MY USMLE STEP 2 CS (CSA) STUDY NOTES-N-TIPS-N-TRICKS

2011-03-26T08:06:00.000-07:00

"You Can Call me 'Dr. J'..."Use this on Step 2 CS as well as real life ! Many IMGs have names or last names that Americans find tough to pronounce. I have seen official name-changing common amongst my Chinese friends. If you have had a problem getting your name across in a single pronunciation, instead of wasting time and struggling with the patient getting your name right, it's ok to say - "Hi

2009-06-17T19:11:00.000-07:00

Getting on the "other side" of Step 2 CS Shocks me!Well not really Step 2 CS, but almost. One of the benefits of being in a University residency program is getting to teach and learn from all the bright new American medical grads. One of the exercises we residents had was grading a observed clinical encounter of a medical student on a video that we watched together, pretty much how the doctors

2008-12-14T20:11:00.001-08:00

Understanding the essence of a "drug-refill" caseThis post is for IMGs who have never worked or observed in the US, and wonder what's the big deal about spending 15 minutes on re-writing a patients prescription :-)In contrast to some countries like India, most medications in the US CANNOT be bought "Over The Counter", i.e. they need a doctor's prescription. e.g. Antibiotics, Anti-hypertensives,

2008-03-07T00:28:00.000-08:00

STEP 2 CS VISA EXPERIENCERegion: Mumbai (India) : EXPERIENCE VIIIPublished with Permission from:Ayaaz Multani Gupta, MDExperience Date: Feb 2008Thanks to the continued warmth of readers willing to share and help, CSprotocol blog is stacking up loads of good karma and hopefully some of it rubs on to me too ;-)Here's a cool experience writeup by Dr. Ayaaz:My interview time was 9:15 am at Mumbai.I

2008-02-03T19:08:00.000-08:00

STEP 2 CS VISA EXPERIENCERegion: Cairo (Egypt) : EXPERIENCE VII:Published with Permission from:An Anonymous Egyptian IMG Experience Date: Jan 2008CSprotocol blog continues to get lucky with readers eager to contribute in the spirit of helping. Here's a very detailed write-up about the visa rejection experience at Cairo in Egypt. The contributor chose to remain anonymous and would like to have

2008-01-28T23:56:00.000-08:00

NEW STEP 2 CS VISA EXPERIENCERegion: Delhi (India) : EXPERIENCE VI:Published with Permission from:Nagendra Gupta, MDExperience Date: Jan 2008Yet another spectacular and graphic Step 2 CS Visa interview experience contributed by a very delighted Dr. Nagdeep from India who "came out jumping with joy ;-)"Many thanks to him and Here goes:"Hello everyone!First of all, I am very very thankful to you an

2008-01-20T05:43:00.000-08:00

Wrist Watches Banned on the USMLE Step 2 CSThis new regulation basically puts my earlier post about Digital / analog wrist watches utterly useless and obsolete. Besides that and the fact that you will need to shove your wrist watch into the lockers before the exam, it should not make any difference to you on the clinical encounters, because a wall clock will be installed in every room ...hmmmm,

2008-01-07T23:10:00.001-08:00

Top Reasons to Finish USMLE Step2CS EarlyThere are some unmistakable personalities in the world that will irritate you not because of the content of what they say - but because they repeat the same content over and over again. [I am sure some people might have already flickered up on your mental screen ;-) ]. I am risking being that irritating entity with this post - not because I feel the

2007-12-26T23:02:00.000-08:00

USMLE Step 2 CS Study-plan for Beginners ...15 Days ?Study ! Study ! Read ! Read ! Oh I am sure you heard it again and again that the key to success in CS is study, study, read ... Yeah Right ! I say it is confidence, confidence - which comes with practice, more practice and studying the right thing.The first natural question before studying for any USMLE Step : "So where exactly do I begin ? "

2007-12-08T13:30:00.000-08:00

A Mnemonic for D/Ds of Confusion and /or Memory LossAt times, I wish I could hire someone just to sort out my emails and sort out the unmoderated comments on various blogs I try to maintain. This blog alone has 250+ unread and unmoderated comments waiting in line that I have yet to publish! My apologies for that, but I am working on it.Here's a cool mnemonic that a reader - Maria Paula, MD

2007-10-04T14:30:00.000-07:00

When Can You Retake the Step 2 CS after a failed Attempt ?Before May 2007, a candidate was not allowed to repeat the same USMLE Step within 60 days of the previous failed or an incomplete attempt. Starting May 2007, this 'waiting period' was eliminated. As per aBUT - The registering for the exam for the next attempt can only be done AFTER the results of the failed attempt are available.That's

2007-10-01T18:39:00.000-07:00

2007 and 2008 USMLE Step 2 CS Reporting ScheduleThis is just some shameless Copy-paste job I have done off the ECFMG website - but hey at least this might be easier to find ;-)Step 2 CS 2007 Reporting Schedule Testing Period Reporting Period

2007-09-06T03:31:00.000-07:00

Forgot to carry a Lab coat or a Stethoscope to the exam ?I was hesitant to put up this pic that says "Don't Forget" - coz the nature of the human mind is to, consciously or sub-consciously, do the opposite of what's suggested - maybe it's the fun & challenge of trying out the prohibited or simply refusal to bow to another authority ..he heAnyways...the other day I got this frantic & panicky email

