stuff up thing, however, is not good...
 
Upvote 0 Downvote
Members don't see this ad :)
erasIM2013 said:
on one case for Neuro I wrote - alert , moving extremities , no obvious deficits noted

But I didn't explicitly test ... NOW IM SCARED!!!
How does that work for observational stuff ?
Click to expand...

Well observational stuff imo wont work against you, but things like certain manuevers and stuff you are suppose to do, and you didn't do, but wrote it.. might hurt.

For your particular neuro example, I think that should be fine.
 
Upvote 0 Downvote
yea i figure NCAT, EOMI, neck w/full ROM, symmetric facial movements, no cyanosis, clubbing or edema are all observational :)
 
Upvote 0 Downvote
Is there a rule about examining a patient only on their right side? I moved from right to left. Did my examine mostly to the patient's right. But for the sake of our comfort, I did some parts of the exam to their left.
 
Upvote 0 Downvote
I'm in the same boat now. Took CS in Atlanta recently. I'm feeling the need to commiserate and feel bad about all the things I missed (and consider the likelihood of being among the unlucky 4%).

Anyone else felt like they barely listed supporting history/PE for the new PN format? (I had almost nothing to put for supporting PE for most of the cases). And anyone else NOT order a bunch of tests for many cases? (or have stories about failing if you don't do a lot of workup?)

(Things like: NOT ordering an EEG for a seizure, ordering only x-rays for knee pain, forgetting CV findings on a likely cardiac case...)


Also curious to hear the outcome of the OP and other people who have gone through the new format with the PN having 3 ddx and supporting history/PE.
 
Upvote 0 Downvote
septoplasty said:
Well observational stuff imo wont work against you, but things like certain manuevers and stuff you are suppose to do, and you didn't do, but wrote it.. might hurt.
Click to expand...

What if you said "full ROM" of a lower extremity joint and didn't do passive or active movement, just strength testing of the joint and watched the SP walk? :scared:
 
Upvote 0 Downvote
It really took me a while to warm up. First few I ran out of time! Felt better afterwards, but still a little concerned overall. Then again I crammed step 2, thought I failed and got a 246. Felt similarly bad on Step 1 and my MCAT. So, I guess my feelings seem to be entirely fail when it comes to these sorts of things. Lol
 
Upvote 0 Downvote
Just wanted to repost to maybe calm some minds.....

Just wanted to throw my 2 cents in about this test:

1. This is the stupidest, most subjective test on earth. No one is a better doctor because of it, only a better actor.

2. Having said that, it does not have to be a horrible test, as I somehow passed doing the following things:

-Barely starting the physical exam with only 5 minutes left to go on at least 3 cases
-Not asking one question at a time i.e. "do you have chest pain, shortness of breath, or abdominal pain?"
-Doing a physical exam (knee) on someone in obvious pain (something I heard was a huge no-no)
-Forgetting to do heart/lung exam on multiple patients
-Forgetting to counsel at least a few patients on drugs, alcohol, diet, exercise, safe sex
-Not summarizing findings for patient after taking HPI
-Forgetting to do a diabetic exam i.e. fundoscopic, foot
-Forgetting to avoid all medical jargon
-Not offering water for coughing patients
-Not expressing empathy for each patient
-COMPLETELY blowing the differential diagnosis on 3 different patients

In short, I worried relentlessly for 10 straight weeks. I was already studying for the retake I knew awaited me. I only post this so that if there are others worrying, maybe this will allay some fears. I was terrified. I hope it all works out for everyone. This test SUCKS!!
 
Upvote 0 Downvote
thanks.. i jsut keeping thinking about all the things i did wrong or didnt even do...
it would suck so hard if i fail and have to pay so much freaking money for it again.
 
Upvote 0 Downvote
chemta2006 said:
I'm in the same boat now. Took CS in Atlanta recently. I'm feeling the need to commiserate and feel bad about all the things I missed (and consider the likelihood of being among the unlucky 4%).

Anyone else felt like they barely listed supporting history/PE for the new PN format? (I had almost nothing to put for supporting PE for most of the cases). And anyone else NOT order a bunch of tests for many cases? (or have stories about failing if you don't do a lot of workup?)

(Things like: NOT ordering an EEG for a seizure, ordering only x-rays for knee pain, forgetting CV findings on a likely cardiac case...)


