USMLE STEP 2 CS GUIDE

Exam done to assess the ability of the doctor/medical student to conduct a patient
centred clinical encounter to address the concerns and provide a diagnostic approach
plan.

REGISTERING FOR THE EXAMS

1. Go to ECFMG.org
2. Click on online services and select IWA
3. Enter your ecfmg id and password and log in
4. Click on begin a new application
5. Fill out form for cs exam and make the payment
6. If your med school participates in EMSWP then get your student status
verified online by calling your med school. If your med school does not
participate in EMSWP then get from 183 signed by med school along with a
copy of medical transcript and diploma and ask them to send it to ecfmg via
mail.
7. Processing of your application takes anywhere between 3-4 weeks. Wait
8. You will receive a mail after your application is verified which also contains
scheduling permit.
9. Scheduling permit is valid for 1 year
10. Go to ecfmg.org and click on online services and select step 2 cs calendar and
scheduling.
11. Login using your ecfmg id and password
12. Select your desired test centre and date.
13. Once selected you will get a confirmation mail to your email id.

IMPORTANT NOTE: REGISTER FOR YOUR EXAMS ATLEAST 6

MONTHS PRIOR TO YOUR DESIRED EXAM DATE.
In CS exam three components are assessed:

 ICE (Integrated clinical encounter):

- History taking
- Physical examination
- Patient Note
(Summarizing the findings, most appropriate differential diagnoses and
diagnostics studies)

 CIS (Communication and interpersonal skills)

- Establishing the role

- Bed side manners
- Active listening
- Empathy
- Building a good rapport
- Support
- Respecting Patients decision
- Answering to the queries

 SEP (Spoken English Proficiency)

- Clarity of the speech

- Word/ phrase choice
- Listener’s effort required to understand the questions asked
- Complete understanding of the concerns that the patient has

NOTE:

- Most failures rates are seen in ICE and SEP component

- Medical students (International students) and the examines who are giving
cs exam as their first step should take an extra care regarding
ICE component
EXAM DETAILS

NO OF CASES 12
(including experimental cases)

PATIENT ENCOUNTER TIME 15 MIN

PATIENT NOTE WRITING 10 MIN

TOTAL DURATION 8 HRS

BREAK TIME 50 MIN

- 1st break after 3rd encounter

for 10 min

- 2nd break after 6th encounter

for 30 min (lunch provided)

- 3rd break after 9th case

for 10 min

SESSIONS - MORNING

- AFTERNOON

EQUIPMENTS PRESENT INSIDE - OTOSCOPE

THE EXAMINATION ROOM
- OPTHALMOSCOPE

- PRESSURE CUFFS

- ANALOG CLOCK

EQUIPMENTS PRESENT DESKTOP WITH A FULL

OUTSIDE THE EXAMINATION FLEDGED REGULAR
ROOM KEYBOARD
THINGS TO BRING - CLEAN/ PRESSED LAB COAT
PREFERABLY WITH NO LOGO
(IF PRESENT WILL BE TAPED)

- STETHSCOPE (ANY REGULAR

ONE WITHOUT ENGRAVINGS)

- LIGHT SNACKS

- WATER

- BREATH MINTS

- SCHEDULLING PERMIT/
CONFIRMATION NOTICE

- UNEXPIRED ID CARD
(PASSPORT FOR IMGs/
DRIVING LICENCE)

THINGS PROVIDED - DOORWAY INFORMATION

-12 BLUE SHEETS

(FOR WRITING BRIEF NOTES
DURING THE ENCOUNTER AND
EACH SHEET RETURNED
AFTER THE PATIENT NOTE
WRITING)

- A BALL PEN RETURNED

AFTER ALL THE ENCOUNTERS

- STETHSCOPE
(LIMITED QUANTITY, ONLY IF
U FORGET TO TAKE)

EXAM LOCATIONS - PHILADELPHIA

(ALL CENTERS HAVE HAS 2 CENTERS
STANDARDIZED PATIENTS
WITH SAME DIFFICULTY - HOUSTON
LEVEL)
- ATLANTA

- CHICAGO

- LOS ANGELES
PLACES TO STAY FOR CS PHILADELPHIA
PRACTICE
- VANESSA AIRBNB

- APNA HOUSE

HOUSTON

- REDROOF

ATLANTA

CHICAGO

- FOREST PARK LIBRARY

(for practice only)

LOS ANGELES

Other places of practice will be updated soon

RESOURCES
 First aid
 Sherazi notes
 DR PRADEEP CS NOTES

ADDITIONAL RESOURCES
(ONLY FOR THOSE LOOKING FOR EXTRA CASES – NOT AN
ABSOLUTE NECESSITY )
 Kaplan CCS
 Bates physical examination
 CSE videos just to get an overview of the exam

CS COURSES
(NOT AN ABSOLUTE NECESSITY)
 GOLD USMLE
 NYCS PREP
DURATION OF PREPARATION
 Those done with Step 1 and step 2 ck: 4-6 weeks/ 6-8hrs
 CS as first step: 6-8 weeks/ 6-8hrs

STUDY PLAN
1. Always start by reading about introduction to the exam.
2. Read about how to do various physical examination.
3. Start mini cases and get to know about all possible differentials for each
complaint.
4. Then start with long cases to know about how and what to ask.
5. After long cases are done, Start timed practising with a live study partner.
6. Work on your patient notes
7. PRACTICE, PRACITCE AND MORE PRATICE!
8. Before the day of exam make sure u have good sleep.
9. Reach 30min earlier to the exam centre
10. Remember! being relaxed is the key to the exam.

TIME LINE TO PRACTICE

 Doorway = 1 min
 History = 7-8 min
 Physical examination = 4-5 min
 Closure = 2-3 min
 Patient note =10 min
If you finish the encounter early, you can utilize the extra time for
patient notes.

IMPORTANT NOTE: THOSE WHO PLAN TO TAKE ANY CS COURSES,

TAKE IT ATLEAST 15 DAYS PRIOR TO THE EXAM DATE!