2007-09-05T21:38:00.000-07:00

Are Digital Watches Allowed on the Step 2 CS ?Attention: As of January 2008 - No Wrist Watches will be allowed while taking the USMLE Step 2 CS Exam - So this post becomes obsolete - Yet I keep this post as a piece of history since I get kinda attached and fond of my own creations ;-)Read about the wrist watch ban here"Questions to me on my Step 2 CS Forum spark new ideas for posts on this blog

2007-07-06T12:01:00.000-07:00

About Knocking on the Door Before EnteringAt times I can't help but wonder how much can the earth save in Electricity bills by banning all electric bells and making it compulsory to have 'knock-only' doors :-) ...Whatever ! me and my weird musingsIn the Step 2 CS experiences database, I had one person put in an interesting remark about him/her knocking on the door and having 'no response from the

2007-05-04T20:03:00.000-07:00

STEP 2 CS VISA EXPERIENCES SERIESEXPERIENCE V: Region: Calcutta (India)Published with Permission from :Tona, MD Nice name Tonya ;-) One good turn deserves another - thanks to user contributions, people who were helped come back to share more. Thanks to Tonya this time about her Visa experience, who had an equally anxious cab-driver bumping into cars to help her reach on time..he he"Dear

2007-03-31T22:20:00.000-07:00

STEP 2 CS VISA EXPERIENCES SERIESEXPERIENCE IV: Region: Mumbai (India)Published with Permission from :Kaustubh Shrivastava, MDAnd here's another great Step 2 CS Visa Experience Write up and tips by another generous reader:"hello guys..just wanted to share my step 2cs visa experience with u people..at the Mumbai consulate..first things first...always take the visa date asap...as the dates are

2007-03-05T14:50:00.000-08:00

CSprotocol wins Blog of the Day AwardSometime back my blog MDsalaries: Physician Salaries in USA won the Blog of the Day Award - and now it's CSprotocol's turn to win the title of 5th March 2007Now....I am beginning to get used to it ..hehe...some modesty eh? ;-)

2007-02-27T13:50:00.000-08:00

2007 BEST USMLE STEP 2 CS STUDY MATERIAL POLL RESULTS(Ongoing)Having options in life is good - yet there will be times when we wonder why things are not simpler, why so many options ! coz' making the right choice without enough information on all the options is a gamble. That's when we use the public polls lifeline ..wish we could do that for the MCQs on USMLE Step 1, 2Ck and 3 ;-)Though I

2007-02-21T23:11:00.000-08:00

STEP 2 CS VISA EXPERIENCES SERIESEXPERIENCE III: Region : New Delhi (India)Published with permission from:Pariskhit Deshmukh, MDIndira Gandhi Government Medical College, NagpurYet another Step 2 CS Visa Experience, and this time it comes from a very helpful Dr. Parikshit Deshmukh. Read on !"Visa officer (VO): come hereMe: good afternoonVO: How are you?Me: I am fine. how are u?VO: I am fine. show

2007-02-20T02:43:00.000-08:00

STEP 2 CS VISA EXPERIENCES SERIESEXPERIENCE II: Region : Pakistan (Islamabad)Published with Permission from "Dr. Pak", MD (Awaiting Real name and institution for credits)A profuse thanks to Dr. Pak to contribute to this series of the much asked about Step 2 CS Visa. Me and this blog is blessed with helpful readers indeed ! :-)Here goes:"My visa interview was scheduled for the 20th of February

2007-02-12T22:39:00.000-08:00

Step 2 CS Visa ExperiencesIt's amazing how we all make plans, have dreams and ambitions and bet everything on them, even though so many events that must concert together to make that happen, are based on 'Chance' - the Luck-factor, which can bend anyways without reason - good or bad.Like, for all you know, this blog may not be operational after the year 2880 - contingent on the predicted 1950AD

2007-01-30T14:53:00.000-08:00

STEP 2 CS Attire / Dress /Clothes for the FemalesThis section represents a blind-spot in my accumulated knowledge regarding the USMLE Clinical Skills test & the attires I would like to recommend girls would most probably be deemed rather unprofessional ;-) Hence, I had called upon the girl readers to help me build up this section ! Here are some great tips that generous readers have contributed:

2007-01-25T18:31:00.000-08:00

Step 2 CS Study Material Poll Results : 2005 - 2006Everyone has probably heard this to the point of getting bored - "Change is the only thing that is constant". Priorities change, seasons change, realities change, moods change, girlfriends/boyfriends change and preferred study materials for Step 2 CS change too ;-)This is how the preference patterns looked for Step 2 CS Study Materials in the

2007-01-25T11:43:00.000-08:00

HOW MUCH MEDICINE DO THE STANDARDIZED PATIENTS (SPs) KNOW ?This is rather something for my own curiosity than readers asking about it - but think it mightinteresting to know anyways. What more better source of evidence to answer this question can there be than to look up the SP employment requirements put up by the ECFMG for the SPs - found it an amusing read. You can read it here.I was of the

