Ahmad Hassan – USMLE Step 2 CS Experience

 

Step 2 CS Experience
Center :Chicago
Total prep time :30 days (8 hours daily atleast)
RESULT :PASS ALHAMDULILLAH

(WILL BE ADDING TO IT AS I REMEMBER MORE ABOUT THIS SO KEEP FOLLOWING THIS)
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Methodology:
5 days : Sherazi , going over them , trying to memorise mnemonics
5 days : Sherazi case practice (typed 2 notes/day just to get hold of it)
1 day : Examinations
1 1/2 hour:read all closures from FA
1-2 days : Just went over tables
All other days : Practice 8-10 cases each day being SP in half and doctor in half + read and try and practice answering the challenging questions from FA by discussing with my study partner and reaching a consensus how to answer it correctly (Typed patient notes throughout 4 minimum and 10 max)
took out 2-3 FULL days for sight-seeing ?

2 days before exam : simulated exam by practicing 12 cases being SP in 2 , doctor in 6 and observing the rest 4 of my study partner and typing patient notes of all 12
Day before:Went over all mnemonics from Sherazi ,Practiced 1 paeds case and 2 adult cases
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Resources used
FA
Sherazi notes
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Some important tips

PATIENT NOTES
1)Try and write patient notes as early as possible and get used to writing it so much that you don’t have to think and organize things in your mind once u start writing it
2)Try and time your cases from day 1 (use NYCS timer app in your mobile) or type it online in timed mode
3)Make a reflex of your examinations and they should be so fluent that you dont have to stop and think what to do next
4)Get your patient notes checked from someone who has already taken/passed the exam
5)Use only those abbreveations that are recommended
6)try and curtail the spelling mistakes
7)i would recommend to write normally and not in ALL CAPS
8)use your blue sheet well to write patient notes (most of the denials can be obtained from ROS so you dont need to worry about denials)
9)your note DEPENDS ON HOW WELL YOU HAVE MANAGED YOUR BLUE SHEET
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Preparation tips:
1)Learn to make your blue sheet (see below)
2)Manage time from the very beggining (first 2-3 cases might be impossible for you to finish in time so dont sweat just keep practicing)
3)Make your own reflex for everything and don’t blindly follow anyone
4)Observe people around you and try and find out with your own common sense what you are lacking if you compare it with them and try and add GOOD things to your case
5)Set aside 1 hour each day only to talk in ENGLISH .
6)Be a SP to different people and perform a case with different people ( 1 each everyday) , this will push you out of your comfort zone with your study partner and will help you gain confidence
7)DONOT LISTEN TO ANYONE WHO IS DISCOURAGING YOU , KEEP YOUR FRIENDS CLOSE and BE A SOURCE OF INSPIRATION TO EVERYONE AROUND YOU !
8)Try and help as many people you can during your prep time , it helps with your communication skills , confidence and builds up your reflexes for the EXAM!
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BLUE SHEET :
DIVIDE your blue sheet into 4 parts

1st part : OFDPLIQRAA/OFDPAAA + Sherazi’s mnemonic
2nd part : Review of systems (THEN-FRCS-PUB-SAWED)
3rd part : PAM-HITS-FOSS and in second S i-e social remember WHARTED (Work,home,alcohol,recreational drugs,tobacco,excercise,diet)
4th Part: PMDC(Screening) + your space for writing your diagnosis and PE findings

Only place a tick or circle what you find positive , no need to cross anything , think of things that are not marked on your blue sheet at the end of the case as NEGATIVE
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CASE PRACTICE TIPS:
1)Your opening & closure should be perfect
2)Make a reflex of how you will greet , enter and communicate with the SP and stick to it
Same goes for closure
practice this day & night until you feel comfortable and you dont have to think about it be it in front of a mirror , while you are walking home from library or just repeating it inside your head
3)Get done with counseling when you ask about social history , DONOT leave it for the end
4)In closure DONOT use technical lingo/Medical jargon else the next question can be ”what is ______ ? ”and most of your time will be used up in trying to explain that
5)Points that you need to cover in closure
-Diagnosis
-Labs and tests
-Short term treatment
-Long term treatment
-Counseling (no need to do it here if u have covered it earlier )
6)NEVER give a pinpoint diagnosis to a patient and tell him that you need to get the results of the tests you are going to run to comment about it

(here is The Sample closure)
For example if your diagnosis is GERD and you are suspecting Pericarditis too then your closure will be like this

Mr ___ , after your complete history and brief physical examination there are number of possibilities that might be the cause of your chest pain but right now i am not sure.It might be due to the stomach acid coming up to your food pipe or it might be due to the inflammation of linings around the heart.I will have to run some blood work followed by some imaging studies and graphical representation of the electrical activity of your heart (ecg) to be sure of it and once the results are in i will be in a better position to comment about it.Right now i will ask my staff to give you some medications for immediate relief of your distress and once the results are in we will plan your treatment further.
Are there any questions for me?
Have i adressed all your concerns ?

7)Give most of the things positive while you are an SP and ask your SP to do the same , this helps you increase your typing speed while writing patient notes
8)Here is the estimated time within which you need to end the examinations
HEENT:40 seconds
CVS and Respo : 2 minutes
Nervous system : 2:30 – 3:00 minutes
Joint exam : 1 minute
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RED FLAGS oF STEP 2 CS (as far as i can recall)
1-announcing the name of the SP outside his/her room
2-not sanitizing hands after you have touched SP’s feet
3-performing other examinations after touching SP’s feet without sanitizing hands
4-speaking whilst you are at the back of the patient
5-Not being clear with what you said (such that SP asks you to repeat what you have just said THRICE)
6-Not respecting the privacy of SP (such that ordering him/her to expose if he i/she is not comfortable with it)

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THE MOST IMPORTANT TIP
WHAT GOT ME THROUGH THIS IS PRAYING 5 TIMES A DAY , SUPPORT OF MY FRIENDS :’) AND MY FAMILY & BELIEF THAT I HAVE PREPARED WELL FOR IT AND RESULTS DONOT DEFINE WHAT I HAVE LEARNT IN THIS MONTH OR SO ,so prepare well and dont over think, keep things simple and ALLAH SUBHAN A TAALA will help u through it IA
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JazzakAllah ul Khair
Remember in Prayers

PS:I am sorry it wont be possible for me to cater individual questions ? but i will try and answer them if possible

ALL THE BEST

October 12, 2019
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