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Tips and Strategies to Prepare for and Ace the USMLE Step 2 CS

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USMLE Step 2 CS Exam Prep

The USMLE Step 2 CS is a critical USMLE step as it unapologetically screens medical students to weed out potentially incompetent future physicians.

USMLE Step 2 CS accesses your ability to take patient history, perform physical examination and communicate effectively with patients in English. It is an interactive exam, but it has a lengthy and demanding assessment structure.

Here are a few tips to give you the confidence to get over Step 2 CS successfully:

These four strategies will help you prep for USMLE Step 2 CS:

1. Understand the components you’ll be evaluated on

To be successful in Step 2 CS, you have to clear each of the three subcomponents – SEP, ICE, CIS. Read on to know more about these subcomponents:

  • Spoken English Proficiency (SEP)
    The SEP assessment is designed to test your English skills. The standardized patients (trained to mock medical encounters) grade you on three aspects of your spoken English skills – clarity, word choice and pronunciation.
  • Integrated Clinical Encounter (ICE)
    In ICE, you are expected to perform a physical examination and type your patient notes. Here the SPs grade you on the basis of the skills you displayed during the physical exam. Your patient notes are reviewed by the physician.

Tips for Step 2 CS that can lead you to higher scores in ICE:

  • Avoid medical jargon, your patients don’t understand them.
  • Document a detailed physical exam and patient history.
  • Diagnose the condition based on the findings you collected from the patient history and physical exam.
  • Communication and Interpersonal Skills (CIS)

The CIS subcomponent assesses your soft skills in patient care. Here the SPs make use of a checklist to evaluate your performance in CIS. Although the whole situation is made up, you need to get into the character and do what it takes to make the patient feel at ease, provide accurate information, and above all, trust you.

2. Take help from helpful resources

Although there are not many preparation books on USMLE Step 2 CS, but the available ones are good enough to help you. You’ll find books that cover all vital information about USMLE Step 2 CS, right from content, scheduling to scoring. You’ll also find books on sample test cases, which you can practice with your peers or study buddies.

3. Practice role plays with your peers

Mock tests with study buddies present an excellent opportunity for you to play a physician as well as a patient. The more you practice the test cases with your peers, the better are your chances of clearing the USLME Step 2 CS with confidence.


These 5 tips will help you when you are practicing sample tests with your peers:

  1. Learn to unlearn as the patient note you are expected to write for Step 2 CS may be different from what you usually write when on the wards.
  2. Practice on a peer who is willing to wear a patient gown.
  3. Time yourself as per the actual exam requirement when practicing the mock test.
  4. Simulate a full exam a week or two before your exam.
  5. Practice to type accurately and quickly.
4. Take a course

Practicing with your friends or other students is different from working with professional Standardized Patients. So, if in any doubt, or if you have no exposure to actual SPs, then challenge yourself by taking a Mock test, attend a CS prep course or even hire SPs and learn how to overcome the fear of the unknown.

5. Plan your test day well in advance

To maximize your performance on the day of the exam, it helps to plan ahead. It’s highly probable that you might have to travel to another city, so try to maintain a routine as much as possible and avoid the last minute stress.

Good luck on preparing for USMLE Step 2 CS!

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