Failed old step 2 CS..... now taking new one

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gmacpac

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So for some bizzarre reason I failed step 2 cs.

I consider myself a decent student. SOM faculty and patients think I do a decent job. I've score really well on step 1 and 2 ck.

Not sure what went wrong......but I failed this silly exam.

Now I'm due to retake it when the entire exam has been changed. Does anyone know if there is a book out there to prepare for this new exam?

For my previous exam (which I failed)...I used first aid cs.

Any help will be appreciated.
 
So for some bizzarre reason I failed step 2 cs.

I consider myself a decent student. SOM faculty and patients think I do a decent job. I've score really well on step 1 and 2 ck.

Not sure what went wrong......but I failed this silly exam.

Now I'm due to retake it when the entire exam has been changed. Does anyone know if there is a book out there to prepare for this new exam?

For my previous exam (which I failed)...I used first aid cs.

Any help will be appreciated.
The first thing that will help you with passing the second time around is stop being in denial about why you failed in the first place. It's not a "bizarre" reason and it's not a "silly" exam. This exam is the most objective measure of your interpersonal relationship with patients there is. SOM faculty and patients most of the time just humor students and say yeah you're ok..... looking up what "ok" usually stands for on a LOR is gruesome, it means that student sucks. Now I am NOT saying you suck (before you bite my head off), however I am saying that the CS is the REAL measure of how YOU do ALONE with a patient. Look at your old report and see where you failed, then read ALL about that in FA CS. FA CS is the single greatest tool for this exam, if you feel uncomfortable supplement it with CS videos.

Moreover, being a good student (grade wise) has nothing to do with your CS performance. Just look around at your hospital, all those neurosurgeons with 4.90000 million GPAs, 300s on their steps and they cannot hold a simple conversation with a patient.

Lastly, if you are still uncertain, go to some CS Live Kaplan patient encounters, those ppl will also be objective, they don't know you, AND they don't want you to fail and ruin their stats.

Good luck
 
I once failed a very important OSCE. I was sure that it was due to some "bizarre reason" and that it was a "silly exam." In retrospect, I think the reason why I failed is because I didn't take it seriously enough.

I don't know if the same is true for you, but I learned a very important lesson from the experience.
 
So for some bizzarre reason I failed step 2 cs.

I consider myself a decent student. SOM faculty and patients think I do a decent job. I've score really well on step 1 and 2 ck.

Not sure what went wrong......but I failed this silly exam.

Now I'm due to retake it when the entire exam has been changed. Does anyone know if there is a book out there to prepare for this new exam?

For my previous exam (which I failed)...I used first aid cs.

Any help will be appreciated.

Just out of curiosity, which section(s) did you fail?
 
I'm not going to bite your head off.

I was asking for advice on finding study resources for the newer exam, and not a critique on what type of student I am.

Firstly, my comment about my clinical skills being "ok" were simply a reflection of my humble personality. If you must know.....I do have strong LORs from all of my attending physicians. One of them also happens to be a medical director at an Ivy league med school, my other LORs are from non-ivy premier institutions.

So now, are you going to accuse me of being arrogant? and give me a talk on how I should not be a number's wh+*&?

Perhaps folks here should focus on the question first.........
 
The first thing that will help you with passing the second time around is stop being in denial about why you failed in the first place. It's not a "bizarre" reason and it's not a "silly" exam. This exam is the most objective measure of your interpersonal relationship with patients there is. SOM faculty and patients most of the time just humor students and say yeah you're ok..... looking up what "ok" usually stands for on a LOR is gruesome, it means that student sucks. Now I am NOT saying you suck (before you bite my head off), however I am saying that the CS is the REAL measure of how YOU do ALONE with a patient. Look at your old report and see where you failed, then read ALL about that in FA CS. FA CS is the single greatest tool for this exam, if you feel uncomfortable supplement it with CS videos.

Moreover, being a good student (grade wise) has nothing to do with your CS performance. Just look around at your hospital, all those neurosurgeons with 4.90000 million GPAs, 300s on their steps and they cannot hold a simple conversation with a patient.

Lastly, if you are still uncertain, go to some CS Live Kaplan patient encounters, those ppl will also be objective, they don't know you, AND they don't want you to fail and ruin their stats.

Good luck

I'm not going to bite your head off.