Also curious to hear the outcome of the OP and other people who have gone through the new format with the PN having 3 ddx and supporting history/PE.
Click to expand...

I definitely had trouble with this format. Coming up with differentials was difficult in that I felt like my patients didn't have any findings. The histories were equivocal - which I get is supposed to help come up with differentials, but instead it's just confusing because none of the diagnoses I would come up with actually fit the story I was getting (again, because everything is [intentionally I presume] vague). And if basically every patient has negative physical findings, how are we supposed to support a pathologic disease with our exam? It just really makes no sense. Nothing localizes. I'm quite sure I came up with 3 ddx on only one patient encounter and had multiple encounters with only one diagnosis, or two diagnoses where the second was extremely undersupported (ie: only one or two examples for supporting physical exam findings and history). You want to talk about feeling incompetent!

Now, did I get a single star for high performance in ICE/CIS? Uh no. But did I pass? Somehow! I'm not going to tell you not to freak out because I certainly didn't listen to people telling me not to freak out haha But really English language proficiency + minimal medical competency = doctor :thumbup:
 
Upvote 0 Downvote
I just took CS and am worried about my CIS component. I knocked before entering, introduced myself, used the patient's name, washed my hands, asked if they had any questions or concerns, and answered all of their questions. When they mentioned a loved one had died I said "sorry for your loss" etc., and in the majority (maybe all of them) I said "this sounds unpleasant/painful/scary, we'll do everything we can to figure out what's going on and get you feeling better." However...

1) I forgot to shake hands with all of the patients. I said "nice to meet you" but didn't shake hands. Is this a critical error?
2) The patients already had the drapes folded in their laps (covering about down to their knees), so I didn't do anything with the drape. I had been expecting it to be on my chair and to have to put it on myself. Should I have unfolded the drape to cover their lower legs below the knee also?

I have heard CIS is the part that is graded the hardest - will these errors result in a fail?
 
Upvote 0 Downvote
copingmethods said:
I just took CS and am worried about my CIS component. I knocked before entering, introduced myself, used the patient's name, washed my hands, asked if they had any questions or concerns, and answered all of their questions. When they mentioned a loved one had died I said "sorry for your loss" etc., and in the majority (maybe all of them) I said "this sounds unpleasant/painful/scary, we'll do everything we can to figure out what's going on and get you feeling better." However...

1) I forgot to shake hands with all of the patients. I said "nice to meet you" but didn't shake hands. Is this a critical error?
Click to expand...

We were supposed to shake hands?

copingmethods said:
2) The patients already had the drapes folded in their laps (covering about down to their knees), so I didn't do anything with the drape. I had been expecting it to be on my chair and to have to put it on myself. Should I have unfolded the drape to cover their lower legs below the knee also?
Click to expand...

Depends on the view they were giving you... the point is to protect their decency, if you catch my drift.

copingmethods said:
I have heard CIS is the part that is graded the hardest - will these errors result in a fail?
Click to expand...

Chances are pretty much zero.
 
Upvote 0 Downvote
LovelyBRass said:
Depends on the view they were giving you... the point is to protect their decency, if you catch my drift.
Click to expand...

:laugh: There wasn't a view between the legs - it was going a little past their knees. When I had them lie down for the abdominal exam it was covering them pretty well.
 
Upvote 0 Downvote
chemta2006 said:
I'm in the same boat now. Took CS in Atlanta recently. I'm feeling the need to commiserate and feel bad about all the things I missed (and consider the likelihood of being among the unlucky 4%).

Anyone else felt like they barely listed supporting history/PE for the new PN format? (I had almost nothing to put for supporting PE for most of the cases). And anyone else NOT order a bunch of tests for many cases? (or have stories about failing if you don't do a lot of workup?)

(Things like: NOT ordering an EEG for a seizure, ordering only x-rays for knee pain, forgetting CV findings on a likely cardiac case...)


Also curious to hear the outcome of the OP and other people who have gone through the new format with the PN having 3 ddx and supporting history/PE.
Click to expand...

Yes! This! This! And this! I took the test today and I had several where I literally had nothing to put for supporting PE findings. For example, I'd be almost positive about a diagnosis (a diagnosis which in the real world would have classic PE findings), but my exam would completely "normal". So frustrating.

