General information
Step 2 CS is a practical skills exam. It consists of encounters with 12 “standardized patients” and it takes 8 hours including 2 breaks. Standardized patients are well trained people who simulate a medical condition. You have 15 minutes for each encounter followed by 10 minutes to write a note into the patient's chart (history, physical exam findings, differential diagnosis, and proposed further tests). It is useful (but not necessary) to know and use American medical abbreviations to save time.
Each clinical encounter starts with the chief complaint written on the door of the “medical office”; example: “A 75-year-old woman presenting with abdominal pain for the last 24 hours.” You read the chief complaint and enter into the office. Your standardized “patient” scores you on how many questions from a given list of questions for this particular encounter you ask. For the example of the 75-year-old woman with abdominal pain you are expected to ask the character of the pain, intensity, location, associated symptoms as nausea, diarrhea, etc. There are specific questions for each chief complaint. You cannot ask broad general questions for everyone as there is not enough time. If the patient smokes, advise him on quitting. The “standardized patient” also assesses your physical exam and the professionalism of your behavior (washing your hands), as well as your language skills. You find further details at www.usmle.org/pdfs/step-2-cs/cs-info-manual.pdf
This exam could seem humbling and stressful but I found it the easiest from all three ECFMG certification Steps. It took me 3 weeks to get ready for this exam. The best way to study is to have a friend simulating the “standardized patient” reading the chief complaint from one of the text books and you asking him questions. Then you look how many questions you came up with and what you missed. There is no score in the results of the Step 2 CS, just pass/fail. You find more information at www.usmle.org/practice-materials/index.html under the title "Step 2 Clinical Skills (CS)"
Text books:
- First Aid for the USMLE Step 2 CS
- Mastering the First Aid for the USMLE Step 2 CS
To study from only one of these books is enough. There is more experience with the First Aid.