2007-01-23T17:03:00.000-08:00

Carotid Bruit Auscultation: Use Bell or Diaphragm ?This question has been a bone of contention between the USMLE 'forumers' since a long time, myself included - felt it was time to attempt to lay this ghost down to rest for good...As many of you might have noted, various websites mention opposing views! The University California San Diego's online Practical guide to clinical medicine puts thus:"

2007-01-01T17:57:00.000-08:00

PHYSICAL SIGNS: MENINGITIS / MENINGISMFollowing Physical Sign's are elicited to support a diagnosis of Meningitis:1. Neck Stiffness / Rigidity2. Kernig's Sign3. Brudzinki's signBefore we proceed, let's understand that the central idea of these maneuvers is to stretch the meninges, which in turn should pain if they are inflamed.Neck Rigidity:Kernig's Sign: 1. Have the Patient lie in the supine

2006-11-28T19:48:00.000-08:00

CSPROTOCOL CELEBRATES 100,000 Visitors !This blog started its humble online existence [ Csprotocol.blogspot.com] from August 2005 (I hate myself for not remembering the exact date) - and a few days back I noticed the number of visitors had crossed the 100K mark (100,000) ...Not much of a reason to celebrate I know..but life's too short to not enjoy :-) :-) :-) :-)Thus on 27th of November

2006-11-24T22:36:00.000-08:00

HEARING TESTS: RINNIE'S AND WEBER'SAbout Listening....I simply love the way Epictetus puts it : "Nature gave us one tongue and two ears so we listen twice as much as we speak" ....a cool way to say it. Not many of us are good listeners, are we ? Maybe we all do need a Rinnie's and Weber's Test, you know...just to be sure ;-) he heLet's get some practical basics straight first in the context of

2006-11-22T17:57:00.000-08:00

STEP 2 CS SCORE RECHECK / RE-EVALUATION : IS IT WORTH IT ? I completely understand the agony, frustration & sadness that a failed Step 2 CS attempt can cause, and getting a score-recheck done is often considered by many who feel they did well on the very sections that they got a 'fail' on. Let us analyze if it really is worth the waiting anxiety and money to apply for a score recheck.First, lets

2006-11-12T00:58:00.000-08:00

About Visa for the Step 2 CS: The "CS Visa"Let us get some basics straightened out for the benefit of newbies to CS -1. You can take the Step 2 CS on ANY visa - visitors (B1/B2), Student (F1), H1, J1, K1 L1 ..just about any legal independent or Dependant visa status. All you have to do is enter the USA legally.2. When you apply to ECFMG for the Step 2 CS exam, you may indicate that you would like

2006-10-28T13:14:00.000-07:00

STEP 2 CS Experience at ATLANTA:By Waqas Tariq, MDThis one deserves a separate post of it's own to credit the extremely detailed experience and tips that this dude has provided us with !Thanks Waqas ! - you cannot miss him on Orkut ;-)"I dunno where to start my experience but I read for step 2 CS for almost 2 months. Wasnt regular at all as I was also having my regular classes in my medical

2006-10-16T02:47:00.000-07:00

LIST OF ACCEPTABLE ABBREVIATIONS / SHORT-FORMS FOR THE PATIENT NOTE:Short, they say, is good at times. In fact, I was amazed to find a amazing support organization for short people explaining the various physical and biological advantages of being short. I do recommend giving that a read Here.Well, on the Step 2 CS, if it saves time , short-hand or Abbreviations are cool for the Patient Note :-)

2006-09-12T10:10:00.000-07:00

SHOULD YOU JOIN LIVE CS-PREP COURSES ?There are many of them around - like C3Ny, PassCSA, Kaplan CS Prep , etc. For those who are not aware, these are short courses that simulate the exam with their own people and coach you for a fee.Well, I did not take any because I did not believe I needed them and yeah - as if the Step 2 CS was not expensive enough !!But all the same, these course could

2006-09-09T20:27:00.000-07:00

RECOMMENDED GOOD BOOKS FOR STEP 2 CSThese are the commonly used books for the Step 2 CS. First Aid remains the hot favourite book. Follow the links to get your low-cost used or new copies...Most of them can be purchased in less than 30 $ !1. First Aid for Step 2 CS : Tao Le + Vikas BhushanThe 2006 Edition is out !2. Case-Based Simulation and Review For USMLE Step 2 CS : Theodore X. O'Connell

2006-08-07T10:08:00.000-07:00

Menstrual / Vaginal Bleeding : A MnemonicOn the first day of my Gyn-Obs clerkship rotations during the second year med-school days, as I stood behind a resident observing, she told me that the first patient was a follow-up case of a PV Bleed. I felt dumb then when I asked - "What's PV?" - he he, but yeah, I was only in my second year ...so maybe we can discount that a bit ! (PV = Per Vaginal)

2006-08-05T18:59:00.000-07:00

STANDARD HISTORY-TAKING MNEMONICS"PAMHUGS FOSS"This standard mnemonic helps us in completing a clinical history after the chief complaint and related relevant history-taking steps have been taken care off.P-ast medical history A-llergy hx M-edication hxH-ospitalization hx U-rinary problems G-I problems S-leep probsF-amily hx O-b/gyn hx S-exual hx S-ocial hx - use 'SODA'"SODA"'SODA' is a mnemonic

