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  1. #1
    Redreflex is offline Newbie 514 points
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    How I passed Step 2 CS in 17 days, having graduated 11 years ago

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    Hello everyone,

    I'd like to share my experience of passing Step 2 CS in the first attempt (got results today) after 17 days of revision. This forum has been useful to me during my preparations for all the USMLE exams.

    My background

    I am a board certified ophthalmologist in the U.K. I went to medical school in the UK, and graduated 11 years ago. I am of Asian origin and grew up in Asia. I have not done any general medicine or surgery for 10 years - only ophthalmology. I am taking the USMLEs, because I plan to do a clinical fellowship in the USA in a very specific area of ophthalmology

    What USMLE steps had I taken before Step 2 CS?

    None. Step 2 CS was the first exam I took, purely because I need to get my USMLEs as soon as possible and the results of Step 2 CS take the longest to be published. Whilst waiting for these results, I have since taken Step 1, and will be taking Step 2 CK in a month. Thus, I had no recent clinically relevant knowledge from Step 1 or Step 2 CK to help me in Step 2 CS (such as remembering all the different diseases, taking a relevant history, etc).

    How did I prepare?

    I only had 17 days to prepare for the exam (had other major work commitments beforehand. Thus I had to be do a super targeted revision. These were the ONLY resources I used:

    1. Kaplan - history taking / examination section only. The physical examination section particularly is more thorough (and necessary in some cases) than First Aid.

    2. First Aid - just a fantastic book. Long cases and mini cases. Even the handling difficult questions during counselling section was a useful read.

    3. Youtube videos for concise physical exam, particularly by this author (there are others too - just look in Youtube): mdofola

    4. Medscape online for basic clinically relevant information for almost all diseases (presentation, differential, diagnostic investigations) - this was extremely helpful.

    5. I did not go to any general medical clinics or wards to see any patients. I just did not have enough time. I am currently doing some ophthalmology research.

    6. CSE video - I subscribed to this but regretted it later. I only looked at 2-3 videos and abandoned the rest because they really were that bad. I thought the cases on CSE video were NOT professionally done. In fact, I thought they were poor. For example, in one of the videos of a simulated examination where the doctor examined the patient's shoulder, I think only 1 side was examined. As you know, you've obviously always need to examine both sides (unless the patient is in severe pain and refuses despite you asking for permission once or twice). In addition, the doctor in the videos was seemingly referring to some prompting notes on the opposite side of the room outside the view of the camera - just appalling I think. Just completely unrepresentative of the exam. My advice - please do NOT use CSE video.

    This was my preparation timeline:

    1. Day 1-2: read the clinical examination section of Kaplan and First Aid. Combined the two sets of information. Learnt that.

    2. Day 3-17: After that, I practised all the systems examinations thoroughly with my wife, daily for the first week, then alternate days or less for the 2nd week (because I was getting a little tired at the end of all that studying). The real difficulty I found with the physical exams, is that I had forgotten everything from medical school, including where to auscultate for various types of murmurs (yup, that basic), the order to do an abdominal examination, etc etc etc. The only ones I perform which are relevant my clinical practice over the past last 10 years are ophthalmic and cranial nerve examinations! Surprisingly, Youtube videos have been extremely helpful in reminding me about the different examination techniques, particular the ones from the author shown above.

    3. Days 3-7: Started reading through mini-cases in FA to learn all the different differential diagnoses. To be honest, this was a mistake. I should've started immediately with the long cases in the second half of the FA book. I got too bogged down by the fear of not remembering enough differential diagnoses relevant to each patient / presenting symptom.

    4. Days 8-16: Simulated history taking using FA long cases. My sisters who are doctors, helped me by being the patient. As they are in a different country as I am at present, we did this all over Skype. I think it's better to ask fellow doctors to be mock patients, as they can better understand the relevance of the history/disease and thus simulate more accurately. So they would read through the relevant long case, and I'd simulate the whole thing via online video, including knocking on the door, introducing myself and taking a history. I simulated a physical exam relevant to each case (via Skype video!), in the sense that I simply used it as a tool to go through the motions of the physical exam so it would force me to think through what relevant examination I would do in the time constraints. The only time I practiced generic general systemic examination on a real person is as indicated in "Day 3-17" above (i.e. not in the context of these long cases practices).

    I then counselled the "patient", closed, and typed up the patient note.. At the end of each long case, we would go through which questions I did not ask in the history taking based on the checklist in FA. Please note that I feel it is IMPOSSIBLE to ask ALL the questions on the checklist in the FA long case. There is just not enough time. Never did I ask all questions - there were always a few that I missed out on. Felt bad at the time of practice, but I just moved on to the next practice case.