I was asking for advice on finding study resources for the newer exam, and not a critique on what type of student I am.

Firstly, my comment about my clinical skills being "ok" were simply a reflection of my humble personality. If you must know.....I do have strong LORs from all of my attending physicians. One of them also happens to be a medical director at an Ivy league med school, my other LORs are from non-ivy premier institutions.

So now, are you going to accuse me of being arrogant? and give me a talk on how I should not be a number's wh+*&?

Perhaps folks here should focus on the question first.........

And here we go.... defense galore. I have not accused you of being arrogant (althoug your ivy league LOR comment is not helping your cause), I was merely trying to make you see that how great you are in clinicals is not relevant in this test.

I still believe that accepting this failure as constructive criticism is a better approach then looking at it like a "bizarre" occurrence. Reason number one for that are interviews. You WILL be asked about what happened during your CS and becoming defensive and/or brushing it off as having an off day will not cut it. Hence you need to show that you learned something about yourself from this experience and that you improved on it.

As for how to study for it.. please see highlights in my previous post;
- CS - my colleagues that took the test after the change still said it was the only tool they used
- Kaplan CS course will provide live patient encounters and you will receive honest and objective assessments
- CS videos - I have seen ppl mentioning them on SDN and stating that they have been great learning tools

Maybe you were nervous, maybe you were jet lagged, maybe, maybe, maybe......
 
I remember looking up CS videos on YouTube as a reference, and the ones I found ended up showing me how to FAIL CS :scared:
 
I'm not going to bite your head off.

I was asking for advice on finding study resources for the newer exam, and not a critique on what type of student I am.

Firstly, my comment about my clinical skills being "ok" were simply a reflection of my humble personality. If you must know.....I do have strong LORs from all of my attending physicians. One of them also happens to be a medical director at an Ivy league med school, my other LORs are from non-ivy premier institutions.

So now, are you going to accuse me of being arrogant? and give me a talk on how I should not be a number's wh+*&?

Perhaps folks here should focus on the question first.........

To my understanding, CS is not a measure of how well your attendings like you. It's a measure of how much your patients like you...
 
Doesn't the new edition of FA reflect the changes?

If not..may be you can use uworld or kaplan qbank for CS?

Also, you know which part you didn't make it in. So - may be concentrate more on that while practicing with other students, people?

If none of those work, you can probably use a prep course? But that's definitely the more expensive route.

Wish you the best for next time!
 
The problem with CS is the problem with all simulated patient encounters -- the actors dont know how to answer medical questions like a real patient would.

The actors are looking SPECIFICALLY for key words so they can check off a box on their form. Real patients are much more able to describe events, fill in some blanks on their own, whereas actors generally wont extrapolate and will answer mostly in curt yes/no answers.

Day 1 of medical school they teach you to let the patient tell you their story. You are supposed to ask open ended questions so the patient can fill in some gaps for you.

Yet, on these stupid OSCE/CS "simulated" encounters, they throw that out of the window and grade you based on your ability to get an actor who cant fill in the blanks to check off stuff on a form.

On a real patient encounter, you can ask 3-4 open ended questions, listen to the patient for a few mins, and basically get the gist of whats happening. In an actor scenario, you have to ask 25 yes/no questions that contain the buzzwords that the actors are looking for.
 
The other part of "simulated" encounters that is absolutely stupid is the ridiculous level of feelgood crap that goes on.

Example:

I knock on the patient's door, the patient says "yes?" and then step in.

Actor: "You didnt ask me if you could enter the room"

Me: "Ummm I'm sorry about that, I thought I heard you say yes"

Actor: "I did say yes, but once you open the door you have to ask for permission to enter the room. When a doctor comes into a patient's room, that is entering their personal space and you need permission to do that. It makes patients feel more comfortable."

Me: 🙄
 
The problem with CS is the problem with all simulated patient encounters -- the actors dont know how to answer medical questions like a real patient would.

The actors are looking SPECIFICALLY for key words so they can check off a box on their form. Real patients are much more able to describe events, fill in some blanks on their own, whereas actors generally wont extrapolate and will answer mostly in curt yes/no answers.

Day 1 of medical school they teach you to let the patient tell you their story. You are supposed to ask open ended questions so the patient can fill in some gaps for you.

Yet, on these stupid OSCE/CS "simulated" encounters, they throw that out of the window and grade you based on your ability to get an actor who cant fill in the blanks to check off stuff on a form.

