02-02-2012, 11:17 AM
Time Management along with professional case taking makes the student to pass CS Exam. Do NOT compromise anything for other as both are deciding factors for passing USMLE clinical skills exam.
There will be 12 Clinical case Encounters in total and you have 25 minutes for each encounter. This includes 15 Minutes for History taking with Standardized patient inside the room and 10 minutes for Patient note typing outside the room.
We have 2 breaks. FIRST after 5th Encounter-30minutes with light snacks and SECOND after 9th Encounter-15minutes
We have to manage our time carefully while dealing with clinical encounters.
There will be 3 announcements with each 15min encounter . They are below in order
1. Examinees you may begin your patient encounter ( 30 seconds before this there will be announcement for SP's to be ready )
2. Examinees You have 5minutes left
3. Examinees You can now leave the room
There will be 2 announcements with each 10min Patient Note. They are as below
1.Examinees you have 2minutes left
2.Examinees please stop typing
Distribute your time wisely. Your encounter begins once you stand before Exam room door after first announcement.
Time distribution for usmle cs case taking for 15minutes duration
1.OUTSIDE the exam door make a note of vital information over blue sheet spending 1minute ( Crucial and worth). After finishing just knock the door 3 times and enter
2 INTRODUCTION to PAMHUGFOSS (History of present illness)spend 6-8 minutes ( This time is very crucial and influence outcome )
3.PHYSICAL EXAMINATION: General+Systemic allot up to 3-4 minutes ( Relatively easy to impress the sp and here you can think inside your brain what to do next)
4.CLOSURE allot up to 2-3minutes (Must for all cases)
Counseling, some students take while asking history and some do it in closures. I recommend to counsel while taking history itself because it makes sense to counsel during history taking and you can avoid forgetting which can happen if you take it at the end. Just prepare standard format and apply for all with minor changes. It hardly takes 1 minute(mostly) to counsel effectively
Next is typing Patient notes on computer-10minutes allotted . Here you better begin as follows
1.DD and work up ( 2-3 minutes)
2.Next Physical exam part (3-4minutes)
3.Finally HPI(4-5minutes)
This strategy was successfully implemented by many students so far. You can do some changes based on your needs. This is just an idea how to manage your time.
While typing PN make sure you check your blue sheet which can make you to enter correct vitals and other crucial information of HPI and PE
Telephonic encounter is also similar to other cases except you dont have PE to do and you talk with caregiver over phone and max time allotted for you is 15minutes.
Try to finish encounter in 13minutes while you practice at home and finish typing in 8-9 minutes while you practice.You can use USMLE PN software for practice at home.
Check details at http://www.usmle.org/step-2-cs/#format
NOTE: For all cases if you finish your encounters with in 15min then you can leave the room and add up that time to PN. But don't compromise on history taking.
CONCLUSION: Time management for usmle cs exam is not easy unless you do live practice with study partner(recommended)/family member/friend. More you practice better will be the results. CIS is vital part and needs lot of practice.
All the best guys !