Passing Step 2CS: Knowledge or Doing the right steps

[Transformers]

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Hey guys, I was gonna do step 2cs before ck and it's been a while my clerkships (months). Looking at 2cs and 2ck, they look like they are completely different beasts so I wanted to clarify what is really important for 2cs, which I will be taking first and I have a few weeks to prep. Kind of worried I suffered a major brain drain since Step 1/away rotations.

1.) For CS, is this ultimately just a test of basically being efficient/doing a focused H&P/ and communicating effectively (washing hands, introduction, closure, asking the right questions, typing a note) and less of getting the right answer (ddx, workup)?

2.) Do you need to know all of PDx cold basically? (i.e.- including all the specific MSK maneuvers of the knee, all tests for appendicitis)...I kind of worry about the subjectivity of these tests and how screwed I would be if I missed a varus/valgus test to diagnose a cruciate ligament tear for example....

3.) In terms of knowledge-base of chief complaints to work with, if I know all the ones in FA 2CS, would that suffice? The chief complaints and cases in FA 2CS seem relatively straightforward (big picture stuff and focused complaints) which is nice and there is a LOT of overlap in the workup for a given complaint (in terms of labs, imaging, etc..)

4.) When I think about CK or even Step 1, a lot of the focus is getting the right answer, but I am not sure how much of this is valued for CS. How important is it to get the right differential dx and workup plan? Part of me worries about erring on too few ddx/workup or too many steps or just being wayyy off and being incorrect.

 

[Plasmatron88]

1) No you have to be decently efficient (not perfect) in both areas to pass the exam, CIS tests you on the communication part and ICE tests you on the Dx and getting the right workup and writing a good patient note, these days both areas are heavily scrutinized, at most you can mess up one or two cases but that's as far as the margin of error goes.

2) Its good to know the maneuvers and some are expected to be performed in order to get a decent scoring like rovsing, obturator, kernigs etc. for msk focused maneuvers are part of the PE (ICE part)

3) FA step 2 Cs 4th or fifth edition onwards only, don't buy previous editions, Its a decent book and yes it can provide you with a sufficient knowledge base however I feel its weak in the area of lab workúps since there is too much overlap and too many unnecessary tests recommended which can make you lose points, Do Kaplan Core cases to further enhance this area

4) Its depends , you need to have sufficient clinical knowledge to be able to give reasonable differentials, you don't have to be correct always but the ddx must be close or reasonable at least and you Need to support your dx from hx this is VERY important, try to come up with common ddx with their common support points, rather than esoteric ones which may have minimal support, also the dx listed must be in order of their likelihood.

hope this helps, don't underestimate the test and study hard for it, SP PRACTICE IS KEY