On a real patient encounter, you can ask 3-4 open ended questions, listen to the patient for a few mins, and basically get the gist of whats happening. In an actor scenario, you have to ask 25 yes/no questions that contain the buzzwords that the actors are looking for.

I am sorry to hear you had this horrible experience. My experience was a whole world of difference. I asked mainly open ended questions (except in ROS) and got ppl to tell me quite a few things, including signs of depression and relationship problems that were in the case as hidden secondary issues. These actors are full-time employees and know how to answer "medical" questions better than the average patient that understand a whole lot less medical jargon. In addition if you ask a question that is not in their scenario they are supposed to answer the truth as what they actually feel/know/do. Moreover they get extensive training on their simulated illnesses and most of them only act 2-3 illnesses per year so that they don't get confused.
 
Sometimes SPs don't know everyday jargon.
This happened to me:

Me: How has your libido been, lately?
SP: That's been fine.
Me: (Seeing that the SP's answer doesn't fit in with the circumstances) Okay, then, how has your sexual desire been?
SP: Oh, just terrible.
 
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Hmmm... it sucks to hear these frustrating experiences.
Wonder where you took your CS? Is this a common problem or only certain centers? I have heard Philadelphia is not pleasant and SPs are mean.

I took mine in Chicago.
 
I took mine in Philly, but don't have anything to compare it to...
I thought the actors were okay for the most part.
 
And here we go.... defense galore. I have not accused you of being arrogant (althoug your ivy league LOR comment is not helping your cause), I was merely trying to make you see that how great you are in clinicals is not relevant in this test.

I still believe that accepting this failure as constructive criticism is a better approach then looking at it like a "bizarre" occurrence. Reason number one for that are interviews. You WILL be asked about what happened during your CS and becoming defensive and/or brushing it off as having an off day will not cut it. Hence you need to show that you learned something about yourself from this experience and that you improved on it.

As for how to study for it.. please see highlights in my previous post;
- CS - my colleagues that took the test after the change still said it was the only tool they used
- Kaplan CS course will provide live patient encounters and you will receive honest and objective assessments
- CS videos - I have seen ppl mentioning them on SDN and stating that they have been great learning tools

Maybe you were nervous, maybe you were jet lagged, maybe, maybe, maybe......



1. You are assuming that I haven't accepted my failure. Clearly I did, which is why I posted on the forum.

2. Thanks for the interview tips. I didn't know you were part of the interview committee......oh btw. I've never sat in an interview before so of course I wouldn't know that the interviewees will ask me about my CS performance (but thanks for reminding me though)......????

3. The tone of your comments suggest you think you're more intelligent than others..... Hope this is not the tone you are using with your patients.

Not sure how good online videos are. I used them as part of my prep.....clearly they didn't help me (this is not to say that they are not helpful to other students).

Read FA CS before taking the exam......it was a decent resource, again, I am not sure why I failed despite using the "typical" formula of success for other students. Again, don't jump to the conclusion that I am brushing it off.
 
The problem with CS is the problem with all simulated patient encounters -- the actors dont know how to answer medical questions like a real patient would.

The actors are looking SPECIFICALLY for key words so they can check off a box on their form. Real patients are much more able to describe events, fill in some blanks on their own, whereas actors generally wont extrapolate and will answer mostly in curt yes/no answers.

Day 1 of medical school they teach you to let the patient tell you their story. You are supposed to ask open ended questions so the patient can fill in some gaps for you.

Yet, on these stupid OSCE/CS "simulated" encounters, they throw that out of the window and grade you based on your ability to get an actor who cant fill in the blanks to check off stuff on a form.

On a real patient encounter, you can ask 3-4 open ended questions, listen to the patient for a few mins, and basically get the gist of whats happening. In an actor scenario, you have to ask 25 yes/no questions that contain the buzzwords that the actors are looking for.



THANK YOU VERY MUCH!

Finally, someone whose giving objective feedback! And not offering judgmental SDN therapy!

I couldn't agree with you more. I think the "silly" "check list"....doomed me!!

I will follow the formula of a novice clinician.....ask for all the symptoms even if they are lower in the differential dx.
 
