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Difference between NAC and CS

1. Cs is 25 minutes each encounter while NAC is 10 minutes each encounter.

2. CS you are alone with the patient with NAC OSCE you have Examiner in the room.

3. With CS you spend 15 minutes on H and P, and 10 minutes for note writing, while in NAC OSCE you you
don't have note writing, examiner listens to you while you take history and during Physical you are
dictating everything.

4. CS is testing clinical skills only, in terms of communications, HnP etc while NAC OSCE it's more along
the lines of management.

5. With NAC OSCE you will have post encounter questions that will be related to encounter and examples
like what is your working diagnosis, what investigations? what treatment etc

6. NAC OSCE has MCQ part as well, I believe it's worth 10% of of the total exam I believe. Last year when I
took it, it was worth more i think.

NAC is much more detailed. Have to verbalize what you are doing at all times what you are doing and
significance of findings.

NAC is also much more focused, you are given and brief scenario and you must stick to that. NAC also has
some dosing questions, or at least it did when I took exam in Sep 2013

M saleh advice to me:


I have to disagree with you one this. I took the Nac OSCE and socred above 80. Here is my advice:

1. Yes, Katrina Hurley's OSCE book and Edmonton's manual book are good BUT they should not be your only study book for several reasons:

These books were made for OSCE's but NOT the Nac. The nac stations got specific time limit that you have to follow. If you just use Edmonton
manual or Katrina's book, you will FAIL because you will not finish any station on time.

2. Taking lessons in-person will help BUT I took online ones and was able to work during the day. I found it way more helpful and efficient than
taking in person lessons that will not teach me anything I can not learn online. The in-person courses charge a lot of money compared to the online
teaching who taught me exact same material and students average was higher.... If you are tech challenged, then yes take only in person but
make sure you pick the right person.

3. Practice is important. However, I say practice in a group of 3 max at time. You can then practice with different group. Having large number will
only waste your time....

At least this was my experience and what helped me score 80+


To all of those who would like to know the differences between USMLE step 2 CS and Nac OSCE, I will
share my experience with you:

1. The USMLE step 2 CS communication skills and physical exam parts are exactly the same as Nac OSCE.

So what are the differences:

1. The way the Nac is conducted differs from CS. Unlike the CS, for the Nac you do not have to write a
note after each station. Timing for each station is different, etc...

2. In the CS, there is no examiner with you in the room; however, in the Nac there is examiner with you in
each station and they will ask you post encounter probes or hand you blood results, ekg's, etc...

3. In the CS, patients grade you for the communication skills etc...In the Nac the examiner does almost all
the grading.

3. There are some stations in the NAC that you do not find in the CS. These could be counseling and
Difference between NAC and CS

management stations...etc

So overall I was glad I took a course for the Nac. My partner who I practiced with me took basil's course
but she had hard time. She first had to travel to Toronto, thinking she will get some practice but his
classes were packed and he wastes a lot of time. His NOTES are very old. (I think 2009) and the price for
the course was ridiculous.

I took the online medical training express course and I was satisfied. The classes were scheduled online
during the night so I was still able to do my obervership. Notes were made in 2015. They helped me know
what previous cases were, what to do for each station, and gave checklist for each physical exam, did
online practice and received a lot of feedback from the instructors (actual residents) and my other
classmates who were taking the course...overall I paid less than half of what my friend paid.

I felt I was well prepared as I did at least 2 history and counseling practice per each 3 hours class. One
more thing, my testing center was in Toronto, medical training express recommended a way of changing
my center which I wanted and it worked!

Overall, I scored 82 and I am very happy.

If you have any more questions, please feel free to ask me and I will be happy to help.

Scoring in the 80's is not impossible. Best of luck everyone.”