Hello friends,

Thanks to all of you. I used this forum a lot during my USMLE study which helped me to make my own study plan for each step ( 1, 2 CK & CS).

I took my CS exam on 29th of April in Philadelphia & got result on 12th June.
Thanks God, I have passed.

My study materials were FA, UW (online) & some CSE video (old version- got from a friend).
I read FA 2-3 times & practiced all the cases from FA & cases from UW which were not in FA- twice. During practice- I followed the sequences in each cases- history taking, next P/E, then typed patient note (PN)- in timed mode. Each day, I practiced 5-8 cases & week before my test, I simulated the exam with 12 cases/day- which helped me to increase the stamina.
I didn't have any study partner, so I studied by myself & practiced the cases with my family member.

I would like to tell some points about CS exam for the people who're preparing for the exam-

* Every step in USMLE deserves certain level of study. Please don't take the CS exam very lightly. Study hard, practice very well- as more you practice, you'll be more confident. Believe in yourself, keep faith on God- you will do good. This is a doable exam.

* Be familiar with orientation video on USMLE.org- practice material for CS exam.

* Recently, people are doing fail mostly in ICE component- which consists of data gathering ( history taking, P/E) & PN. Please work hard on this component during your preparation. Memorize D/D & relevant investigations from FA book.

* In history taking- fluency of asking questions to patient comes from practice. Ask open-ended question & get more information from patient.

*In P/E- Do focused & relevant examination. You don't have time to do everything. Prioritizing will come with repeated practice.
Please be very gentle during P/E & always ask permission before examination. Inform the patient what you're doing now & say " Thank you" after each procedure.

Offer help while patient is lying down or sitting up. If you see that patient is coughing- offer tissue, if patient already has tissue, then ask whether he/she needs a cup of water to drink.

* Regarding PN- this is the only part scored by physician. Please take more care to type PN in an appropriate way. Try to avoid grammar/spelling mistake. Practice type PN on USMLE.org software, this format is exactly same as real exam.

* Try to practice your cases on live person. If you don't have any study partner, you can practice with your family member or your friends.

* Before each encounter- organize yourself, be confident, write down patient's last name, age, chief complaint, abnormal vital signs from the instruction sheet on the door. You can also write down some mnemonics, probable D/D & make a quick plan for that case.

* Knock the door, enter into the room with smile, greet the patient with his/her last name, introduce yourself, ask about patient's comfort ness in the room, drape the patient. Then ask about chief complaint & take history.

* Always look at patient's eyes, speak boldly & clearly- these show your confidence.

* Closure is VERY important. Leave at least 2 minutes for closure. Ask whether he/she has any question. SPs always have questions, so please don't ignore that. Answer in simple sentences without using any difficult words & make sure that patient understands your explanation.

* Again greet & smile before leaving the room.

* In acute case, patient demands more empathy, so ask more about patient's comfort ness & ensure the patient that you will try your very best to make him/her better.

* During the exam, time passes very fast. Don't think about previous case, just move forward for the next case. Be positive & tell yourself that you're doing your best.

I'll be happy if this helps to any one.
My best wishes for all of you.

hey...congrats on passing...
i gave my cs few days back...
i really screwed 2 of my cases...1st one i completely blanked out...although my PE was ok, my differentials were wrong.
another case i missed entering a finding and made a wrong differential.
most of the other cases were ok...i might hv missed a point or two in pt notes like name of meds etc, but overall they were ok...
am pretty worried...do u think messing up differentials in 2 cases are bad enough for failing???

subhs,

Thanks.

I don't know exactly, messing up how many cases are bad enough to fail. I saw in the forum, people still passed after messing up few cases, even they gave up to pass.
You had 12 cases in the exam, so 12 trials/chances to pass. Please hope for the best & do your prayer.
I'll be glad to hear that you passed when you'll get back your result.

Good luck.

I failed ICE, in other components ihave higher score, I really want to know wat happened.For each case I make D/D before entering into the room, ask qs according to D/D, ask every patient if they wanna tell me anything, openended qs, etc finish ontime except first case, then wat happen. Plz advice I couldn't sleep for three days but crying, badly need help.thanks

Hello wanali,

I'm very sorry to hear about your result. It's really a painful situation.
Please start for cs study again. since you just took the test, the content for cs exam is still in your mind.

Improve your ICE component- study more & don't leave SEP & CIS components. So, work more on all three components. Please read my original post regarding ICE component.

In addition, I would like to give some tips for ICE-

For history taking- please memorize the questions from 44 long cases in FA. I heard that, these questions mostly covered SP's check-list.

For P/E- watch P/E videos from UW, the old version, these videos are also available in u-tube.

For PN- you can also follow PN style from FA. Just add 3 D/D- with history & P/E findings.
Please learn signs-symptoms of diseases from mini cases in FA.

PRACTICE very well.
Work on your typing speed accordingly.

I hope you'll pass the exam next time with higher performances in all 3 components.
Best of luck.
edited by Nufa26 on 6/15/2013

Hi guys! Got my CS result recently. Passed with high performance in all three sections. This was my second attempt. Before my first attempt I joined Kaplan's 5 day course in NJ. They prepare you (too) well for the communication part but NOT for the Patient Note. They actually misguided regarding the Note. Following their tips made me fail the first attempt in Pt. note section. After the shocking result I sat down and analyzed what went wrong. It seems that we need to spend more time (15 min) in writing the note and less (10 min) in history/exam/counseling. Since if you have not recorded it you have not done it. In my second attempt I spent 5 min more on patient note giving it the required amount of detail. As a result my pt interaction was 5 min less but got me a passing score with high on all 3 sections.

did you talk fast or how could you make it in 10 min?

what was your plan to improve your PN?
Can you help with some advice about your study plan to take your test?.
How long did you prepare for the second attempt?.

Thanks for your help!


edited by on 10/20/2014