STEP 2 CS : An IMG Experience – by Dr. Sara Khan

Bismillahi Ar-Rahman Ar-Raheem (In the name of Allah, The Most Merciful)

Name: Dr. Sara Khan

Exam: Step 2 CS, Morning Session, Chicago.

Exam Date: 13th October, 2017

Result: Passed on 13th Dec, 2017.

Prep Time: 1.5 months to be exact.

Steps taken before: None.

Resources used:

  • First Aid CS
  • Study Partners (both Live & Skype)
  • Sherazi notes (very well written) and Neeraj Notes – both are in the CS forum files section.
  • Blue sheet mnemonics – Also in CS forum files section.
  • CSE and UWorld videos for examination
  • A youtube video (https://www.youtube.com/watch?v=du7iyMtjvEM)

About me:

I’m an average IMG from India, who came to USA in July 2017 for settling down in this country with absolutely no exposure to hospitals here,  I was preparing for Step 1, wasn’t getting good score so decided to take a bold move and give Step 2 CS as my first step. I had scheduled my exam about 6 months ago, so I got the exam date and place I wanted. I took my exam on the last day when my eligibility period was expiring, this means I couldn’t even delay if I felt unprepared. I was obviously very terrified as this was going to be the first exam I had ever taken in USA.

No observerships, No clinical exposure here, No previous steps, No courses or mock exams- This is why I say I’m not the best person for guidance and I made a very bold move to give Step 2 CS right away!

Exam prep:

Phase 1: I started preparing for CS in August, I was trying to get familiar with the exam pattern and First Aid for one month and watching videos on youtube. Then I found a Live study partner, was practicing with him (as his exam was very near like 2 weeks away, I got to learn a lot form him as he was already exam ready — best way to learn is get advanced study partner).

Phase 2: I was practicing cases on a moderate pace, this is when I read Neeraj Notes and decided to stick to them along with FA, watched UW and CSE videos to get the hang of physical examinations. Here my partner had already taken his exam and said IT WAS NERVE WRACKING!! I thought to myself if he being a Caribbean graduate says this, I stand no chance coming from India just 2 months ago! (I couldn’t even postpone my exam as my eligibility was expiring the next day of my scheduled exam)

Phase 3: Last 2 weeks, I started putting in more effort, found another Live SP and 3 Skype SPs (I highly recommend practicing with different people as it breaks the person anxiety).. This Live SP of mine was very advanced as well, he helped me with physical examination and introduced me to SHERAZI notes which helped me very much. I kept practicing with him all the cases I could, practiced my patient note typing, I liked the the FA style so I stuck to it.

Day before: I practiced only 1-2 cases, couldn’t study anything was very apprehensive.

Couldn’t sleep properly, kept waking every hour!

Exam day:

Got off the bed 3 hours before time, revised Sherazi Notes one last time and went through FA differentials section quickly.

At the Exam centre, I saw ALL AMGS, except 2-3 IMGS from Caribbean colleges, everyone around me was very casual and joking pranking etc, because they were all from same class!!! This freaked me out and started giving me headache, so I popped in the Tylenol I took with me. I also took a lot of food items and coffee because I couldn’t do breakfast in stress (don’t do this please, you need energy to give this 8 hour long exam plus they do give food)

Exam Experience:

We were given our number and divided into 2 batches, all lined up, soon we were standing at the door of my first case, my heart was pounding, I couldn’t believe I was giving this exam! Announcement was made and my time started, I was scribbling my mnemonics on my sheet and I see around everyone was already in the room and I was only one standing out! (this will happen, please don’t freak out at this, AMGs are trained very well so they are quick and dont need any memory aids) I took my full minute outside the door writing my memory aids, took a deep breath and knocked… this is how my exam began, trust me the time was flying and i didn’t even realize when I came down to half cases done!

During the breaks I drank coffee and Vitamin water I took with me, along with snickers & granola bars to keep me energetic. They do provide meal but I was too anxious couldn’t even eat.

I had to use bathroom every break because of the coffee/water I was drinking too much fluids. when I in the bathroom, in the mirror I took a minute to see myself if I’m looking professional and said to myself, I came this far, I can do this! this boosted me for upcoming cases. My performance got better after first 2-3 cases because that’s when you actually get accustomed to the stress and anxiety and start performing optimally.

There were 2-3 cases where I actually messed up but they were not drastic mistakes except for in 1 case which I had no clue about, the patients were really nice, didn’t give me a tough time but you have to ask them right questions to extract history from them.. they will not tell you anything if you don’t ask!!!

I made sure I followed all protocols to the best of my knowledge, knocking, calling them by their last name, introducing myself, shaking hands, smiling, saying sorry when needed, asking permission before touching them, helping them sit up or lie down, wearing gloves etc, coz I knew these were the things which will fetch my marks, so I was very conscious about that!!

After Exam:

I felt I completely messed up and will fail it, other examinees felt the same, so its normal! Exam is designed in that way to make you feel you’re doomed LOL! Don’t lose hope, give your best shot and keep praying when waiting for results.

IMPORTANT TIPS:

  • Time yourself – train yourself to complete the cases 2-3 minutes before so that on Exam day you be able to manage in-spite of the anxiety.
  • Take Tylenol on exam day – you will get headache because of stress and tension
  • Take some snacks/drinks with you.
  • Dress professionally and neat – All formals.
  • Don’t wear any jewelry coz you have to remove them
  • I preferred standing in all cases (except one where I had to do the discussion and patient was sitting)
  • Do focussed exam only, you cant do a lot in such short time.
  • ALWAYS ask if there’s anything they’d like to tell you, 90% they will tell you what you missed.
  • Practice Patient note typing 1-2 weeks before.

P.S I wore good neat makeup on my exam day to feel confident, this is was suggested by my dear friend Moe Man, it actually helped boosting my confidence on D-Day! 😉

Why am I writing this?

I’m writing this hoping this will help someone as someone’s experience once helped me!

I know there are not many people writing CS experiences, not enough guidance, they say CS is easy, I say its easy for AMGs not IMGs, maybe at least wasn’t easy for me!!

Give your exam when you feel you’re ready, when you know you want to go for it, don’t listen to anyone who says you can’t or you should… You know what is best for you!!

Good luck in whatever you do!! Keep me in prayers.

Regards,

Dr. Sara Khan.

If this experience helped you, check out the following:

USMLE Step 2 CS (Clinical Skills) – An IMG Perspective

Steps to Success – Step 2 CS Review by Dr. Mina Fransawy Alkomos

Step 2 CS in 28 Days – Experience by USMLE Lyfe

December 26, 2017
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