CIS , ICE and SEP Components - Whazzat ?
Going back to the lessons learned from the historic battles all over
the world, the first step to planning one's offensive is knowing the enemy, right ?
The Step 2 CS grading is structured around three parameters:
1. ICE = Integrated Clinical Encounter
2. CIS = Communication & Interpersonal Skills
3. SEP = Spoken English Proficiency
To pass the CS, you essentially need to get through all of these separately - which means even if perform par excellence on the ICE - you can still fail if you go real bad on SEP. The point I wanna drive home here is that a balanced prep is the best prep and dont overlook anything.
Lets have an overview of what is included in each of these.
1. ICE - inludes data-collection skills (History taking) , Physical Examination and everything on the Patient Note. To master this part, memorize all D/Ds for all cases given in First Aid + Usmleworld , the data-gathering for each of these and practice writing a Patient Note in short hand.
2. CIS - As I mentioned before on the post on Communication Skills , includes rapport building skills, the way you present yourself (your confidence, concern and a plesant demeanour), the way you handle SPs questions and tough situations and counseling. This calls for lots of practice with a practice partners ( psssssst - did you enlist yourself on USMLEbuddies.com yet ? ) At the beginning of these practice sessions, you are bound to feel a bit odd, shy or whatever - but you do a case or two...its actually kinda fun!
3. SEP - will include the clarity of your English while you speak in your SP encounter and your ability to explain medical terms and phenomenon in the layman language. Again refer to the article on Communication skills to get some tips on improving this sector. Another point I would like to add in this context - when you talk to yourself or do thinking inside your head - which language do you use ? If its not English and your english ain't too good - then I suggest you start thinking in English. Its a great way to improve fluency in a language besides reading and listening :-)
And 2 golden rules for all IMGs for the SEP :
"Slow down on your speech and don't use too many words if a few can be as effective"
Need Examples ?
"Were you ever admitted to the hospital" v/s "Were you ever hospitalized?"
"What actions make your pain get more instense ?" v/s "What worsens your pain?"
A bit of time saved on every sentence you utter saves a valuable amount of time in the whole encounter ! And this refinement will come by practicing encounters, then practicing again and keeping on practicing till it comes to you as fluently as Tom Cruise's dialogue deliveries in a "A Few Good Men" ;-) Well - thats an exaggeration. But do enough timed practice to have your own smooth and comfortable SP encounter built up.
IMPORTANT NOTICE: Starting 15th July 2007, the 'passing standards' for USMLE Step 2 CS will be increased. Read the Announcement Here. It's amusing in a way, since they do not even release the scoring system for Pass/ Fail decision at the present. This increase will mostly be a pass threshold increase, will not probably be a change in the kind of cases asked. Such increase in thresholds are done to maintain the failure levels to a critical percentage or number.
Google Keywords to this article:
- 'Grading for Step 2 cs'
- 'CSA scoring'
- 'what decides pass / fail on Step 2 CS'
- "how is step 2 CS scored?"
- "step 2 cs grading"
Going back to the lessons learned from the historic battles all over
the world, the first step to planning one's offensive is knowing the enemy, right ?The Step 2 CS grading is structured around three parameters:
1. ICE = Integrated Clinical Encounter
2. CIS = Communication & Interpersonal Skills
3. SEP = Spoken English Proficiency
To pass the CS, you essentially need to get through all of these separately - which means even if perform par excellence on the ICE - you can still fail if you go real bad on SEP. The point I wanna drive home here is that a balanced prep is the best prep and dont overlook anything.
Lets have an overview of what is included in each of these.
1. ICE - inludes data-collection skills (History taking) , Physical Examination and everything on the Patient Note. To master this part, memorize all D/Ds for all cases given in First Aid + Usmleworld , the data-gathering for each of these and practice writing a Patient Note in short hand.
2. CIS - As I mentioned before on the post on Communication Skills , includes rapport building skills, the way you present yourself (your confidence, concern and a plesant demeanour), the way you handle SPs questions and tough situations and counseling. This calls for lots of practice with a practice partners ( psssssst - did you enlist yourself on USMLEbuddies.com yet ? ) At the beginning of these practice sessions, you are bound to feel a bit odd, shy or whatever - but you do a case or two...its actually kinda fun!
3. SEP - will include the clarity of your English while you speak in your SP encounter and your ability to explain medical terms and phenomenon in the layman language. Again refer to the article on Communication skills to get some tips on improving this sector. Another point I would like to add in this context - when you talk to yourself or do thinking inside your head - which language do you use ? If its not English and your english ain't too good - then I suggest you start thinking in English. Its a great way to improve fluency in a language besides reading and listening :-)
And 2 golden rules for all IMGs for the SEP :
"Slow down on your speech and don't use too many words if a few can be as effective"
Need Examples ?
"Were you ever admitted to the hospital" v/s "Were you ever hospitalized?"
"What actions make your pain get more instense ?" v/s "What worsens your pain?"
