Step 2 CS Blues...

[neur0science]

Took the exam recently... so nervous about result! I will update with eventual pass/fail score, but this would destroy my residency process this year. Everything else has been great - step 1 above 255, highest 10%ile on my school's OSCE, great clinical comments and remarks in each rotation. I HATE THIS TEST. American Med Student

Mistakes:
1. Missed 4 diagnoses, including 2 diagnoses that I didn't even have as part of my 3 differentials.
2. Forgot to counsel 2 patients (counseling not relevant to CC, but still)
3. Wrote down incorrect facts in my physical exam note for one patient.
4. I don't know why, but couldn't get one patient to look me in the eye at all and she just gave one word answers
5. Only took 30-45sec to summarize most cases, probably didn't do a sufficient job.
6. No empathy for one of my patients
7. Did not introduce my role (MD vs student) for a few patients since I'm just so use to introducing only by name on the wards
8. Almost no physical exam findings on my Ddx
9. Poor supporting evidence in general, a lot of copy/pasting.



I will find out in a while and update this thread.

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[PickleRick19]

I feel your pain. I did most (if not all) of the things you listed and a whole lot of other things that you didn't. Recently got my score back, passed very comfortably. Hang in there! The wait sucks but I'm confident you did well.

 

[ryanr]

I made similar mistakes and passed comfortably as well.
You will most likely be fine. I know it's an agonizing process. Good luck! Gonna be a huge relief when you pass!

 

[whackamole21]

Same boat. I definitely did not have a counseling point for each patient. I did my best to remember Soto summarize... this is agonizing.

 

[neur0science]

I passed to update everyone, worst section was ICE, but without any asterisks in the borderline zone. This test was god awful and for some reason lowered my confidence for months more than either of the other Step exams.

If I can do anything to help anyone, please let me know. Unfortunately, I can't give as good advice to non-AMGs since I'm not familiar with the experience of an IMG/FMG. I studied hard for 3 days and was on an emergency medicine rotation for 2 weeks leading up to this, which was extremely helpful since it was all about rapid assessment and communication. Other gems from this thread and friends were:

1. Practice with a friend, especially things that are uncomfortable to you (for me this is ObGyn)
2. Go through First Aid completely
3. Practice writing out a few notes.
4. Have a template written out before you enter the patient's room. I was always the last one to enter the room since mine was pretty involved but I didn't want to forget anything.
5. Start with open ended questions.
6. At the end of the history, ask "is there anything else you'd like to tell me that you feel is important that we haven't covered?"
7. Physical exam should be no more than 3-4 minutes.
8. Good summary at the end. I never mentioned a specific diagnosis but did tell them "I'll be getting some laboratory studies and perhaps some imaging to ensure our diagnosis is correct. How does this sound to you? Oh by the way, I'd like to discuss *** [counseling]"
9. Strong handshake and get out of there and get to your note.
10. Do the diagnoses/ddx/supporting evidence first. Then fill in history and physical. I totally blanked some of the minor details in my histories and physicals, but always had time to finish them up.
11. If you're a slow typer, get up to 60-100 words per minute at least before taking this exam.
12. If you get anxious immediately upon entering a room (ie an emergent patient or a psych patient), slow down and stick to your framework. Ask that open ended question.

Good luck.