2006-07-22T15:09:00.000-07:00

Travel Resources for the "New-to-USA" IMGI suppose a lot of IMGs who come to the USA to take the Step 2 CS are newcomers to the United States. This information might be useful for such IMGsAir Travel within the USA :The General rules are:a. The earlier you book (i.e. in advance), the better the deals you getb. The wierder the time you choose to fly (the non-rush hours), the better the deals you

2006-07-17T19:08:00.000-07:00

THE "DIX-HALLPIKE" MANUEVER / TEST ?Every now and then, on various USMLE forums you come across a message asking about the Dix-Hallpike Test or maneuver ! Since the blog is dedicated to be a beacon of light for everyone thinking of , planning to or taking the CS, here goes ;-) :This funny-sounding Test is a confirmatory diagnostic test for "Benign Paroxysmal Positional Vertigo", which accounts

2006-07-16T03:28:00.000-07:00

ASKING ABOUT SEXUAL HISTORYCheck out this logical pattern that I learned during a lecture I attended during my observership sessions - which means this should not only help you for the CS , but also when you get into a residency :-)Q 1. "Mr. John, Are you Sexually Active ?"Q 2. "How Many Partners are you active with ?"Q 3. "Are your partners male or female or both ?" [Unless the SP says wife or

2006-07-15T13:36:00.000-07:00

THE "GET UP AND GO" TESTThis test is to used as a measure of balance in elderly patients. I would rather that this test were called "Get up, go and Get back" Test ..you will see why.How is the Test Done ? Have the patient sit in a straight-backed chair and ask him/her to:1. Get up from a chair to standing position2. Walk forward feet in a straight line3. Turn back around & walk back to the

2006-06-18T12:04:00.000-07:00

STEP 2 CS EXAM TIMINGS / SCHEDULEAs most of you may already be aware - the Step 2 CS [Clinical skills] exam is conducted in two sessions : the Morning session that begins at 8:30 am and the Afternoon session that begins are 3:30 pmThe Morning session ends at about 3:30 to 3:45 pm , while the evening session will be done at around 10:30 pm - it's important to know that so that you can schedule

2006-02-25T11:42:00.000-08:00

The art of History Taking......or is it a science ? They say medicine is both an art and a science. Hell forget it - I like to keep it logical and simple so that it works for me when I need it. We can't really have mnemonics for everything on the USMLE clinical skills assessment, but we sure can have protocols...Step 1: SP tells you his/her chief complaints,Step 2 : O.D.P + Details ..yeah that's

2006-02-24T19:37:00.000-08:00

2006 & 2007 Step 2 CS Results Reporting Schedule...There are some questions that always seem to be unanswered like "When will ECFMG be very very efficient ?". But then I let it go after I read what Felix Frankfurter had to say - "I don't like a man to be too efficient. He's likely to be not human enough! " Afterall, ECFMG is made up of humans.They are getting better slowly :-) Starting 2006, a

2006-02-22T23:08:00.000-08:00

A Simple Protocol(SP) for your SP(Standardized Patient) EncounterDid you know that, on the USMLE Step 2 CS exam (formed called Clinical Skills Assessment), having a standard protocol saves times and prevents memory lapses ? Read on...This simple pattern can be used for almost all cases - except of course for telephone encounters and patients for lab results counselling...I used the following

2006-02-20T20:26:00.000-08:00

Snellen's Chart, Visual Acuity and Step 2 CS ?So should you perform the Snellen's chart reading on the CS ? Don't bother about it on the CS ... merely mention that as an Investigation on the Patient Note (PN). But yeah guys - do the Finger counting test instead.This is how : Ask the SP to look striaght ahead and then hold your fingers in front of the SP at approximately 3 feet from his/her eyes.

2006-02-10T17:29:00.000-08:00

TEST / EXAM CENTERS FOR STEP 2 CSIncluding this info since quite a few visitors land up on this site searching for test center information ![Related Links for IMGs/ AMGs: - Frustrated about how to decide which test center to choose ? Read This.- Where to stay for USMLE Step 2 CS ? Which Hotel To choose ? Click Here- To see the earliest Available Date at the above centers - Click Here for the

2006-01-27T19:16:00.000-08:00

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 Encounter2. CIS = Communication & Interpersonal Skills3. SEP = Spoken English ProficiencyTo pass the CS, you

2006-01-23T22:45:00.000-08:00

A FEW WORDS FROM THOSE WHO DID IT :-)If you find CSprotocol useful for your CS prep - its a personal request to all of you to come back after your exam and share your CS experience and tips at the CS-experience database at USMLEtoMD.com :-)1. Sukanya, MD: Center = HoustonThis is what she had to say immediately after she took her CS :"Did my CS in Houston a few days ago & although I didn't do so