    5. Days: 15-17. FA mini-cases. Read through all of this again. Very important.

    6. Day 18. Exam day.

    Exam day experience

    I made a lot of mistakes on the day:

    1. Forgot to pull out leg rest during supine exam – first case
    2. Forgot sex history 1 case (16 yo with depression)
    3. Time ran out when only just started closing statement “I’d like to share with you what I think…” – 1 case. I didn't explain diagnosis, etc.
    4. Forgot to document ophthalmoscopy exam 1 case in PN (even though I performed the examination).
    5. Forgot to ask PPD in COPD exacerbation case
    6. Forgot to ask Pap smear in amenorrhea case
    7. Forgot to ask menarche age in amenorrhea case (did ask about when periods became regular)

    Some final tips:

    1. Ask patient anything else they’d like to mention before moving on to physical exam – x2 cases brought up useful things in history I forgot to ask.
    2. Ask patient for generic name of drug – they usually know and will help - I asked x2 patients. I'm not familiar with the brand name of drugs in the USA.
    3. Use this blog for some useful tips: google csprotocol dot blogspot dot com
    4. Atlanta great place to take exams if if you don’t live in one of the CS2 site cities – hotel 5 minutes from airport by complimentary shuttle to Country Inn & Suites By Carlson - Atlanta Airport South – EXAM CENTRE only 5-7 minutes WALK away
    5. Revision:
    a. Use Kaplan for examination detail
    b. Use First Aid, and in retrospect, this is what I should've done:
    i. Firstly, read through practice cases – explanation needed for diseases there, so I could've spent a lot LESS time trying to look up what Plummer Vinson disease is, etc etc. The relevant explanation for each diagnosis and test is all listed at the end of each long case.
    ii. Secondly, read through mini cases
    iii. Finally, go through (i) and (ii) again

    Summary and Conclusion:

    It is actually possible to pass Step 2 CS in just over 2 weeks. Remember, I had been out of general clinical medicine for 10 years, and did not have the benefit of clinically relevant knowledge from a recent Step 2 CK exam (taking this in a month's time!). During my revision, I never saw or practiced on any real patients on the wards or clinics, just because I thought I could use my very limited time (17 days) more efficiently by practising with family/friends. It was actually very odd when I examined the first patient on the actual Step 2 CS exam day, because that was the first time in 10 years that I did a systemic / physical examination on someone who's not my wife (whom I had been practising on)!

    Just be very focused with your revision, and you'll pass. Just don't neglect any of the 3 main sections of Step 2 CS (e.g. don't leave your introduction or counselling as an after thought - leave nothing to chance).

    Good luck to all of you. Hopefully my entry can help you as much as others on this forum have helped me.

  2. #2
    girlmd99 is offline Newbie 510 points
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    csevideo is an exact depiction of the real exam i passed with high performace august of 2011 with them

    this guy is a fake user all the fourms have deleted this post and have blocked him from comming back, he is tutor i got an email from him with exact post telling me he charges 500 and he better then kap and uw
    he has gone on every single forum with this same post then follows up a tutors phone number
    so many people are telling to stop spamming and we as students need real feedback
    go somewher else with your ad red

  3. #3
    Redreflex is offline Newbie 514 points
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    girlmd99,

    Do you think I would've put in so much effort to write all those exam tips just to make up something fictitious about CSE Video? Bear in mind that I don't even refer to CSE video in the title of my post, in the first 10 sentences or the even in the last few sections of my post. My sole intention is to share some exam preparation and taking tips to hopefully help others, in the same way I have benefitted from others' help.

    Where does it state in my post about me being a tutor, and posting a phone number? I think you need to go back and read my post again, one word at a time. It has been 6 days since my post above, if I wanted to advertise as a tutor to follow-up on my post, I would've done so already? Your comments truly beggars belief.

  4. #4
    girlmd99 is offline Newbie 510 points
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    i passed with csevideo higher performance in each section

    i dont trust you
    just cause you watched 2-3 videos you think your some kind of expert on it
    ihave freinds studying right now for that exam and i suggested to them to use csevideo i know it worked for me i passed and i watched all the videos all my cases came from cseideo i did exactly like the women in hte videos and the exam was pretty understandable and easy for me

    so your opinon doesn tmake sense and your reply is the exact reply you gave to everyone else as if you already had it planned
    who cares wht you think just cause you want to put someone down you wast other peoples time doing it
    that will not make you a good doctor
    you know if you want to practice in the us you need to take a class on etiqute because you dont seem to have much of it
    i have seen posts by you all over the place demanding that everyone listen to your long address about the cs exam your not done the iwth other exams why should anyone consider your advice b/c in reality your a tutor i have five emails from you selling me tutoring services and telling me why every other program doesnt work.
    so its apparent your just trying to sell somehting.
    bye

  5. #5
    girlmd99 is offline Newbie 510 points
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    dont write back to me i dont want to hear
    im busy with the match

  6. #6
    hanky is offline Newbie 510 points
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    csevideo highyield for cs
    hi red
    thanks for your post

  7. #7
    hanky is offline Newbie 510 points
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    csevideo highyield for cs
    hi red
    thanks for your post wow it seema syou have a long road ahead you must be old and this is a big undertaking i admire your ambition i hope you make it
    i wanted dto thank you i never heard of csevideo befreo and im preparing for cs i just got the monthly package and saw the first set of videos they are great im so glad i found out about them they are defintely highyeild for cs boards
    thanks and take care

  8. #8
    Redreflex is offline Newbie 514 points
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    girlmd99- Like I said, we are all entitled to our own opinion. I am simply sharing mine with the readership so people get to see 2 sides of the coin. Readers can make up their own minds. We will have to agree to disagree.

    hanky - thank you for reading, although there is no need for cryptic comments about age. Again, I would have to disagree with you about CSE Video, but it you find it useful, then good for you.

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