When it comes to the USMLE Step 2 CS, time and points are the two most important factors. To get the highest score possible on this timed exam, you need to know what’s expected and what not to do. We have tips for working with standardized patients (SPs), so you nail your exam.

This US medical licensing exam tests medical students and graduates on the ability to perform standardized patient care. It’s a pass or fail exam. However, you must get through all 12 patient encounters within an 8-hour time frame. So, you don’t have time to lose if you want enough points to pass.

USMLE Step 2 CS: Learn How to Provide Awesome SP Care & Nail Your Exam

USMLE Step 2 CS: Learn How to Provide Awesome SP Care & Nail Your Exam. Photo by Sharon McCutcheon on Unsplash

What to Expect During the USMLE Step 2 CS to Nail Your Exam

During the CS exam, you’re tested on two different types of patient encounters:

  1. Telephone Encounters
  2. Standardized Patient Encounters

Making mistakes during the exam costs you both time and points. So, use these tips to make sure you know what not to do during your telephone and SP encounters at test time.

The USMLE Step 2 CS is not a multiple-choice test. It’s a real-world exam where you demonstrate your clinical skills during mock patient encounters. There are three major sections:

  1. On-Site Orientation – Unjudged portion where you get familiar with the facility and what’s expected of you
  2. Patient Encounters – You only have 15 minutes to complete each one of the 12 patient encounters
  3. Patient Notes – After each encounter, you must use a computer to enter a patient note within 10 minutes (more if you finish the encounter early)

Once again, time is important during the USMLE Step 2 CS exam. You need enough points to pass, which means you must be prepared. The examiners score you in three separate categories:

  1. Communication and Interpersonal Skills (CIS)
  2. Spoken English Proficiency (SEP)
  3. Integrated Clinical Encounter (ICE)

During both the telephone and the SP encounter portions of the CS, you’re being judged on your ability to provide quality patient care in clinical settings. These are the three areas that count during Step 2 CS standardized patient care:

  • Ability to gather information from patients
  • Capable of performing physical exams
  • Skilled at communicating findings to colleagues and patients

What NOT to Do During USMLE Step 2 CS Telephone Encounters with Patients

You will encounter 12 standardized patients during the telephone portion of Step 2 CS. Most of them are scored, while others aren’t. There’s no point in trying to figure out which ones count toward your overall score. So, don’t waste time trying if you want to nail your exam.

Instead, treat every single telephone encounter like your future as a doctor depends on it. Here are some things to avoid during while dealing with standardized patients during the telephone portion of this US medical licensing exam:

  • Do not play with the buttons on the phone
  • Use the yellow speaker button to make or end calls
  • Do not press any other button or the call may disconnect during the exam
  • Once a call ends, avoid call the patient back
  • Do not allow past experiences and encounters to cause you to make assumptions

Keep in mind that once a call ends, the encounter ends as well. So, if you didn’t get all the information you needed or have more questions, do NOT call the patient back. You must make your diagnosis and treatment based on what you already have.

Patients do NOT like arrogant doctors.

Patients do NOT like arrogant doctors. Photo by Sharon McCutcheon on Unsplash

What NOT to Do During USMLE Step 2 CS Standardized Patient Encounters

Remember, time is not on your side during the Step 2 CS exam. That means you need to utilize yours wisely to get the points you need to pass this extremely important test. These are some things to avoid during your standardized patient encounters while taking Step 2 CS if you want to nail your exam:

  • Do NOT perform prohibited tests on SPs – Some tests are prohibited, including but not limited to an inguinal hernia, pelvic, corneal reflect, rectal and female breast exams. Do NOT perform them. If they are part of your diagnosis, recommend the tests in the Patient Note.
  • Avoid wasting time on unnecessary consents from SPs – There are certain physical tests that you’re allowed to perform with the assumption that you have the consent of the patient. Don’t waste time asking permission to perform every little test… because wasting time costs you points.
  • Do NOT handle standardized patients forcefully – Compassion and empathy are important parts of being a good doctor. Avoid being forceful while conducting physical exams on the liver, gall bladder, abdomen, etc… You will lose points for applying more pressure than necessary.
  • Avoid making standardized patients feel uncomfortable – During the Step 2 CS exam, it’s important that your patients feel comfortable with you. Standardized patient care should be provided with the same quality you plan to use to treat your real patients in the future. Treat them with professionalism and be sensitive with modest patients.

3 Tips to Help You Effectively Handle SPs During the Step 2 CS Exam

Use these three essential tips to help you nail your exam by providing quality care during standardized patient encounters:

  1. Greet Patients with a Smile – Standardized patients can be just as nervous and uncomfortable as real patients. It’s your job as a future doctor to make them feel comfortable during conversations and physical exams. Greet your patients with a smile. And treat them with kindness.
  2. Remain Calm – Remember, you plan to become a physician someday. That means you’ll be expected to stay calm for the sake of patient care. Practice this same idea on test day. Don’t get so nervous that you forget to ask your SPs very important questions. Remember, you can’t call them back. So, stay calm and get what you need to come up with the correct diagnosis and recommended treatment.
  3. Concentrate on Counseling the Patients – More points are given to counseling your patients than interviewing them and performing physical exams. So, spend more time counseling each patient. And be sure to give yourself enough time to provide valuable patient notes, which also carry a lot of weight.

Important Tips for International Medical Students, Graduates and Doctors Who Want to Practice in the US

If you want to practice medicine professionally in the United States, you must pass all of the USMLEs. This rule also applies to foreign medical students and graduates, as well as physicians licensed to practice in other countries.

As an international medical graduate (IMG) or foreign med student, you must complete a residency program in the US. But to do this, you must get certified through the ECFMG (Education Commission for Foreign Medical Graduates).

However, your certification can’t be verified until you pass all USMLE Step 1, USMLE Step 2 CK and USMLE Step 2 CS.

The problem many students, graduates and physicians have when taking the Step 2 CS is their inability to pronounce English words correctly. This exam assesses your ability to communicate effectively using the English language.

That means you can’t pass this exam if your English skills are poor. Patients and colleagues must understand you. Therefore, you must know how to pronounce your words properly.

Nail Your Exam: Atlanta USMLE Step 2 CS Test Prep

Understanding the art of patient care alone won’t get you a passing score on the USMLE Step 2 CS. You need to develop skills that help you overcome anxiety and use your time wisely.

MedSmarter offers comprehensive Step 2 CS prep courses and mock exams in the Atlanta, Georgia area. Our campus is located right in the heart of Suwanee. We offer the following CS test prep services:

Learn how to remain calm during patient encounters in an exam-like setting. Our instructors are licensed physicians. Each one holds an MD and/or Ph.D. So, they know how to perform professional patient care with the quality needed to pass the USMLE Step 2 CS.

Improve your English-speaking proficiency and your clinical skills with MedSmarter’s CS courses, tutoring and mock exams. Click the link below for more details on Atlanta USMLE Step 2 CS Prep Services.

Atlanta USMLE Step 2 CS Prep