Step 2 CS or earlier CSA or Clinical Skills Assessment exam.
Effective July 1, 1998, applicants who had not met all requirements for ECFMG certification by June 30, 1998 are now required to pass Step 2 CS. It is offered after or before you pass the written step 2. It does not give you a numeric score but just a pass or fail result.
The earlier CSA was replaced by Step 2 CS is June 1, 2004. This will be taken by both the US grads and IMGs. For more info on this, go to ECFMG site link.
Step 2 CS is a judge of appropriate and systematic handling of a case. The most important thing is to be logical and polite in one's approach. Accuracy of diagnosis is not of paramount necessity.
Each candidate sees 12 cases and is scored on all 12 cases.
There are 5 main content areas.
If you have done the MRCP in Britain, it is very similar to it (short cases) with a brief history. One thing that is easier is that in Britain they have real cases but here they have simulated scenarios so you do not have to go and do a fundoscopy to look for macular degeneration type findings (although you must perform the examination, you just have to pretend as if you know what you are looking for).
Each case is limited by time. You get 15 minutes with each patient then 10 minutes to write up / type on a computer -the whole thing. Treatment is not to be written. Do not write for consults either meaning thereby that Consult neurology or consult Obstetrics cannot be in your plan. You are expected to do the thinking and workup yourself.
Practice makes a man perfect. One MUST practice the cases before one approaches the real exam itself. I will try to present cases from each of the above content areas and train you to perform with more confidence and smoothness.
I will walk you through the important negatives/positives you should go through with different scenarios. All of us have our own method of doing so. I am just an ordinary physician and will teach you how I improve my performance by using a simple method. You are most welcome to do the same or carry on with your own system.
Before you proceed with examination of the patient, ask patient for permission to do so.
Drapes are kept on a stool - it is made of cloth and before you proceed with the examination part, please drape the patient.
Examine the painful part in the end. Tell the patient - I will try to be gentle as I approach the worst area. In case of abdomen, auscultate before you palpate as it may change the bowel sounds.
If you see a migraine patient, ask them if they would like the lights dimmed while you ge t the history.
Inspect, Auscultate, palpate & percuss in case of abdomen. (Auscultate before palpation or percussion)
CVS - note apical impulse (apex beat) for sure.
Always examine on the skin - not on top of the gown. Never unnecessarily expose the patient.
At the end of the examination, thank the patient for allowing you to examine him/her.