2006-01-20T04:43:00.000-08:00

A MNEMONIC FOR HEADACHE CASEThe girl in this picture is Jennifer and she's got a headache [ she most probably is a medical student ;-)]Mom: "Jennifer - u holding your head..wuts wrong ? "Jennifer: Mm...It aches mom"MM...IT ACHES" - that phrase gives us our mnemonic for the differential diagnoses for a headache..M - MigraineM - MeningitisI - Increased Intracranial PressureT - Tension Headache +

2006-01-15T12:26:00.000-08:00

Step 2 CS RUMOR MILL: We churn out rumors here !In this post, I shall be including floating rumors about Step 2 CS we tend to believe in and don't seem to find a way to confirm it...unless one of you has a definite answer and would be kind enough to leave a comment on this post at the bottom !1. Step 2 CS will be scrapped for AMGs from the next year, while IMGs will continue to face SPs (

2006-01-10T23:58:00.000-08:00

HEEL PAIN...Heel Pains ? Foot Pains ? Same thing ? Well almost - at least for the sake of our Mnemonic for Heel Pain ;-)This mnemonic was generously contributed by Dr. Nikhil Gohokar, MD [ GMC - Nagpur, India]"FOOT PAINS"F - Fat Atrophy (age related) + Foreign BodyO - Osteomyelitis (not common)O - Osteoporosis (not common)T - Tarsal Tunnel Syndrome, Tendonitis (Achilles) + TumorP - Plantar

2006-01-10T21:09:00.000-08:00

Blood in Stools(Hematochezia)Not to confuse this with Melena, which implies black tarry stools (most commonly due to a bleed within the upper Gastrointestinal track making the blood turn black due to it's digestion to hematin).Hematochezia is frank blood that goes down the drain - i mean the Pot :-) I used the word Drain here for a reason : A Mnemonic !!DRAIN gives us the D/Ds for Hematochezia :D

2006-01-10T16:34:00.000-08:00

The Dreaded MMSE (Mini-Mental Status Exam)Breath in - Breath out - Breath in - Breath out and relax.......feeling the tension ease away ? :-) The MMSE is really not such a big deal as your mind and peers would make it sound like - provided you are prepared for it. Here's what you need:First things first- When to do an MMSE ? In cases of non-focal-deficit CNS Cases like memory Loss / dementia,

2006-01-08T14:45:00.000-08:00

Which Exam Center to choose for CS?This is another common doubt that crops up amongst most IMGs. Questions like "Do some centers have better passing rates for IMGs than others ?" " Will LA guys hate my accent ?" "I Have heard center 1 is more IMG-friendly than Center 2" .....Lets solve this now and for all ! - Any center is fine and equally IMG-Friendly ! No Bias there.The Human Mind gets biased

2006-01-05T21:31:00.000-08:00

Handling a Lab-Result Explanation Case ?This presents an amusing paradox - on most cases on the CS, we are worried about finishing on time, whereas the main concern on this one is how to expand all you can talk to fit those 15 minutes ! This somehow reminds me of my daytime sleep ;-) it seems to effortless expand and fill-up all the space it gets ;-)But tell you what, lets have a protocol to

2005-12-08T15:12:00.000-08:00

Damn ! Where did my Orange Permit go ?Ha ha - That reminds of how stressed I was with sweaty palms & forehead when I thought I had "Lost" my "Orange Permit" just 2 days before my exam - just like Ashton Kutcher felt in the 1999 classic comedy "Dude Where's My Car" !Though I mentioned this elsewhere, lets go over this again - you DO NOT GET an Orange Permit for the Step 2 CS - all you get is an

2005-11-11T13:11:00.000-08:00

COMMON BRAND NAMES OF DRUGS FOR STEP 2 CSWhat's in a name ? When it comes to drug industry a Brand name synonymus with a drug = Billions of Dollars ! Thanks to the strict patent laws in America, a single drug is associated with a single brand name - unlike some other countries where it isn't unusual to find 20-30 brands of acetaminophen as against the single "Tylenol" in the US. It's good to

2005-10-19T00:04:00.000-07:00

To Sit or to Stand during the encounter is the question...During a SP encounter, use your own judgement to decide this. This is simple - just think of the clinical setting before deciding on sitting - (wow, did that just rhyme) - would that patient be seen in an emergency setting ? (acute abdomen, chest pain) or in an outpatient clinic setting? (Pre-employement checks, chronic knee pain).You

2005-10-17T22:46:00.000-07:00

About washing Hands !!!!! he he Man!!! Haven't we all been washing hands all our life ? ...and suddenly for this one exam we get freaked out about washin' them right ;-)Follow this :1. For the SP to grade you on washin', you need to show the SP how you washing them, right ? ..which logically means you should not face your back to the patient while washing. The sink (or wash-basin as some might

2005-10-16T17:20:00.000-07:00

Doctor's / White Coats & Step 2 CS ...There was some Hollywood Movie, I don't recollect which, which had this funny miserly guy all dressed up in Suit and formals and all, arrives home daily and removes his suit - and what do you see ! Within that suit , the only components he actually wears is what was visible from outside ;-) The Collars and the upper half of the shirt, A Half Tie and Formal

