Test Date and Location: November 1st, 2017 in Philadelphia.

 

Steps Taken Before: Step 2 CK in August. Shall take Step 1 next.

 

Educational Status

IMG. Fresh graduate (finished medical school in my country in September 2017).

 

 

About Me

Average (to maybe slightly above average) medical student. Grew up (somewhat) bilingual with English and German. I like to go to the gym and I like dogs.

 

Preparation Time

2 weeks. Never more than 3 hours a day. However, I did prepare 3 weeks for approximately 8 hours a day for my final OSCE with my friends from medical school between August 16th and September 5th, 2017 (also with FA).

 

Materials Used

📚  UWorld Step 2 CS (barely used it though),  

📚  First Aid Step 2 CS (5th Edition),  

📚  Blue Sheet.  

I DID NOT do any of those ridiculously expensive prep courses.

 

Preparation Timeline

As mentioned above, I used to study already for my country’s final OSCE for approximately 3 weeks with FA, Step 2 CS checklists and some books in German (my medical school friends being the SPs) so I was somewhat in the OSCE mood, though my country’s OSCE is quite different than Step 2 CS (e.g. no patient note etc.). I was super exhausted and tired after studying 6 months straight for my finals so I was not really in the studying mood anymore, to be honest. I did master the courage though to somewhat study and prepare on and off for 2 weeks, but never more than 3 hours a day. I studied with my dad (also a doctor) as an SP and went through all the cases once.

 

HINT: Read the mini-cases in FA, they are very VERY helpful. Actually, just read the book from cover to cover, it’s worth it.

 

The Day Before

I flew in the night before (was vacationing in the States) to Philadelphia and booked a room in an Airbnb close to the test center. HINT: the area around the test center is somewhat sketchy and I am actually 95% sure I dodged getting robbed at gunpoint because just when the guy came towards me, a police patrol drove by. Hence don’t walk there at night or when it’s dark. The Airbnb was good and very clean.

 

What to Bring

Stethoscope, a coat which can be closed in the front, scheduling permit, passport/ID/driver’s license/whatever. Guys should wear slacks, a shirt and a tie (important!), gals should wear a nice dress and keep those nails short (I reckon).

 

Image - Quote

 

Test Day

Due to the whole almost getting robbed thing and me being super nervous I did not sleep AT ALL at night, so when I got up in the morning (approximately two hours before the test started) to go to the test center, I was super tired and exhausted. Had a bagel and a coffee for breakfast (there are coffee places close to the test center). The test center is OK I guess. I obviously cannot say anything about the cases. However, I felt rushed all day long and wished I had more time. Lunch was served but it was shit. DID NOT have a good feeling at all after the test and I was pretty sure I had a completely wrong diagnosis in 2-3 cases. I was 99% sure I failed.

 

Strategy

LIQORAAA and PAM HITS FOSS on any patient. Introduce yourself and ask for the patient’s name. WASH YOUR FUCKING HANDS. DRAPE THE PATIENT. Always extend the leg rest! Always ask for PERMISSION before you touch/examine the patient. Be compassionate and empathetic. Treat the patient nicely. Keep calm!

 

Patient Note

Oh boy. I wish I had trained for that. Keep in mind that you have to be able to type FAST. Like, really REALLY fast. Try to develop a system and stick to it. Familiarize yourself with the abbreviations!  

 

Example for the Heart: RRR; normal S1/S2; no murmurs, rubs or gallops. Try to use all those US abbreviations (c/o for complaining of, LMP for last menstrual period etc.). This is key!!!

 

After the Test

I got ridiculously drunk  😜.

 

Test Result

Got my result on December 13th… PASS. Average/borderline in ICE, above average in both CIS and SEP.

 

Tips and Tricks

I passed Step 2 CS with VERY LITTLE preparation and despite being a bad test taker, especially concerning OSCEs. In my humble opinion, the purpose of OSCEs is not primarily to check your medical knowledge but to check HOW WELL YOU TICK OFF A CHECKLIST (which is the reason I do not like these tests and think OSCEs are stupid anyhow). The primary purpose is to see how well you can take a history and do a physical examination, and, to a certain extent, check how fast you can type a patient note (stupid I know). I do believe I had a slight advantage due to me taking USMLE Step 2 CK beforehand (because I could deduce quite some differentials). So, let me list a few high-yield hints:

 

💡  Can’t speak English all that well? Watch US series (Netflix is your friend) and practice your speaking.

💡  PRACTICE WITH AN SP (preferably a medical student/physician).

💡  FA FA FA!!!

💡  Read all the MINI-CASES in FA!

💡  Practice writing the PN in timed mode! This is key!

💡  Learn the commonly used abbreviations on the PN and memorize a system for each organ system.

💡  Try to get a good night’s sleep beforehand.

💡  WASH YOUR FUCKING HANDS 🖐, DRAPE THE PATIENT. Always ask for permission.

💡  LIQORAAA and PAM HITS FOSS on every patient. Mnemonics are your friend.

💡  Be kind and empathetic to the patient. Don’t be a robot  🤖.

💡  I DO NOT think it makes sense to prepare for this exam for more than 4 weeks MAX. Anything more is overkill, at least IMHO.

💡  KEEP CALM AND CARRY ON. I completely blacked out on my first patient because I was so nervous. Keep it together and relax, you’ll be fine.

💡  Book your exam early. Slots fill very fast.

💡  I don’t think it makes any difference where you take the test. All those rumors about Philly being super hard for IMGs are BS. So are the rumors about Step 2 CS having become ridiculously difficult to pass recently.

💡  Always summarize and close at the end of your encounter.

💡  Don’t overdo your PE. Remember, after all, you only got 15 minutes for the entire encounter.

💡  Manage your time! This is crucial  ⏱ !

 

If you Think you Failed

You probably didn’t. I never felt as terrible after a test as after this one but I did well and passed. Hence don’t worry, you’ll be fine.

 

If you Actually Failed

Chill. This DOES NOT mean that you are a bad doctor. As I said, I don’t think it’s a great testing format anyhow. So, get your shit together, sit down with an SP, practice the cases in FA, practice typing the PN, learn your mnemonics, maybe revise some common differentials and sit the test again. You’ll pass.

 

Summary

USMLE Step 2 CS is an annoying test, however, it is very well doable, even for below-average medical students/graduates, with a reasonably short prep time. Keep in mind what I said about the purpose of OSCEs. Remember your mnemonics. Practice typing your PN. FA. MINI-CASES. Be nice to the patients. Keep calm. You’ll be fine  🙂 .

 

 

✨  Note

The author wished to keep her/his name from publishing.

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Image editing by Arnab Mukherjee.

 

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