Also, I usually had time to write my note (no time to spare or even proofread, but at least I would finish), but 15 minutes is not enough time to perform a thorough history and exam. Especially, if the patient brings up two or three issues that each need to be addressed. It's hard to do a complete neuro exam by itself in 15 minutes.
 
Upvote 0 Downvote
Im so totally screwed! gotta wait another month for my results and gave my exam in September!..i hope i pass but i totally screwed up on the test...almost always ran out of time...didnt get the time for closure in atleast two cases...didnt finish the PN in atleast two cases...i'll probably get the sympathy and empathy points but will that be enough for me to pass?? urghhhh!!
Guys i feel all i've done is going down the drain...is there a future for me here if i fail this test? :confused:
 
Upvote 0 Downvote
Guys im so totally screwed! Gave my exam in September and still about a month left till the report comes out...specially coz i feel i screwed the exam...i didnt counsel three patients...didnt finish the PN in two others..and couldnt close the case in two atleast!! I did the easy stuff well, being empathic and sympathetic..but i donno man im freaking out!

Do you guys think I have a future here if i do fail :confused:
 
Upvote 0 Downvote
Is CS still pass/fail or is it being changed to graded?!

thanks in advance :)
 
Upvote 0 Downvote
Still pass/fail as far as I know.

For what its worth, OP, I walked out of that exam feeling like total crap, and I passed with pretty solid margins.

CK on the other hand... well, I'll find out soon enough.
 
Upvote 0 Downvote
Just giving you an update. I took CS in early Oct, got my score report back today...Pass! Like the other 99% of us who are US seniors at an allopathic med school. And with pretty good margins. And like many others, I felt terrible about the exam at the time...I was running out of time consistently.

So, most likely you will pass too.
Good luck you guys, and hopefully you'll be able to stop worrying soon!
 
Upvote 0 Downvote
I took the test on Sept 18. and got my score report today. I passed! I felt like I had failed especially after my first case. The person had dizziness and I totally blanked out on the physical exam and only did the tilt test, CNs, and forgot listen to the heart. Was so frazzled I only wrote one differential.

So for anyone curious, you get three subscores and an overall score. Every section is pass/fail. One section is english proficiency, another is intergrated clinical encounter and communication and interpersonal skills. So anyway, it's over and I couldn't be happier! I think for all the money we pay, they could give us a more detailed report. But who cares, I passed!!
 
Upvote 0 Downvote
hey guys, just wanted some of your input. I took CS in philly last week and overall feel great, except for some reason on all the cases in which i did a pulmonary exam, i only did tactile fremitus, inspection, and auscultation. Forgot to percuss period. Also didn't ausculate any of the anterior lung fields. I'm only nervous because I've heard of people getting screwed over in the Data Gathering section and failing while passing everything else. Has anyone else done anything similar yet still passed? am i freaking out for no reason? Thanks!
 
Upvote 0 Downvote
kings8490 said:
hey guys, just wanted some of your input. I took CS in philly last week and overall feel great, except for some reason on all the cases in which i did a pulmonary exam, i only did tactile fremitus, inspection, and auscultation. Forgot to percuss period. Also didn't ausculate any of the anterior lung fields. I'm only nervous because I've heard of people getting screwed over in the Data Gathering section and failing while passing everything else. Has anyone else done anything similar yet still passed? am i freaking out for no reason? Thanks!
Click to expand...

I did pretty bare-bones PE's and passed with wide margins. You'll be fine if that's all you're worried about.

Now if you forgot to wash your hands for every encounter...
 
Upvote 0 Downvote
kings8490 said:
hey guys, just wanted some of your input. I took CS in philly last week and overall feel great, except for some reason on all the cases in which i did a pulmonary exam, i only did tactile fremitus, inspection, and auscultation. Forgot to percuss period. Also didn't ausculate any of the anterior lung fields. I'm only nervous because I've heard of people getting screwed over in the Data Gathering section and failing while passing everything else. Has anyone else done anything similar yet still passed? am i freaking out for no reason? Thanks!
Click to expand...

I didn't do tactile fremitus on anyone and I percussed maybe once. I also never auscultated the anterior lung fields. Still got near the top with stars on my ICE component, and that's after missing a whole lot of other things I won't get into.

