Just got my score 3-4 days ago and glad to have passed it also. One thing I highly recommend before seeing every pt is based on the given info outside the door and the chief complaint generate a rough differential and outline on the h&p sheet cc, hpi, etc. this way one won't forget to get obgyn history on a woman, development hx on a child, etc. that are not necessarily general for every pt. Also, having a quick differential in mind will guide you through your history taking in terms of asking the right questions to narrow the differential. This may take 40-50 sec of your time but I found it incredibly helpful. Plus, when you get to note taking you've already generated a good differential and narrowed it down so no time wasting thinking about it, just think of the right tests to be ordered. Also, no need to perform a perfect physical exam maneuvers; just go through motions and do as much as possible to cover, e.g. just place stet on heart quickly in the 4 areas, no need to wait and listen to heart sounds, murmurs, etc. same thing with lung exam and stuff. Do take the last minute or so to tell the pt what your thoughts are, a preliminary differential perhaps and a counseling tip. This is important for Interpersonal skills portion of the exam. otherwise just do what you normally do, the key is being very efficient through this whole thing as time is limited. Good luck.
