USMLE Step 2 CS: How to Avoid Common Pitfalls

Kaplan Medical’s Step 2 CS LivePrep program.

By: Melanie Piatkowski, Medical Programs Director for Live Programs at Kaplan Medical

How much thought have you given to the USMLE Step 2 CS when planning your road to residency? There are many aspects of this exam that I have seen students underestimate. I hope that by the end of this article, you will have gained insight as to the importance of this exam and how to avoid common pitfalls students encounter.

Don’t Underestimate the Cost.

It is important to consider the $1,480 cost of the exam itself as well as the additional travel and hotel expenses to one of the five USMLE Step 2 CS testing centers (Atlanta, Chicago, Houston, Philadelphia, and Los Angeles). Also, be aware of the new rescheduling fees (shown below).  Don’t underestimate the logistical and academic planning required in order to avoid having to pay up to $1,230 in rescheduling fees on top of the exam cost and travel expenses.

Don’t Wait. Schedule Early.

Try to schedule your exam date early, because oftentimes available test dates are difficult to find and it can take up to three months to receive your results. Remember there is no guarantee of a new test date within your eligibility period due to the fact that testing centers book up approximately three months ahead. Between that time frame and waiting for your results, your Match(R) timeline may fly by faster than you think.

Pass Step 2 CS on the FIRST Attempt.

If you have all of the planning under control, the next thing you should think about is passing the exam on your first attempt.  Aside from having to pay the additional cost if you need to repeat the exam, you will be delaying your residency match timeline in order to book another date and wait for those results. Also, you want to stay competitive by avoiding multiple attempts on the Step 2 CS. Though some programs may forgive a second attempt on Step 2 CS, others may not.

Know What’s Being Tested and How You’ll Be Evaluated.

Many students underestimate the content and scoring of this unique exam. Because you must pass all three Step 2 CS components: Communication Interpersonal Skills (CIS), Spoken English Proficiency (SEP), and Integrated Clinical Encounter (ICE), it is important to know how you will fare in all three components as set forth by the USMLE standard before you walk in to your exam.

The evaluation process for how well you communicate your medical knowledge in a verbal encounter with a patient, as well as a written documentation in your patient note, has standardized expectations. How you conduct yourself with a patient and write up a patient note must meet these expectations. You may want to complete Step 1 and most of your Step 2 CK review before preparing for Step 2 CS so that your focus can be on how to communicate rather than what to communicate to your patient and on your patient notes.

I have seen students who speak English as their primary language fail CIS and/or SEP. I have also seen students with very high Step 2 CK scores fail ICE on the Step 2 CS. Do not risk such a high stakes exams and high cost on what you assume about the evaluation process.

Prep Appropriately.

This leads me to my last observation of trouble I have seen students fall into when it comes to Step 2 CS:  preparation.  Practicing with a friend or even someone who has taken the exam is great. However, you need simulated evaluation circumstances that provide feedback of your verbal and written communication, based on the standards set forth by the USMLE exam. Your friend who received a pass in the three components can only guess which conversations and patients notes were strong enough to warrant a pass. It is worth the cost to prepare with people who are trained, as the standardized patients are on the exam, who will give you feedback of what you need to improve before your test date. Don’t miss out on learning how to handle patient interaction and how to document correctly. Make your test day feel so comfortable that it is like “just another day of practice.”

After all, taking these exams is stressful enough, especially a live interactive exam. Why not be as prepared as possible to avoid unnecessary stress on exam day?

Kaplan has advisors who can help you plan the academic and logistical timeline to relieve stress, as well as an intensive, comprehensive 5 Day course.  The course breaks down all the components in lecture, small groups, and one on one formats throughout the week, including a full 12-patient simulated exam.  This gives you the tools and skills you need as well as practical experience, and live, immediate guided feedback on your execution of the skills required.

Best of luck to all!

Bio:

Melanie Piatkowski is the Medical Programs Director for Live Programs in Kaplan’s Newark Center in New Jersey.  She has worked specifically in the CS department for 10 years, serving in many different roles such as standardized patient, communication skills instructor, and CS Manager. Melanie has also contributed as a CS consultant for curriculum and technology development in Kaplan’s Step 2 CS programs.

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