USMLE STEP 2CS

(Information compiled by Tracy Lower, MD)

Resources:

2004 USMLE CD available in the Office of Student Affairs

www.usmle.org

Registration/Scheduling

  • Once you register, you have 12 months eligibility to schedule your exam.
  • There are 2 sessions (am and pm) each day-12 students each.  They fill the am sessions before they open the pm sessions.
  • Keep checking back -- what looks unavailable initially may open up when 1st session filled.
  • Cancellations/rescheduling incur a fee -- amount depends on number of days before that you reschedule.
  • They told me must be more than 30 days before scheduled appointment to reschedule.

Case Development

  • May focus on history only, physical only, or history and physical.
  • Categories may include:  cardiovascular, constitutional, gastrointestinal, genitourinary, musculoskeletal, psychiatric, neurological, respiratory or women's health.
  • They digitally record all encounters for quality control (not direct observation).
  • Cases vary with acuity, age, gender.

Exam

  • Need your white coat and stethoscope ... everything else in room.
  • Review door chart for presenting complaint, vitals etc.
  • Besides the patient, other types of encounters include interview with a caregiver, in person or by telephone, or focused exams on mannequins (e.g. GU).
  • If want rectal, GU, breast, corneal reflexes ... ask for them in the diagnostic plans section of your note.  No cards.
  • Perform RELEVANT H&P depending on door instructions.
  • 15 minutes with patient.
  • 10 minutes for written note after encounter.
  • If you finish early with patient, you can use extra time for your note.
  • Review format for note.  Relevant history, relevant physical findings, differential diagnoses, initial workup.  Does not include management, referrals, consultations.
  • Must fit in space given (no extra pages etc).
  • Note can be handwritten (but must be legible) or typed into computer.
  • 5-minute warning announcement before end of time.

Scoring

3 parts: 

  1. The integrated clinical encounter (60% SP lists and 40% note)
  2. Communication and interpersonal skills
  3. English proficiency
  • Scores are pass/fail.  Must pass all 3 parts to pass the exam.
  • SP generated:  history checklist, physical exam checklist (Bates), interpersonal skills and communication, English speaking proficiency.
  • Patient note:  quality of documentation of pertinent positive and negative findings, differential diagnoses and diagnostic assessment plans.
  • Looking for:  organization and quality of information, interpretation of data, egregious/dangerous actions, legibility.
  • Notes are assessed by trained physicians.
  • The only abbreviations that are allowed are given on the website.

 

3.24.2004