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How do I prepare for Step 2 CS?

Activity Forums USMLE Step 2 CS Forum How do I prepare for Step 2 CS?


This topic contains 1 reply, has 2 voices, and was last updated by Dr. David Delnegro MST USMLE Tutor Dr. David Delnegro MST USMLE Tutor 2 years, 2 months ago.

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  • #241
    Dan S., MST USMLE Tutor
    Reputation: 30
    USMLE ExpertMD or DOContributor

    Step 2 CS scoring is broken down into three components: Communication and Interpersonal Skills (CIS), Spoken English Proficiency (SEP), and Integrated Clinical Encounter (ICE). You’ll need to pass all three to pass the test.

    Some CIS quick tips: introduce yourself, shake hands, ask what name the patient prefers you use, use open-ended questions, respond to questions with empathy (don’t be dismissive of fears – acknowledge that they are real and reflect back why the patient might be feeling scare, explain why that fear is or isn’t warranted, and provide a plan for next steps); in the physical exam, wash hands before starting, use proper draping technique, tell the patient what you are planning to do before you do it, and ask if that is okay; finish the exam with time to update the patient on your plan and to see if they have any further questions.

    Some SEP quick tips: If English is not your first language, go through practice cases from Step 2 CS with someone for whom English is a first language. Ask them to fill out the checklist honestly as you go. If you think you hit a checklist item that they didn’t check off, work with them on how to better express the question or statement.

    Some ICE quick tips: It’s probably worth using a combination of the practice form that USMLE provides ( and a resource like First Aid for Step 2 CS to read through a sample case and try writing a note for the case in the form. Technically you have 10 minutes for the note on exam day, but I’d try timing yourself to 8 min to account for some exam day nerves. Note that the 950 character limit for the history is actually potentially limiting, and it’s worth practicing keeping that section concise. FA will have a sample note as well with which to compare (and USMLE has a few examples with scoring, which can be helpful to see: Practice some cases with another medical student as well – it will feel silly, but it’s important that exam day not be the first time you are working through timing and awkward situations.

    Post below with any questions!


    Don’t leave the encounter before the 5-minute warning either! You don’t need the entire time for the interview, but a friend of mine who was very smart ended up having to retake the exam and he was told that leaving too early were auto-fails for that station.

    CS is weird…

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