USMLE Step 2 Clinical Skills

Yay! My step 2 CS is over!

Last night I flew down to LA and stayed at just about the most sketchy hotel ever. Here's a picture of the room:

Yes, that's a giant painting of parrots. Anyway, I was only there for about eight hours, from 11 pm until 7 am, because the stupid shuttle took about an hour after I called to come pick up and take me to a hotel five minutes away. I was not in a happy mood by the time I arrived.

After an abbreviated night's sleep on the world's most uneven mattress, I got all dressed up in my professional clothes and white coat and grabbed a taxi to the testing center. I ended up getting there about 7:15, so two of my fellow test-takers and I wasted some time by getting some breakfast and coffee (the breakfast was me, coffee was them). Then at eight, the whole thing started. Here's how Step 2 CS works:

8 am: orientation ("use the otoscope to look in the standardized patient's ears"...)

8:45ish-11:15: see five standardized patients. For each, there is fifteen minutes to get a history and physical, including history of present illness, past medical history, family history, social history, review of systems, and focused physical exam. Then there's ten minutes to write up a note, come up with a differential diagnosis, and "order" up to five tests to try to diagnose the patient. Then it's time for the next patient.

11:15-11:45: lunch (catered sandwiches with way too much mayo. Yuck)

11:45ish-1:45ish: four more standardized patients

1:45ish-2ish: break

2ish-3:30ish: last three standardized patients

So in all, twelve standardized patients, of which ten count (but we don't know which ten). We're graded on English speaking skills (which includes the ability to explain what we're doing in lay-person English), ability to elicit a complete history, physical exam skills, and differential diagnosis and ordering the appropriate tests. It's this magical, confusing process to come up with a grade, which I don't understand, but supposedly, in a couple of months, they'll let me know if I'm one of the 93% of US medical students who passes.

Because we're told to plan for the exam taking until 5 pm (you never know what kinds of delays might occur), my flight isn't until 8:40 tonight, so in the meantime, I'm hanging out at the USO at LAX, enjoying their free internet, free food, and the company of a whole bunch of 18 year old Marines playing video games.

USMLE countdown:

CS: done

CK: 6 days