Step 2 CS: Waste o' Time!

[passlineandodds]

I recently took Step 2 CS and without a doubt I can say that it was an incredible waste of time. Not only that, but it was an incredibly expensive waste of time! The encounters are contrived and seem nothing like what you experience with real patients. In my experience with SP's at my home school and now with Step 2 CS, it seems as if they are trained NOT to answer open ended questions. Doesn't that fly in the face of what we are trained to do in an interview? Furthermore, in almost every encounter I have had with a real patient, they respond to open ended questions and actually tell their story.

When you think about it, a real patient has an agenda and that agenda is to seek your help for care. They have an incentive to partner with you in order to help you take care of them. An SP also has an agenda and that agenda is to evaluate you! Because of that they do not act like real patients! They are guarded in what they say and only seem to responds to trigger words. I don't know if other people noticed this, but it seemed like when I would say one of those trigger words there was actually an audible buzzer that went off almost as if to indicate to the SP that he or she could relate some information to me. After a while it was starting to really weird me out! In addition they have two-way mirrors so someone can observe you. That did not bother me, but I did get annoyed when I could hear people talking on the other side of the mirror. I blocked it out but it was a little distracting and was unprofessional on their part.

On a more positive note, I do have to say that the proctors were professional, polite, and courteous. They did not seem to power trip on their role as proctors. At my school, they have some secretaries from medical education proctor the OSCEs and they always power trip on us. The only thing that I did not like was that they referred to us medical students as doctors. Isn't that somewhat unethical?

On a humorous note, the food that they served was not that bad! For $1000 I was expecting champagne and caviar but I was only deluding myself. What they had available for us to eat was actually edible and some of it was even tasty!

Overall, the exam was not worth the time, money, and effort that a student has to put in to take it. Unless you go to school near the testing center, it is a guarantee that you'll have to spend time and money traveling. Depending on how far you travel, you might also have to cough up some cash for a hotel room. Finally, there is the opportunity cost involved in taking the exam. I would have preferred spending all that time and money taking my wife on vacation!

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[Stinger86]

Thanks for the info, passline. You confirm several points about this worthless exam that have bothered me for a while. The bit about the SPs responding to trigger words and not answering open-ended questions had me shaking my head in mock surprise. I suppose I'll feel right at home at the CS then, seeing as how my OSCE experiences at school were identical. "What seems to be the problem? My head hurts. Ok, tell me about the pain. Um, my head hurts." Sigh.

The part about hearing voices behind the mirror is aggravating. That's enough to compel me to turn around during the patient case and scream "shut the hell up! Have some respect!"

Looks like I'm going to put this exam off as long as my school lets me, and hope some lawsuit or nationwide earthquake or something destroys this thing next year.

 

[passlineandodds]

No doubt that if I were in your shoes I'd put off the exam as well. The reason for that being that I would want to see if I could get out of it and save the money. You'll be well prepared for it, so if you know it is not going away and you can't get out of it, just take it when you have the time to. Don't worry about it during third year. Good luck with your rotations!

Thanks for the info, passline. You confirm several points about this worthless exam that have bothered me for a while. The bit about the SPs responding to trigger words and not answering open-ended questions had me shaking my head in mock surprise. I suppose I'll feel right at home at the CS then, seeing as how my OSCE experiences at school were identical. "What seems to be the problem? My head hurts. Ok, tell me about the pain. Um, my head hurts." Sigh.

The part about hearing voices behind the mirror is aggravating. That's enough to compel me to turn around during the patient case and scream "shut the hell up! Have some respect!"

Looks like I'm going to put this exam off as long as my school lets me, and hope some lawsuit or nationwide earthquake or something destroys this thing next year.

 

[prominence]

some of my friends who have taken the Step 2 CS had 12 patient encounters. Others had 11 patient encounters. how is this fair? do they drop any of the encounters when they come up with the final score/grade? or are some of the encounters purely experimental?

 

[passlineandodds]

they told us that the am groups have 12 and the pm groups have 11. they also said that 1 out of the 12 is experimental.

some of my friends who have taken the Step 2 CS had 12 patient encounters. Others had 11 patient encounters. how is this fair? do they drop any of the encounters when they come up with the final score/grade? or are some of the encounters purely experimental?

