I am an AMG who hasn't done amazing in medical school but has been average/slightly above average. H's and HP's throughout M3 and M4 years, average on Step 1, above average on Step 2 CK, and never had any issues with any OSCE's. Took Step 2 CS in November 2018 and was shocked when I found out in January that I failed the CIS component.
Communication/Interpersonal Skills have always been a personal strength of mine and have been mentioned multiple times in my clerkship evals. Needless to say, I was crushed. I picked myself up and retook the exam in March 2018 and just found out today that I passed! My CIS score went from in and below borderline to so far to the right I earned one of those awesome stars. I spent hours reading through forums throughout this journey so I hope my experience might help someone else out.
Major morals of this story: Do NOT take Step 2 CS lightly and do NOT put it off until late in the year. Schedule and take this examination ASAP so you aren't scrambling to retake it in time for interviews/rank list submission. I assumed I could casually read FA, practice a few notes, and then cruise through it. This examination is all about hitting checklist items, not about actual skills so if you can still absolutely fail even if you are a great student. I didn't use any mnemonics and never practiced any cases on anyone beforehand. Thinking back through my first attempt, I'm pretty sure that not counseling enough played a large role in killing my CIS score.
Here is what I did to prepare for my second attempt. I read through FA again, made flashcards to help me memorize differentials and important orders, practiced timed encounters with two of my classmates who passed CS, used the online note form to practice writing notes for every practice encounter, and came up with a template that I wrote down before walking into every patient room.
Here is the template I used:
HPI (FORDPAPP - Frequency, Onset, Relieving factors, Duration, Precipitating factors, Associated symptoms, Previous episodes, Progression)
-How is this affecting your life?
-What concerns you the most?
OBGYN Hx (if female)
Birth Hx / Immunizations (if infant/child)
PMH
-Meds (side effects, compliance)
-Allergies
PSH
Fix
SHx (TAIMODESS - Tobacco, Alcohol, Illicit Drugs, Married (relationship), Occupation, Diet, Exercise, Sex, Support systems)
ROS
COUNSELING
As I said before, just making these simple additions to my study schedule took my CIS score from the left side of the profile to going clear off the right side.
After I finished my examination, I was sure that I had failed and seemed to remember something else I had done wrong every day until I actually got my score. It always helped relieve some stress when I read about mistakes other people made while still passing so here is a list of the mistakes I clearly remember making:
1. Totally spaced including a diagnosis in two differentials that should have been one of the top two in the differential.
2. Forgot important counseling topics for two patients. Was saved on one of them by asking multiple times if they had any other questions and the patient brought up the counseling item.
3. Forgot a few physical examination steps that weren't huge but should have been done on two cases.
4. Had a brain fart and didn't use proper medical terminology for two diagnoses.
5. Can't remember if I washed my hands before doing the physical exam with one patient.
6. Was totally stumped by a physical exam finding that made no sense until I was on the plane ride home and I realized a massive diagnosis I forgot to include on my differential.
7. Ran out of time as I was ending one encounter and didn't have a chance to wrap up properly.
Even with these mistakes, I passed ICE w/out any borderline marks. Remember that the ICE component is very forgiving so don't beat yourself up too much for mistakes that were made. No one actually understands how this test is graded so all you can do is give it your best shot and hope for the best.
Hopefully this helps someone out there. I understand the feelings of despair and discouragement that hit if you fail this exam but you can totally prepare and dominate it your second time around. If you haven't taken it yet, again I beg and plead with you to NEVER take this examination for granted. It has the potential to completely derail your residency plans, is freaking expensive, and will lead to MONTHS of soul crushing anxiety and stress that could otherwise be avoided. Feel free to PM me if you have any questions.
Communication/Interpersonal Skills have always been a personal strength of mine and have been mentioned multiple times in my clerkship evals. Needless to say, I was crushed. I picked myself up and retook the exam in March 2018 and just found out today that I passed! My CIS score went from in and below borderline to so far to the right I earned one of those awesome stars. I spent hours reading through forums throughout this journey so I hope my experience might help someone else out.
Major morals of this story: Do NOT take Step 2 CS lightly and do NOT put it off until late in the year. Schedule and take this examination ASAP so you aren't scrambling to retake it in time for interviews/rank list submission. I assumed I could casually read FA, practice a few notes, and then cruise through it. This examination is all about hitting checklist items, not about actual skills so if you can still absolutely fail even if you are a great student. I didn't use any mnemonics and never practiced any cases on anyone beforehand. Thinking back through my first attempt, I'm pretty sure that not counseling enough played a large role in killing my CIS score.
Here is what I did to prepare for my second attempt. I read through FA again, made flashcards to help me memorize differentials and important orders, practiced timed encounters with two of my classmates who passed CS, used the online note form to practice writing notes for every practice encounter, and came up with a template that I wrote down before walking into every patient room.
Here is the template I used:
HPI (FORDPAPP - Frequency, Onset, Relieving factors, Duration, Precipitating factors, Associated symptoms, Previous episodes, Progression)
-How is this affecting your life?
-What concerns you the most?
OBGYN Hx (if female)
Birth Hx / Immunizations (if infant/child)
PMH
-Meds (side effects, compliance)
-Allergies
PSH
Fix
SHx (TAIMODESS - Tobacco, Alcohol, Illicit Drugs, Married (relationship), Occupation, Diet, Exercise, Sex, Support systems)
ROS
COUNSELING
As I said before, just making these simple additions to my study schedule took my CIS score from the left side of the profile to going clear off the right side.
After I finished my examination, I was sure that I had failed and seemed to remember something else I had done wrong every day until I actually got my score. It always helped relieve some stress when I read about mistakes other people made while still passing so here is a list of the mistakes I clearly remember making:
1. Totally spaced including a diagnosis in two differentials that should have been one of the top two in the differential.
2. Forgot important counseling topics for two patients. Was saved on one of them by asking multiple times if they had any other questions and the patient brought up the counseling item.
3. Forgot a few physical examination steps that weren't huge but should have been done on two cases.
4. Had a brain fart and didn't use proper medical terminology for two diagnoses.
5. Can't remember if I washed my hands before doing the physical exam with one patient.
6. Was totally stumped by a physical exam finding that made no sense until I was on the plane ride home and I realized a massive diagnosis I forgot to include on my differential.
7. Ran out of time as I was ending one encounter and didn't have a chance to wrap up properly.
Even with these mistakes, I passed ICE w/out any borderline marks. Remember that the ICE component is very forgiving so don't beat yourself up too much for mistakes that were made. No one actually understands how this test is graded so all you can do is give it your best shot and hope for the best.
Hopefully this helps someone out there. I understand the feelings of despair and discouragement that hit if you fail this exam but you can totally prepare and dominate it your second time around. If you haven't taken it yet, again I beg and plead with you to NEVER take this examination for granted. It has the potential to completely derail your residency plans, is freaking expensive, and will lead to MONTHS of soul crushing anxiety and stress that could otherwise be avoided. Feel free to PM me if you have any questions.
