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Step 2 CS…….. Made Ridiculously Simple

Step 2 CS…….. Made Ridiculously Simple. Muhammad Ali Khan M.D. Step 2 Clinical Skills Exam. The Exam Overview The Exam Itself How to Prepare Mnemonics for History (made by Adnan Saleem Polani ) Pearls for the Exam. The Exam Overview.

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Step 2 CS…….. Made Ridiculously Simple

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  1. Step 2 CS…….. Made Ridiculously Simple Muhammad Ali Khan M.D.

  2. Step 2 Clinical Skills Exam • The Exam Overview • The Exam Itself • How to Prepare • Mnemonics for History (made by AdnanSaleemPolani) • Pearls for the Exam

  3. The Exam Overview • 5 cities ( Atlanta, Chicago, Houston, Los Angeles & Philadelphia) • Schedule the exam 4 to 5 months before the intended date. • One year eligibility period, you have to take the exam within it. • Choosing the Center and myths about them • Preparation time varies from 2 to 4 weeks. • Check out the reporting period atwww.usmle.org • Watch the orientation video at www.usmle.org

  4. The Exam Itself • Orientation of 20 minutes • 12 patient encounters • An encounter includes • History taking • Physical Examination • Counseling and Conclusion • Each patient encounter is of 15 minutes followed by a 10 minute patient note

  5. Preparation • Book to use • First Aid for CS • Practicing is the key for success • Practice preferably with a medical student or doctor. • If not the above you can practice with anyone. • If you do not find anyone then you may practice in front of a mirror. • Do all cases at least twice

  6. The Clinical Encounter • Doorway information • You write down patient’s name, age & chief complaint. • Write down the mnemonic. • Make four differentials. • Knock on the door. • Address the patient by his/her name. • Greet warmly, shake hands and introduce self by name. • Ask the simulated patient (SP) if he/she is comfortable in the room. • Drape the patient.

  7. The Clinical Encounter • Please during the encounter, no matter what goes wrong, do not have this question mark look on your face. • Just be CONFIDENT, YOU ARE GOING TO DO WELL.

  8. Mnemonic for Presenting Complaint • O Onset • P Progression • F Frequency • A Alleviating Factors • A Aggravating Factors • A Associated Symptoms (Depends on the DDs)

  9. Mnemonic • P Previous Episodes of this particular complaint. • F Fatigue • F Fever • R Rash • A Appetite changes (Diet and Exercise) • W Weight changes • S Sleep changes

  10. Mnemonic for General Health • R Review of systems (go head to toe) • A Allergies • M Medications • P Previous medical history Previous surgical history Family history

  11. Mnemonic for Personal History • Sex Sexual history (Active, Partners within last 1 year, contraception, protection etc.) • S Smoking • O Occupation • D Drugs (Recreational) • A Alcohol • T Travel • L Living condition • A Anything else?

  12. Mnemonic for Ob-Gyn • L Last menstrual period • M Menarche • P Periods lasting how long • R Regular/Irregular • T Tampons/Pads (How many ) • V Vaginal Discharge • C Cramps in abdomen • S Spotting • P Pap Smear • A Abortions • P Pregnancy

  13. Mnemonic for Peds • B Birth History • D Development History • I Immunization history • D Diet

  14. Physical Examination • After completing the history (say in 7 minutes), wash your hands. • Proceed on to the Physical Examination after taking permission from the patient. • Do the relevant system first, then if you have time you can do CVS and Respiratory system examination.

  15. Physical Examination • Be precise in your clinical methods and do not waste time, there are no findings on the simulated patients. • When the 10 minute warning announcement occurs you should be half way through your examination. • If you are lagging behind, speed up, you will need time for counseling and closure. • Avoid medical terminology.

  16. Closure and Counseling • Tell the patient about your initial diagnostic impression and the tests you would like to run. • Counsel the patient as required for • Smoking • Alcohol consumption • Safe sex practices • Social issues • In the end ask the patient if he/she has any questions for you. • Shake hands and say good bye.

  17. Pearls for the Exam • Relax the day before the exam (do what you like & enjoy). • Book a cab the day before your exam. • Reach the exam center one hour before the mentioned time. • HOLD YOUR NERVES. • Most important thing in the encounter is to finish it with adequate counseling. • It does not matter if you mess up a case or two or even three, just keep on telling yourself that you will pass.

  18. Pearls for the Exam • Just be yourself and you will see how things click for you. • Confidence is the key. • You should be polite and smile (but not excessively). • Show empathy to the patient. • The best time to take CS is when you go for electives in final year.

  19. Pearls for the exam • Feeling sad or after the exam???????????? • It is PERFECTLY NORMAL!!!!

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