 

[CaptainJack02]

they told us that the am groups have 12 and the pm groups have 11. they also said that 1 out of the 12 is experimental.

the school i go to requires the step 2 cs for graduation and i was worried about this. can you tell me a little about the cs part? do they generally test you on common ailments and throw a monkeywrench in the works to trick you...or can they throw anything your way? do they combine the cs and ck parts to give you a overall score for step 2 or do you get 2 different scores? what's the average score for the cs part?

i know nothing about it! englighten me, por favor.

thanks
captjack

 

[passlineandodds]

cs and ck are scored separately. cs is pass/fail and going into the test the administrators at my school who are tied into the aamc and nbme said the encounters would be common clinical problems. without compromising the exam, i can say that they were pretty much right.

the best way to prepare for the exam is to work really hard during your third year. get feedback from residents and attendings on your history and physical exam skills. actually have them watch you take a history and do a physical. to help the process, you might want to ask them for feedback on specific aspects of history taking or a certain part of the exam. this will make their job easier and will give you more meaningful feedback than "great job!"

most of all, i would say do not stress out over step 2 cs. like i said, it is a big waste of time and money. it's just another hoop for us to jump through.

the school i go to requires the step 2 cs for graduation and i was worried about this. can you tell me a little about the cs part? do they generally test you on common ailments and throw a monkeywrench in the works to trick you...or can they throw anything your way? do they combine the cs and ck parts to give you a overall score for step 2 or do you get 2 different scores? what's the average score for the cs part?

i know nothing about it! englighten me, por favor.

thanks
captjack

 

[Gauss]

did you guys wear ties to this thing?
other than stethoscope any other tools of your own they let you bring in?

 

[jbernar1]

I think that only 10 are scored no matter if you have 11 or 12. I took it this past Sunday in the am session and my group had 11. I did wear a tie and they do not allow anything other than your lab coat and stethoscope (you can't even bring your own pen!).

 

[spikyhairedgirl]

... (you can't even bring your own pen!).

That's horrible! I keep all of my patient relation skills in my magic pen! What am I going to do?!?

 

[Long Hair and a Beard]

I can totally relate to the bit about the patients not responding to open-ended questions! But I asked them anyway, since that might be part of the evaluation too!!

As an IMG, I was more worried about my communication skills, by which I mean not just my accent, but the whole thing of being overtly polite to the patient, and getting graded for it too! I'd say PIPE was a good practice for me in this regard, and gave me time to work on these things. In the real exam, I think I did good. Although, as I later joked to my friends, I said more 'I'm sorry' than I had said the whole of my life!

As for people talking behind the glass, that was really wrong, I must say... But we were told that people watching from behind the glass are there purely for research purposes. They don't grade you.. So you can holler at them all you want..

spikyhairedgirl, do some more magic on your pen, and make it look like the pen they provide

 

[Amy]

In addition they have two-way mirrors so someone can observe you. That did not bother me, but I did get annoyed when I could hear people talking on the other side of the mirror. I blocked it out but it was a little distracting and was unprofessional on their part.

Let me get this straight.... they spent (wasted) millions of dollars on these testing centers and they can't even install video cameras in the room so faculty can observe us elsewhere via CC television?!?!?! This exam is supposed to represent real pt encounters.... I've never seen an exam rm w/ mirrors!

Sounds like my school has better facilities. Remind me why I have to travel to take this exam??

 

[PsychFuture]

are there any study materials that helped with the CS part of Step 2?

 

[Idiopathic]

Anyone know about osteopaths who take USMLE Step II if they have to take CS to pass or to have their scores count? Ill take COMLEX-PE, but will not take USMLE Step II.

 

[Ursus Martimus]

I suppose the biggest contention I have with the CS exam, which I am yet to take, is the fundamental rational. I understand that foreign students have been taking a similar exam for some time. The idea is that they want to make sure physicians have a "minimum" competency in interacting with patients. But this is where the rational falls apart. SInce the exam does nothing to stratify test takers, unlike the scoring system of step I and Step IICK, it truely is an issue of "minimum competency". It seems like that should be an issue implicit to the accrediation procress. The LCME should, during their weeklong visit to school, be able to adequetly asses the school's ability to produce minimally competent pysicians - for what else is their mission. And yet again, because some organization can't adequently fulfill their mission to their constituency (of which medical students are included) we have to foot the effort and expense for their poor efforts. It really is a shame.

 

[mig26x]

another money sucking test with the only excuse of us becoming better doctors. I cant join the dots in this one, cant see how this exame correlates with the real thing out there.

"Money, Money, Money". Why does this song comes up to my mind when i think of this tests!!! LOL.