This is the most ridiculous worry I've seen so far. :laugh: You're going to pass by huge margins.
 
Upvote 0 Downvote
NTF said:
I did pretty bare-bones PE's and passed with wide margins. You'll be fine if that's all you're worried about.

Now if you forgot to wash your hands for every encounter...
Click to expand...

Even for handwashing, I forgot in two stations and still scored within the "high performance" area. I think the worry about this is HUGELY overblown.
 
Upvote 0 Downvote
I don't know why people still insist on hand washing
It's a complete waste of time,use gloves!
 
Upvote 0 Downvote
ArcGurren said:
I didn't do tactile fremitus on anyone and I percussed maybe once. I also never auscultated the anterior lung fields. Still got near the top with stars on my ICE component, and that's after missing a whole lot of other things I won't get into.

This is the most ridiculous worry I've seen so far. :laugh: You're going to pass by huge margins.
Click to expand...

i'm glad you're saying i'm just crazy! :)

a good friend of mine actually failed data gathering, so i feel like the possibility of actually failing CS is more tangible to me than most people...that plus the thought of a stupid exam messing up everything after a great interview season just had me a bit paranoid....but anyways thanks for the reassurance!

cheers
 
Upvote 0 Downvote
I need to take step 2 cs by dec 31st in order to take part in the match. Anyone willing to switch I am willing to pay for your entire CS exam!!!!! Please help me!!!
 
Upvote 0 Downvote
TheDoc2313 said:
I need to take step 2 cs by dec 31st in order to take part in the match. Anyone willing to switch I am willing to pay for your entire CS exam!!!!! Please help me!!!
Click to expand...

you need to keep checking the scheduling site, spots are always opening up, as of this post there is a spot open dec 8 in houston...
 
Upvote 0 Downvote
kings8490 said:
i'm glad you're saying i'm just crazy! :)

a good friend of mine actually failed data gathering, so i feel like the possibility of actually failing CS is more tangible to me than most people...that plus the thought of a stupid exam messing up everything after a great interview season just had me a bit paranoid....but anyways thanks for the reassurance!

cheers
Click to expand...

I don't know what your friend did, but I'd say the data gathering is probably one of the most lax graded parts of the exam - if anything I think the empathy/humanism stuff is the toughest graded. No worries, good luck on your interviews, and I'm sure your score will be a solid pass!
 
Upvote 0 Downvote
LovelyBRass said:
I definitely had trouble with this format. Coming up with differentials was difficult in that I felt like my patients didn't have any findings. The histories were equivocal - which I get is supposed to help come up with differentials, but instead it's just confusing because none of the diagnoses I would come up with actually fit the story I was getting (again, because everything is [intentionally I presume] vague). And if basically every patient has negative physical findings, how are we supposed to support a pathologic disease with our exam? It just really makes no sense. Nothing localizes. I'm quite sure I came up with 3 ddx on only one patient encounter and had multiple encounters with only one diagnosis, or two diagnoses where the second was extremely undersupported (ie: only one or two examples for supporting physical exam findings and history). You want to talk about feeling incompetent!

Now, did I get a single star for high performance in ICE/CIS? Uh no. But did I pass? Somehow! I'm not going to tell you not to freak out because I certainly didn't listen to people telling me not to freak out haha But really English language proficiency + minimal medical competency = doctor :thumbup:
Click to expand...

I had multiple diagnoses without anything in physical exam to support it. Heart, lungs, vitals, and legs were normal!
 
Upvote 0 Downvote
You must log in or register to reply here.
Next unread thread

Similar threads

bengalsfan0525
  • Question
Fyi for all - Step 2 CS
Replies
4
Views
3K
NeuroMaster316
NeuroMaster316
I
  • Question
STEP 2 CS PARTNER IN HOUSTON
Replies
2
Views
764
atonks
A
K
  • Question
Any reliable step 2 cs scheduler ?
Replies
6
Views
1K
Diphyllobothrium latum
Diphyllobothrium latum
sella.turcica
  • Question
Step 2 CS Podcast
Replies
2
Views
1K
shtumpa
shtumpa
D
  • Question
Any reassurance for step 2 CS?
Replies
3
Views
2K
Dokitor21117
D
Top