2005-10-16T15:03:00.000-07:00

STEP 2 CS Attire / Dress Code / Clothes for the Males / GuysRoyal Blue, Sky Blue, White or a Grey shirt with an appropriate sober tie and formal pants are good. Though some people wear suits, I preferred not going ballistic over dressing and I kept mine simple, comfortable yet professional. After all, your dressing is only going to matter inside the SP's room, where you have a doctor's coat

2005-10-11T23:59:00.000-07:00

Will I die ? SPs are amazing actors - and they are trained to asked amazing questions ! Their idea is to stump you - but your goal is to stump them and leave them without any more questions ! The idea is 'never to commit anything' - and why is that skill important ? So that you dont give any false hopes to your patients in real life and get sued and screwed !Here are some common SP 'difficult

2005-10-11T15:52:00.000-07:00

Miss or Mrs. ?Another concern that has been doing the rounds on many IMG USMLE forums now and then is the issue of addressing a female SP! And brings us to an interesting light discussion here. It is amusing how a 'Miss' is hurt by calling her a 'Mrs.' while a 'Mrs.' is bugged when you push her to her teens by calling her a 'Miss' - Remember Freaky Friday ? ;-)- which although is not universal ,

2005-10-10T21:29:00.000-07:00

Counseling...Awrite ! All our lives, haven't we simply loved to give advice to anyone and whenever we get a chance (coz deep inside makes you feel kinda superior and good about yourself ;-) ) It ain't nothing different when it comes to 'counseling' your SP on the CS exam !Difference is - you got to be fast and to the point or concise. Because after you leave the room and the SP starts marking his

2005-10-09T12:13:00.000-07:00

Phone Encounter !Inside the Telephone Room: Wouldn't it be hilarious if someone actually knocks on the door for a phone case ? Ha ha..hmmm...Jokes apart - after you enter, wait till you are ready, then pick up the handset and press the Red Button/Yellow Button on the phone when you are ready ! However, please follow the instructions given to you before the test - they may change. One useful hint

2005-10-07T21:34:00.000-07:00

Darn ! Are you forgetting that Ophthalmoscope...Well bad news and good news ...Bad News - Yes you do need to use the Ophthalmoscope....Good News - Only required if the patient gives a history of Hypertension, Diabetes, Visual Complaints and any condition where you would expect increased Intra-cranial tension.Very Good News - You only need to 'pretend' that you are using it , but you got to

2005-10-07T17:01:00.000-07:00

Female Chest Examination ??Many exam takers have questions about modesty concerns while examining the chest of a female patient. Here are the facts you should know so that you don't get your SP angry and embarass yourself !1. It is perfectly OK to expose the Bra in a female SP - - BUT politely inform the patient before proceeding to untie the gown knot present behind her neck. So, you go : "I

2005-10-05T13:02:00.000-07:00

Drape them right dude !The pic shows how to 'Drape' the patient in a case of Abdominal Examination. Notice that the 'gown' (SP's Shirt) is pulled up to expose just the abdoment. For the rest of the cases, the SP will be sitting and we only have to take the drape and cover the legs while the SP is sitting...Under no circumstances will we ever need to expose the area below the waist - remember

2005-10-05T12:43:00.000-07:00

Measuring JVPAfter ur general examination...i.e. 'PICKLE'1. Recline the patient at 45 degress..2. "Before we look at the heart, I need to see if I can see anypulsations on your neck - could you please look to your left Mr. Smith ...Thank you"3. Shine a light on the neck so that light falls almost at 180 degrees on the surface - Of course u woudn't see any pulsations on the Step 2 CS test (No need

2005-10-04T16:12:00.000-07:00

What is the 'OASIS TRICK' for USMLE? Important: Starting August 2007, all USMLE score reporting will be electronic, making the OASIS trick obsolete and unnecessary. So read this only to amuse yourself ;-)This 'trick' refers to 'fooling' the ECFMG guys and finding out for yourself whether you passed your CSA or not before those slow pokes update the site - Black Magic ? WooooHoooo ...Important !!

2005-10-03T20:52:00.000-07:00

Get Step 2 CS Practice Partners/Buddies here...Why is a Practice Partner Important for CS ? Recently I watched an executive briefing video of a Professor lady presenting a talk at Stanford University on how an Organization Culture is important for the performance of a Company. She cited an interesting study done on how people's behaviors are affected by the presence of another individual: 90%

2005-09-30T11:39:00.000-07:00

2005 Step 2 CS Pass - Failure RatesData Extracted from 2005 USMLE performance reportStudents are scored on three sections for the CS exam: Integrated Clinical Encounter (ICE), Communication and Interpersonal Skills (CIS), and Spoken English Proficiency (SEP).This applies to candidates tested during the period from June 14, 2004 to June 30, 2005.Here are the Failure RatesAmerican + Canadian

2005-09-29T22:15:00.000-07:00

Apply Apply and no Reply ? Let us get slightly off-topic in response to many emails I received about a apparent paucity of interview calls this year for people who have applied for the 2006 residency match !First of all, it's true that this year the competition is bizarre with many IM programs receiving more than 1,600 applications for their 20-30 seats and this is understandably disturbing !!But

