How I prepped for the Step 2 CS
Hey guys. So I’ve been getting a lot of questions regarding the CS lately so I thought I would just
write it all down in one place. In this guide I talk about the specifics that go into the test. As far as
the breakup of the exam and all the exam details, read their official guide. For this exam, I studied
with my friend and I would definitely advise that the exam is A LOT easier to get through if you
have a study partner. Schedule your exam at least 4 months in advance, as dates gets booked out
pretty fast.
Prep time: 4-8 weeks.
Book: First Aid for the Step 2 CS
1st read - Distribute the cases between you and your partner, one person does odd cases, other
does even. For the fi rst read we read every case out loud. One person would play the doctor and
the other the SP and we would read the cases out loud directly from the book. We would then read
the notes, D/D and explanations in full. Then proceed to reading the associated mini-cases and
then move on to the next case. Start with about 2 cases/day and work your way up-to doing 4/day
cases.
2nd read - In this read we had switched the cases so the the person who did the odd cases in the
last read would now do the even cases and vice versa. Plan to do at least 4 cases/day but you
should be up to 6/day now. We would read the cases the night before (you can choose to read the
explanations but I realised it would skew my own differentials when we practiced so I would only
read the Q/A section) and also read the associated mini-cases on your own. In this read, the doctor
doesn’t refer to the book, you just read the case information on the first page, walk in and ask your
questions. The SP marks the questions that you’ve missed on the book and you discuss it in the
end. Try and simulate this read as realistically as possible (go all out on acting and stay in
character). Use this read to practice how you would examine the patient as well, as you need to
take history, counsel and examine all in 15 minutes. Practice typing the note for at least 1 case that
day. If it's a good day, do 2.
3rd read - This is optional. If you are a paranoid study-er like I am then go ahead, but 2 reads is
more than enough. Alternate and do the book again OR just do select few cases every day. This is
the time to do mini-cases properly again and practice your exam skills and note typing. At this point
you will be pretty good with the Q/A and counselling so focus on the other stuff.
Managing time: is very important!
Aim to finish your case in 13 minutes. Any time that is leftover gets added to your note typing time.
Know that taking a history is the most important. Counselling after that. Followed by examination.
So if you’re ever running short on time you can cut short your exam but never skip out on your
counselling.
Communication:
From the very first read work on your PEARLS. Incorporate it into the cases as you practice them
(i.e smiling, greeting properly, if somebody sneezes say bless you, offer a tissue if someone has a
runny nose, if someone mentions sth tragic then take a moment to be empathetic, or is someone
shares good news then congratulate them etc). It's important to have these skills from the very
beginning and make it seem natural. Otherwise, tbh, you will forget to be nice which I know sounds
strange but it happens. Remember that the “patients” are actors and not doctors so you need to be
really good with your communication skills. You’re already really stressed out in the room so the
only things that will come to you would be the things that you’ve practiced over and over and are a
reflex.
Mnemonics:
There are TONS. Please do not memorise unnecessary ones. Only use the ones that
make sense and you can remember and try to use them when you start the second read so that it
becomes a habit. There’s the “blue sheet” that most people use and I’ve uploaded an additional
document on ZIPPs that has many different mnemonics. So pick what works for you. I honestly
only went in with “SOCRATES” and a modified version of “PAM HUGS FOSS” and it was all I
needed.
Note typing: [Link]
There is also an offline version of the software that you can use which lets you save the typed note
afterwards.
You can get an old keyboard and practice note typing more accurately but please start this early
on. Note typing is actually quite hard and we aren not very good at it. Always write the note in
reverse order as the differentials section is scored higher than the HOPC/HPI section. So go from
bottom to top.
Timing:
Great after elective/US clinical experience. Also…it doesn’t matter where you take it.
Exams:
Exam sequence is different from how you do it in school. You only need to do RELEVANT exams
to rule out your differentials. Absolutely no need to do any extra manoeuvres or check systems that
do no pertain to the presenting complaint. As you practice, this will come to you automatically so
don’t worry. For e.g for each Cranial Nerve just check one thing (like just do pupillary light reflex for
CN 2 and then move onto the next, no need to do Rinnes/Webers just snap near each ear and ask
if they can hear it). Refer to the examination section in FA for additional exams.
Scoring:
In the guide, they talk about the 3 different areas you are scored on. Go through that properly so
you know what you need to focus on. You need to pass each component separately.
For Exam Day:
Take snacks, any medicines that you might need, water, they will provide lunch, make friends. Its
gonna be a long day so just try and stay relaxed. Don't worry about the spots that you've already
messed up and just move on.
Hope this helps with your exam prep. I’ve uploaded most of the resources I’ve mentioned on to
ZIPPS. If you have any questions, feel free to email me: aleenaayila@[Link]
Good Luck!
Aleena Arshad
ZU - Class of 2018