(account deleted) 09 Feb 2009 21:21
The 3rd year Clinical Skills Exam is very much like the actual Step 2 exam and will overprepare you for the real thing. The following is an overview:
* One of the exam proctors will give you a brief orientation and provide you with a clipboard, scrap paper, and a pen.
* On each door, you will be provided with patient's name, age, gender, chief complaint, and vital signs.
* You will spend 15 minutes on History/Physical and then 15 minutes typing out your H&P, Differential Diagnosis (5), and Plan (5) on the computer outside of your room.
* The H&P is very focused and it is best if you just go through the motions for times sake. Remember to…
o Wash hands
o Do a problem focused-history i.e., OLD CARTS, HEEADSSS, SIGECAPS, etc.
o Auscultate under clothes
o Always drape
o Sum up impression/plan with patient (communcation/compassion points)
o Note: You will never have to do a rectal, breast, genital or corneal reflex exam. If appropriate, you can ask the patient if you may do this, and they may give you an index card with the "findings", or you can tell them that your plan is to do a pap smear or whatever.
* For the write-up, no "template" is provided other tan the aforementioned categories, so you'll have to remember & type out PMH, Surg, soc hx, etc. (see First Aid Bk for exact layout). DDx and Plan are simple lists (do not need to explain)
After each case and at the end of the test day, you will realize how many little things you may have forgotten. Be reassured that there is plenty of room for error and I think average/passing for the school was something in the 60s, and almost everybody passes. The "big" & "easy" points are in communication and compassion.
Regarding preparation: If you feel pretty comfortable in outpatient clinic, then you don't really need to prepare much. If you are feeling rusty, it is a good idea to review First Aid Step 2CS and practice with someone.