2005-09-26T23:50:00.000-07:00

The SP Challenge Quiz ! Evaluate answering skills !Doctor, is this a fracture ?I think it is a fractureNo Mrs. Boren, this is not a fractureIt is a possibility, but let us wait for the Xray reportI am not sureOooooh Doctor, Please give me a pain killer fast !I don't have one right now with me...Which one do you normally take ?My nurse will give you one soonIt

2005-09-24T12:52:00.000-07:00

Look for these 'Acting' Hints and Tips from the SPs These are soft signs that SPs might display. Showing that that u noticed it says oceans about your observation powers ! and courteous behaviour ! I looked for these the moment I entered the room and introduced myself.1. Yawning SP : Ask - "You look tired Mr. Smith, did you sleep well ?" This could unearth a duodenal ulcer that kept the patient

2005-09-20T11:48:00.000-07:00

Be patient about the 'Patient Note' (PN) Whew!! You are done with what you dreaded the most - the SP (Standardized Patient) encounter ! You come out of the room relaxed and ready to write the PN - but lets bear in mind that quiet a few people have been failing on the patient note. We need to get professional and have a protocol for that one too !First things first: To write or type the PN is the

2005-09-19T23:01:00.000-07:00

Sore Throat Case ? No Probs !!! Here's an excellent mnenomic submitted and published with permission from Dr. Birju D. Shah, M.B.B.S, Medical College, BarodaIt is a complete study in itself ! giving all pointers to data-collection and investigations too :-) Applause ...SORE THROAT WAS BAD !S- wallowing food is painful ?O- rigin, Duration, ProgressR- unny NoseE - ar Problems ?T- emp ? / Chills ?H-

2005-09-19T15:16:00.000-07:00

A Potent Mnemonic for Impotence LIMP P3ENISWhen things don't stand ... it's time to use this outstanding mnemonic for data-collection in a case of Erectile Dysfunction on the Step 2 CS ;-)L-ibido changesI-njuryM-edications (B-blockers)P-ast / Present medical history (HTN, DM, Vascular= e.g.: Leriche Syndrome)P-revious prostate SxP-erformance AnxietyP-eyronie's DiseaseE-rection at all? (Are you

2005-09-16T22:21:00.000-07:00

What's with 'SPORTS' & Knee Pain ? The Knee is a pretty common injury in Sports....So lets use the word 'SPORT' to our advantage on the Step2CS - a pretty good mnemonic for D/Ds for Knee Pain !!!!S - Septic arthritisP - Pseudo-gout + Patello-femoral pain syndrome + Psoriatic arthritisO - OsteoarthritisR - Rheumatoid arthritis, Reactive arthritis (Rieters syndrome)T - Tophi (Gout), Trauma (Fall,

2005-09-16T13:42:00.000-07:00

A Stupid Mnemonic for Amenorrhea !!!Well..calling it stupid coz the word really means nothing and it against my principles of having a mnemonic that is self-suggestive. This one really means nothing - Do you even wanna know what it is ? ..well..if you think it will help you on the CS -( coz it did help me ) so why not !!!!!P6 A5i.e. PPPPP AAAAAP- regnancyP - rolactinemia (Prolactinoma /

2005-09-13T01:02:00.000-07:00

STICKY SITUATION BPatient moving with extreme pain on the bed the moment you enter the room !1. Introduce Yourself with appropriate soberness2. Say "I am sorry that you are in so much pain - I shall go through some quick questions and physical examination - as soon as I am done, I shall promptly have my nurse give you something for your pain. I only ask you to bear with me for a few minutes - Is

2005-09-13T00:56:00.000-07:00

STICKY SITUATION A Patient refuses to answer questions about his/her sexual history?"Dear Mrs. Bush, I understand the sensitive nature of this question, but be assured that this will not go out of this room. The way clinical medicine works, there may be important clues hidden in this kind of information and I want to do my best to help you. So shall we try answering these questions again ?"If

2005-09-09T17:58:00.000-07:00

Is the depressed SP depressing you ?Don't be - coz you got help :-)First things first - get your data collection sorted out (Step 3 of History Taking) - and we a have a mnemonic for doing just that...This pic should help you remember this mnemonic :"FACE SLIPS"Yeah...when depressed and sad , did your face not slip into your hands ? Arrite..here we go :F - Feelings of : Guilt, anger and

2005-09-07T14:14:00.000-07:00

Shoulder examination ?Let us look at examination for a case of Shoulder Pain (People you gotta supplement this with your standard notes). Assuming that you have already washed, wiped and warmed your hands...1. Expose both the shoulders - and examine as if you are comparing both shoulders for swelling, deformity. Especially look out for painted bruises - cause those suggest elderly abuse (besides

2005-09-06T23:06:00.000-07:00

About the Exam Center... Here's a photo of how the exam center looks, when candidates are about to enter their respective rooms to see the Standardized patients - and my non-medico friend thought it was a picture of a Doctor's restroom or something ....made me think - it sure does ....Click here to Judge for YourselfLOL!Yes - they have lockers. So if you must carry your tons of jewelry,

2005-09-06T00:00:00.000-07:00

So your Step 2 CS Exam Day has arrived !!! Yeah ... after all your preparation, tips from various sources and other 'secrets' you gathered, finally the real truth is out there somewhere - - - In your exam center - - - somewhere between what you think you should know and what USMLE Step 2 CS exam really has in store for you... ...Not freaking you out , just helping myself dramatize this blog !!!

