Mr. Lesch – USMLE Step 2 CS Experience

Took my exam on 24th of July, Houston and I got my result on 10th. Yay! I passed.

– Everyone makes mistakes in their exam. Normal to walk out of exam scared and having nightmares for a week or two about the mistakes you made.
Remember, this exam is very forgiving.

– Recommended protocol for the encounter –
1. Knock – thrice
2. Introduction – your Dr. second name and patient’s full name
3. handshake – firm
4. smile and make eye contact
5. permission/consent – to sit, make notes, examine. Put your feet on the ground as you sit. Do not sit for emergency cases.
6. empathy – offer water, comfort, soothing words etc
7. Confidentiality – assurance to the patient
8. History – present, past, surgical, menstrual, social, sexual, occupation
9. Summarize – Make sure to ask “anything else to add”?
10. washing hands – make sure hands are fully dry. Make conversation about job, weekend as you wash.
11. physical exam – consent, disrobing only the needed area, explain procedure, start with normal side and very gentle examination (remember 12 more students are repeating the same) apologize for the pain caused(no need of deep palpation of abdomen, no need of hard hit with knee hammer). Once you hear “ouch”, don’t repeat the same.
12. counselling – offer 2 possible diagnosis. Use growth/mass instead of cancer/tumor. Simple
remedies like rest, applying ice, Keigel excercise, tips to avoid smoking alcohol etc could be recommended. Never forget to ask “Do you have any more questions?”
13. Thanking the patient with handshake, offering your contact details, meet you soon with the results
14. PN (history, ROS, Allergy, PMH, PSH, SH, SHx, 2-3 DDx, lab tests).

You may not be perfect or right, but make sure you dont miss out any of the 14 components mentioned. You will be in a much better position to pass despite major mistakes.


October 12, 2019
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