1. Tips for CS preparation:
• I have difficulty to finish physical examination in timely manner. Any suggestions.
o It is very difficult to finish physical examination in timely manner especially cases of CNS or any difficult patient.
o You should only do focused physical examination. Think about most relevant system of your cases, it could be either 1 or 2 system.
o Quickly finish focused physical examination while explain what you are doing.
o You should not spend time to look for any abnormal signs. Quickly move on to next steps of physical examination.


1. Tips for CS preparation:
• Which points do I need to include in my closure?
o Closure is very important part of encounter. You should have at-least two minutes for it.
o You should include what you think- give about 2 differential diagnoses including possibility of something else, tests you want to order, explain any medical terminology before patient ask and offer pain medications if patient has pain.
o You should also give patient opportunity to ask question. Patient might ask you challenging question.

1. Tips for CS preparation:
• Which points should I include in my introduction?
• You should greet patient professionally by last name, professional hand shake, your name, your role in the hospital, what you will do in next 15 minutes and offer to ask any questions.
• You should also drape patient at this time.

1. Tips for CS preparation:
• How to better prepare for patient note:
o Patient note is very important sub-component of step 2 CS exam. Please do not ignore it. Prepare it very well.
o It starts from door information. You need to know age, sex, chief complaint and any abnormal vital signs.
o When you ask history, please inform patient that you will take small notes. Patient will never mind.
o Try to remember things if you can, if you can’t remember specific things, write it down in your notepad.
o Organize your thoughts before you start writing PN.
o Always have enough practice for PN


1. Tips for CS preparation:
• How to continue history when patient insists pain medication during encounter.
• In CS exam, you will encounter difficult patient. If patient is in pain, than it would be difficult for him to answer your questions and he will ask for pain medication. It will tests your counseling skills.
• Your should convince this patient to continue encounter. You can say something like this, "Mr. XYZ, I can understand that you are in pain. But to give you right pain medication, I need to know what is causing it. So let me ask you few more questions and quickly I will do physical examination. After that I will give you pain medication. Is that OK with you?"
• Most likely patient will say yes and you can continue encounter.


1. Tips for CS preparation:
• How to answer challenging questions.
1. In CS exam, every case has one challenging question to test your counseling skills.
2. You should remember few points when you answer challenging question.
o Always be diplomatic, never say yes or no to any diagnosis. Exp. A 59 year old female came with blood in stool with strong family history of colon cancer. She asked you, "Doc, do you think, I have Colon Cancer?". Never say yes or no. As you do not know. You need to do physical examination and run tests such as colonoscopy.
o Always offer help when you answer questions. Say something like"Whatever the diagnosis, I will do my best to help you."
o If patient ask about any trip planning before getting full work up. Explain him/her that accurate and early diagnosis is very important and these tests will not take much of your time.

1. Tips for CS preparation:
• Should I take Blood Pressure during encounter?
o You will be given vitals on door information. You should not take blood pressure or any vitals during encounter.
o You should use door information to formulate your differential diagnosis.
o If you think, Orthostatic vital signs is important in your case, write it down in your work up.

Very helpful, thank you!

Thank you for all the help I really appreciate it goldusmlereview was great and also helped me pass thank you so much

You are very helpful thanks

Thank you for information, based on your experience what kind of keyboard did u use in exam? was it a regular computer keyboard with large keys? or laptop keyboard?