2005-09-05T22:00:00.000-07:00

Digitaldoc's Top-Health Pick !Down Syndrome Now Detectable In 1st Trimester !A first-trimester screening test can reliably identify fetuses likely to be born with Down syndrome. The newer regimen uses an ultrasound test called the nuchal translucency to measure the thickness of the skin on the back of a fetus's neck and a blood test to measure levels of pregnancy-associated plasma protein A (

2005-09-04T15:05:00.000-07:00

After CSprotocol ...It is time for PSprotocol Get your Personal Statement(PS) rolling...writing it is a pain , but there are ways to reduce that pain at :http://psprotocol.blogspot.comCheck out the Quick Self-Screen for your PS and other tips !Give your PS the edge it needs.

2005-09-04T12:12:00.000-07:00

Liked This ? Wont you tell your friends ?Well...it is a competitive world ! But if you are feeling extraordinarily kind and would like to share this information with your buddies - would appreciate if you spread the word about USMLEtoMD.com :-)Secondly, if you use Google's Orkut.com, you are welcome to join my Step 2 CS community by clicking Here.For those inclined towards the popular MySpace

2005-09-03T00:31:00.000-07:00

How Much would the USMLE Step2CS Cost you ? Exam Fees = $1,200.00 Hotel Stay = $80.00(approx.) Flight to Exam-Center =

2005-09-02T12:04:00.000-07:00

Failed & feeling blue ? No - I wouldn't say "It is OK, next time" and I wouldn't say "Don't worry" .Take the defeat to your stride, keep aside all wrong emotions that pin you down, think not of the world pointing fingers and do not drown yourself in self-pity.In the last 25 to 35 years of your life, we all have seen so many defeats and we were dejected each time...but life never stopped, did it

2005-08-26T21:26:00.000-07:00

Fun Stuff on the InternetDon't even ask me why I am writing this post - these are just random links and things that could perhaps serve as a temporary amusement detour while taking breaks from your monotonous studies....- Cannot access or download your favourite chat messenger program at a public computer lab or a library ? Then Meebo.com is just for you.- For those of you addicted to laptops and

2005-08-26T19:20:00.000-07:00

How to exchange Step 2 CS / CSA DatesOh yes - many of you might have to do this stealth operation and needs two to tango ;-)If two people wish to exchange CS dates - all they need to do is find a willing partner and pre-decide an unearthly time like 3:00 am. They then both proceed to reschedule dates simultaneously on OASIS. This releases their respective dates at the same time, which shows up

2005-08-22T19:00:00.000-07:00

Most Common Errors on the USMLE Step2CSAll IMGs - do take note of these and avoid them :-) Not washing hands before phy. examNot calling SP by nameNot looking for Carotid Bruit and JVP (cardiac SP)Not mentioning D/Ds in the descending order of probablity on PNNot using ophthalmoscope in HT, DM or visual complaintsNot asking about Hematuria in a case of Hemoptysis (& vice-versa)Not asking SP for

2005-08-20T17:17:00.000-07:00

Gloves and the USMLE Step 2 CS (CSA)I have been avoiding writing anything about gloves for a while - coz the topic always seems to be debatable - at the same time I don't wanna risk sounding diplomatic. So let me just tell u how I handled it and suggest a few more points.1. I did not use Gloves at all. The pro-gloves student society might say a big "U Nuts ? How about Oral exam". Well, I simply

2005-08-19T17:19:00.000-07:00

Yo Listen up yall ! This is 'bout Auscultation...Many of us always have doubts about how far should we go about auscultation on the Step 2 CS - especially if the case is not about Cardiac conditions or Respiratory condition. Do we auscultate in other cases at all ? Let's keep a simple rule:Ausculate the usual complete details in a CVS and RS case - in ALL OTHER cases, with the SP in a sitting

2005-08-18T17:24:00.000-07:00

WHEN SHOULD YOU TAKE THE USMLE STEP 2 CS ?As some jokingly say - Yesterday ! Thats because our ECFMG guys are sooo slow about giving out the results that sometimes they may not even come out on time for the Residency Match you are planning to participate in ...and then - you lose a year :-( So ..beat the system - get going fast and finish up your Step 2 CS fast 1. Yes you can give Step 2 CS

2005-08-17T21:51:00.000-07:00

Were you planning to measure BP?Don't need to - Yeah ! you heard me - you don't need to measure it on the Step 2 CS - All measurements provided on the door are to be assumed to be officially recent and accurate.This is what the instructions on the ECFMG site manual for Step 2 CS says:"The examinee instruction sheet gives you specific instructions and indicates the patient's name, age, gender, and

2005-08-16T21:58:00.000-07:00

Communication Skills ? English Problem ? Accent Question ? Here goes a quick primer:Communication skills are important on the Step 2 CS exam - coz you are graded on them ( CIS Component of CS Grade) !! And please note that communication skills do not imply ONLY English and/or your accent ! Let us logically analyze and work on the components that communication skills consist of - ( from the Step 2