Step 2 CS – What to do if you fail Step 2 CS

By Law2Doc, SDN member:

Best thing to do is see what part of CS gave you the trouble, read through FA (again?) – cover to cover — it’s pretty helpful, and read through the threads on SDN talking about the things you need to do to pass. Stay away from mnemonics and formulaic approaches and try to treat the thing like a real patient encounter. Make sure you do all the niceities — shake hands, handwashing, eye-contact, draping, using the patient’s name, asking before untying things, explaining what you are doing, don’t repeat painful maneuvers, etc — IMHO this is a huge component of the grading on this test. Try to have a nice conversation with the patient, an exam targeted to the area of trouble, some sort of wrap up where you explain your thoughts and where you want to go next with the patient, and if the person is a smoker/drinker/drug abuser counsel them on safe practices. Also don’t forget to ask about the possibility of pregnancy/STDs/contraception in any female with abdominal symptoms below the age of 40. But most of all simply treat it as a real clinic visit. The SPs seem to respond best if they feel like you are actually treating them like they are the real deal

By Law2Doc of SDN:

Over-reliance on mnemonics is actually a common reason people fail IMHO. You really have to treat it as a normal patient encounter, not a test of substantive material. Get away from looking at this as something you need to memorize things for, and look at it as being a clinician. Ask lots of questions — especially the where does it hurt, describe the pain, when did it start, does it radiate, anything make it better or worse variety. Do the niceties like eye contact, handwashing and draping and not repeating painful maneuvers, use the patient’s name and show some empathy when appropriate. Tell smokers to stop smoking, tell drinkers to stop drinking. Ask before you untie anything and talk your way through the exam so the SP knows what you are doing. Do a little counseling — tell them what you think is wrong and what tests you need to get to confirm. And then write up a soap note with a few ddx and tests. Really the exact same thing you should be doing in any family med, community med or ED rotation. If you overthink this thing and try to memorize mnemonics you are going to come off wooden. This should flow like a regular conversation/patient encounter, not come off stiff like you are playing “check the box”.

source: Student Doctor Network

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source:

http://forums.studentdoctor.net/showthread.php?t=623978keywords

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