How much social crap is there on Step 2 CS?

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devildoc2

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Do they throw curveballs at you like patients who are screaming and wont calm down?

What about patients that are deliberately hiding info from you that you are supposed to get out of them, such as domestic abuse, or alcoholism?

Do they train the SPs to always give you the info if you ask for it directly, or do they play games and not give the info unless you spend 5 minutes hugging them and letting them cry on your shoulder?

Do the SPs just answer all the questions and act straightforward, or are some of them trained to do histrionics or avoid your questions?
 
Do they throw curveballs at you like patients who are screaming and wont calm down?

What about patients that are deliberately hiding info from you that you are supposed to get out of them, such as domestic abuse, or alcoholism?

Do they train the SPs to always give you the info if you ask for it directly, or do they play games and not give the info unless you spend 5 minutes hugging them and letting them cry on your shoulder?

Do the SPs just answer all the questions and act straightforward, or are some of them trained to do histrionics or avoid your questions?

Someone can correct me if I'm wrong since I only took the test once (July), but...

1) No...Well, I did have one weird one SP who kept rolling his eyes and seemed a bit agitated, but I'm not sure if that was acting or his baseline (psych vs drug abuse diagnosis). I did ask him about it ("You seem agitated...Is there something you would like to talk about?") and he denied so I left it at that. At any rate, he answered all questions in a straightforward manner.

2) Again, I don't recall anyone deliberately refusing to answer any questions. That being said, if you didn't ask the right question, you may not get the answers you're looking for. (i.e. If you're thinking domestic abuse is a possibility, you should ask about domestic abuse otherwise, s/he won't tell you)

3) I would advise that you be as direct and specific as you can with your questions. I had maybe one crier. But as she cried (and used the tissue I provided :meanie:), she answered my questions.

4) See 1, 2, 3.

You have 15 minutes in the room. They know you have 15 minutes to get out all of the pertinent information and they act accordingly. I think you'll be pleasantly surprised to see that it's not as difficult as you may be anticipating. I think I only stayed in the room for the full 15 minutes once.

The only ones that I can recall being a little bit unsure about were the ones involving kids. The kids aren't there for you to examine but you still have to make DDx based on second-hand information. Thankfully, Peds was my last rotation before CS, so I could work my way through it.

Use First Aid as your guide (although I used somebody's hand-me-down CSA book - no I'm not an IMG/FMG - with no problems) for what scenarios you will encounter.

HTH.

ETA: I took the test in Atlanta, which is where I'm from, so I had the advantage of knowing the area (but not the building) and staying at my parent's house. Also felt more relaxed when I saw one of the SP who works at my school in the instruction video (although none that I knew within the actual exam).
 
I expected difficult patients and had none. Be prepared for the "challenge questions" - FA is perfect for these. THis is when the pt says something like, do I have cancer. Of course you have to respond with some kind of non-definitive answer.

Compared to the SPs at our school, the Philly ones were much more difficult to work with and less like real patients. You have to ask the exact specific question to get the right answer. That said, FA tells you which questions you will get scored on. Ask those.

I found 15 minutes to be very, very short when working on problems with big differentials, because there are so many possibilities and so much you could examine. You can end up off on the wrong track and in trouble. Again, follow FA for realistic cases.

I have never recommended FA for anything before. CS is the exception.
 
Compared to the SPs at our school, the Philly ones were much more difficult to work with and less like real patients. You have to ask the exact specific question to get the right answer.

I found 15 minutes to be very, very short when working on problems with big differentials, because there are so many possibilities and so much you could examine. You can end up off on the wrong track and in trouble. Again, follow FA for realistic cases.

This is basically true, though i have no idea if it influences who passes or does not pass. I finished all of my interviews within 30s of the alotted time, but I definitely took my time. The other thing I noticed is that the SP quality was not as good as those at my school.

This is the most murky test I've ever taken, I really have no clue if I passed or not.
 
Do they train the SPs to always give you the info if you ask for it directly, or do they play games and not give the info unless you spend 5 minutes hugging them and letting them cry on your shoulder?

One of my classmates failed the CS because he didn't show enough compassion.🙄😡👎
 
One of my classmates failed the CS because he didn't show enough compassion.🙄😡👎

Hence, the tissue 😛

I have been told I have a compassionate face (sometimes too compassionate - the first time I "delivered bad news" during PBL I almost cried with the "patient" :laugh:) so I knew that wouldn't be an issue.

Maybe I didn't take it seriously enough (or maybe I did since I passed 👍), but I didn't go much past what was in the CSA (read: First Aid) book in coming up with a differential. Again, I don't think this is a test so much of your abilities as a diagnostician as it is your ability to properly interact with a patient.

Best advice? Think out loud. If you're thinking it, say it out loud ("I'm going to examine your heart", "Your heart sounds fine", "The reason for your headache could be migraines, caffeine withdrawal, or, least likely, tumor so I'm going to order....", "Does everything I said make sense?")

This covers a lot of bases, from communication to compassion to making patient feel at ease.
 
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