A bit of time saved on every sentence you utter saves a valuable amount of time in the whole encounter ! And this refinement will come by practicing encounters, then practicing again and keeping on practicing till it comes to you as fluently as Tom Cruise's dialogue deliveries in a "A Few Good Men" ;-) Well - thats an exaggeration. But do enough timed practice to have your own smooth and comfortable SP encounter built up.
IMPORTANT NOTICE: Starting 15th July 2007, the 'passing standards' for USMLE Step 2 CS will be increased. Read the Announcement Here. It's amusing in a way, since they do not even release the scoring system for Pass/ Fail decision at the present. This increase will mostly be a pass threshold increase, will not probably be a change in the kind of cases asked. Such increase in thresholds are done to maintain the failure levels to a critical percentage or number.
Google Keywords to this article:
- 'Grading for Step 2 cs'
- 'CSA scoring'
- 'what decides pass / fail on Step 2 CS'
- "how is step 2 CS scored?"
- "step 2 cs grading"
Labels: Step 2 CS Grading, Step 2 CS Scoring
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posted by Digitaldoc, MD at 7:16 PM
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Post a commenthi, what does D/Ds stand for? thanks
Differential Diagnosis !
I got very good score on ICE(especially on Data gathering) and CIS but very low on SEP. Will that be a mistake. I did communicate with my SPs during the test.
Suggestion/comments will be appreciated.
You may wanna ger a score-recheck you wish to - but it seems they only do the computer scoring again rather than going all the transcripts and videos...not sure if that's gonna be a help. This is the text from the ECFMG site:
"For Step 2 CS, score rechecks first involve retrieval of the ratings you received from the standardized patients and from the physician note raters. These values are then resummed and reconverted into final scores in order to confirm that the reported pass/fail outcome was accurate. There is no rerating of your encounters or of your patient notes; videos of encounters are not reviewed. Videos are used for general quality control and for training purposes and are only retained for a limited period of time."
Basically ECFMG does a bad job at rechecks and may not worth the wait..
IS IT TRUE THAT CS WUD BECOME TOUGHER TO PASS WEF 16 JULY 2006
As per the announement, the passing criteria levels have been raised for the ICE and CIS component - not for the SEP..in effect, yes, passing became a little tougher for people taking the exam on and after 16th July 2006
hi digital doc
do u think wef 16 july they wud change the type of cases....like add tougher cases
or wud they give same cases and only tighten the scoring system
thnks
We can't anything about that until the first few days after the July 16th and see what people have to say...though I think that only the scoring will be tighter
Hi,
Just wondering, how soon can one take the CS again if he/she fails?
Not earlier than 60 days since the exam date
hi digital doc,
ur awesome man,ur of a great help to us struggling people,I am scared about my step 2cs results.forgot many things to do in the exam.like forgot flexing knees of the patient during abd. exam,cudnt finish talking to the patient about the investigationa and management completely.also cudnt finish examining all the systems.plz. do reply.will i pass.
Hi;
My scores for CIS, and SEP were really good, but my ICE was bad (like It was blank). I do not understand why? I wrote everything. Can I ask for a recheck in this case?
Thanks for your help. You have an excellent site.
I would encourage you to call ECFMG and ask them if the blank on ur score indicates a mistake ...
Answer 1 = Step 2 CS result prediction is highly unreliable coz they spring up many surprises - good and bad. We tend to remember the bad things and errors mentally discount our strengths on the exam. generally speaking if the main relevant data-collection and examination points were taken care of AND if the other niceties like counseling and explanations were done well in MOST cases, that seems to have passed people. g/l to u and keep us posted.
Answer 2 = I would encourage you to call ECFMG and ask them if the blank on ur score indicates a mistake. Also read the post about Step 2 CS Score rechecks on this blog..
Can anybody tell me how long it takes to get the result of CS? I have not taken it yet but I heard it can take upto 2 months, which is freaking crazy but oh well like lots of other stuff about these exams and USMLE is too :)))). I would appreciate quick replies thanks.
Anywhere from 8 to 12 weeks ..sometimes more. Do look up the reporting schedule for 2007 mentioned on USMLE.org or This blog..g/l
hi mr digitaldoc..wat u r doing reflects my thoughts which i couldnt make it true..i.e helping people who r in need just from ur experience and generousity..keep it up..the wishes u get from all of us will be ur positive force in life to get succeded in life..i have a doubt to be clarified..recent ecfmg notification of 23rd march states review of step-2 cs passing criteria from july 2007..wil they increase the passing standards from july 2007...hoping for ur reply..thanks a lot ones again..take care..
Why do you say you could not make it - you still can contribute tons and tons on this blog and help people :-)
About your question - increase in minimum passing scores will mostly not change the exam format and the cases asked - it only means we need to practice the same material more vigorously.
I did CS 2 weeks ago. I was so nervese in the morning session that my mouth became very dry, so I drank a cup of water during two cases. I just told SP I need water, I am sorry. Do the behaver affect my results?
Things happen :-) It should not affect scoring as long as it did not interfere with data collection , communication and the clinical part of the encounters as such :-)