:smack: it is now obvious you were only looking for +pity+ and for someone else to share your sorrow :shrug:

Good luck to you
 
1. You are assuming that I haven't accepted my failure. Clearly I did, which is why I posted on the forum.

2. Thanks for the interview tips. I didn't know you were part of the interview committee......oh btw. I've never sat in an interview before so of course I wouldn't know that the interviewees will ask me about my CS performance (but thanks for reminding me though)......????

3. The tone of your comments suggest you think you're more intelligent than others..... Hope this is not the tone you are using with your patients.

Not sure how good online videos are. I used them as part of my prep.....clearly they didn't help me (this is not to say that they are not helpful to other students).

Read FA CS before taking the exam......it was a decent resource, again, I am not sure why I failed despite using the "typical" formula of success for other students. Again, don't jump to the conclusion that I am brushing it off.


I didn't read the whole thread, but this is my take on this. Yes, I would say it is a completely absurd exam. I don't know why one of the posters gave you attitude and pretended like this is a real exam, or step 1/2ck. It's not. The only reason why this exam exists is to fatten the wallets of whoever the fees go to. The "patients" are not real patients. For the most part, most of these people do a horrible job of simulating a real experience. When you ask them a question, and for example they respond, yes i do have x complaint or no, i do not have x complaint you can see how rehearsed and ridiculous it is. No real patient I have ever encountered has talked/acted like that. Many of them do not remember the questions they are supposed to answer, some are difficult interpersonally, and I do not think it's because they are supposed to be, and as one of my program directors in med school said, they have to be critical and find something wrong. That's their job. They also do not have the medical knowledge to know that things can be asked in a number of different ways and it can still be correct.

With that said, I passed on my first take and took it seriously because even though it is a ridiculous exam, it was an expensive and I absolutely despise wasting $$$. I do not know what the new exam looks like, but some tips which I was recommended and which I will pass on to you:

-You need to make sure that you DO act like they are real patients even though they are not. Just pretend for that day that they are patients in a real clinic with real issues
-Show compassion/good bedside manner
-WASH YOUR HANDS!!! every single time at the beginning of the encounter
-Speak English as clearly as possible (I assume that's not an issue, but just in case)
-Tell patients what you are doing/going to do when doing an exam-example now I will check your heart, now I will do a neuro exam, etc. Many times they do not realize whether things are right/wrong but will check you off if you tell them you are doing this or that
-When writing the note, it's not always easy to figure out what the diagnosis is-but be thorough in your notes, order as many exams as you need, try to put down reasonable diagnosis/differentials
-I used First Aid and went through both the book and the cases (I thought the cases were pretty good). I cannot offer suggestions on what objective things to study since it's new. But I think that ultimately most people fail not because they were not objectively correct, but mostly due to soft factors, which are far easier to control!

Good luck!
 
Sometimes SPs don't know everyday jargon.
This happened to me:

Me: How has your libido been, lately?
SP: That's been fine.
Me: (Seeing that the SP's answer doesn't fit in with the circumstances) Okay, then, how has your sexual desire been?
SP: Oh, just terrible.

Yes, absolutely. I just alluded to this in my recent post! It's very frequent that these patients do not understand that things can be asked in different manners and they are still correct! It's important to use clear, non medical jargon.
 
The other part of "simulated" encounters that is absolutely stupid is the ridiculous level of feelgood crap that goes on.

Example:

I knock on the patient's door, the patient says "yes?" and then step in.

Actor: "You didnt ask me if you could enter the room"

Me: "Ummm I'm sorry about that, I thought I heard you say yes"

Actor: "I did say yes, but once you open the door you have to ask for permission to enter the room. When a doctor comes into a patient's room, that is entering their personal space and you need permission to do that. It makes patients feel more comfortable."

Me: 🙄

Yep, this is why this exam is ridiculous. No one in real life acts like that or should act like that. And people get docked on these things all the time.
 
Yep, this is why this exam is ridiculous. No one in real life acts like that or should act like that. And people get docked on these things all the time.

Thanks DrAwesome!
Glad to know that there are more mature people here who offer a real perspective on the exam.
I followed almost all of your suggestions in my previous attempts. I will make modifications to the next attempt.


The person above clearly has his/her own insecurities to deal with. I'm not bothered by those comments at all.
 
I've only taken the osteopathic PE but if you haven't already retaken your exam make sure to be overly nice. To the point where it is laughable. If you have any medical knowledge and do that I'm sure you will pass.
 
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