My Step 2 CS experience

I am now relaxing in sunny Puerto Rico but 2 weeks ago I took Step 2 CS!

Scheduling 
I wrote a whole post about scheduling but make sure to register and schedule 4 months in advance at least to get the time you want.

How much time do you need to prepare?
I was nervous if 2 weeks would be adequate because you have 14 days prior to your test date to reschedule without fees but I wasn't going to start studying until 14 days out because I was studying for a shelf. I choose to take Step 2 right after my Internal Medicine core which I believe was a good decision. I was also going to be leaving for Puerto Rico but had a couple of weeks before I started so I wanted to get it done before I left Atlanta, one of the 5 cities it is offered.

Two weeks was a perfect amount especially after completing Internal Medicine where I was taking histories and doing physicals every day. It's all a personal decision. If you feel comfortable, go for it!

Preparing:
It is necessary to have a partner or someone that can help you prepare. I was looking and looking for someone to help me study and my roommate actually saw someone studying the First Aid CS book in Starbucks and approached them and asked if they needed a partner. I was very thankful because it's nice when someone else is preparing as well.

The First Aid for CS was the only book I used to prepare. It's set up really nice. The beginning talks about the exam, the next part is mini cases which just help you practice differentials and work-up. I used these mini cases and made flashcards of a single sentence such as "35 yr old presents with abdominal pain" then listed all the differentials. On the real exam you have access to what the patient came in with on the door before you even go into the room so you should be able to come up with at least 3-5 differentials right away before you even go in and ask your questions accordingly. The last part is 44 full length cases that have the patient responses and allows you to practice with a partner. It also has what the note should look like for that case as well as a sample closure and counseling. It also includes a list of differential diagnosis' and work-up. Do all of these cases at least once to know what type of questions you should be asking!

If you're a mnemonic person there are a ton here http://www.medical-institution.com/best-usmle-step-2-cs-mnemonics/ Honestly, I think they are waste of time because by now you should know what to ask regarding symptoms etc. Spend your time memorizing diagnoses instead of mnemonics.

Exam Facts:
You have 12 cases over an 8 hour period with a break after every 3 cases. You get 15 min to complete a history, physical and then counsel the patient and 10 min to write your note. You can practice typing your notes up on this template which is the exact same as the exam http://www.usmle.org/practice-materials/step-2-cs/patient-note-practice2.html . There is a character limit and line limit for the notes so it is important to practice.

There are usually 2 different times you can schedule your exam, the morning (8 AM) or afternoon (3 PM), they will serve you a light lunch or dinner depending on when you take it.
If you want to become more familiar with the exam, I recommend you watch this video on the USMLE site. They show it to you on the day of as well but it was nice to know everything before. http://www.usmle.org/step-2-cs/#overview

What to bring to the exam:
Your white coat and stethoscope. (They will cover all logos and names with duck tape)
Some energizing snacks to eat during breaks
Tylenol or ibuprofen in case you get a headache
I brought contact solution in case I had a problem with my eyes during the exam
Anything else you think you might need!

My Experience:
I approached the exam as something fun because it is! It helped me not be so nervous and after the first case, it was like talking to all the other patients I had in the clinics and offices. You will do great! Be calm and collected. Inform your patients of the necessary steps you need to take in order to determine was is causing their symptoms and be there to answer any questions! The biggest reason people fail, is they don't take it seriously. Don't listen to people when you hear them say "you don't have to study." You do need to study in order to be prepared and be more comfortable!

Internal Medicine

I'm done with Internal Medicine which means another 12 weeks of rotations completed! I am still in Atlanta at DeKalb Hospital. The first 6 weeks of the rotation was outpatient and myself and 5 other students saw a lot of patients! The second 6 weeks was inpatient and I learned a ton! I wish the entire 12 weeks was inpatient. The attendings challenged us constantly to think outside the box and also make connections. It was a great experience. Every morning we had morning report led by an IM resident in which we would present a case and the group would have to work through it, asking the right questions, coming up with differential diagnosis' and a plan of action. It really made me think about how to approach a patient in an inpatient setting. I have nothing but good things to say about the residents we worked with. I learned sooo much from them! We worked with IM residents as well as podiatry residents that are required to rotate through IM. The attendings would then let us see patients on our own, take a history, do a physical exam and then present the patient to them on rounds. We were required to know up-to-date labs and other information about our patients and it helped us understand management better. We also had weekly lectures over common topics by attendings to solidify our knowledge. Of the 6 weeks inpatient, 1 week of that was spent in the ICU. I really enjoyed my time, learning about end of life care and critical care in general.

I took the shelf, a few days after I finished the rotation. I thought it was challenging. To prepare, I uses Case Files: Internal Medicine and UWorld questions. I tried to read Step Up to Medicine at the beginning because everyone said it is a great resource but I never got through the whole thing due to time but plan to use it more as I prepare for Step 2.

Going forward: I am set to take Step 2 CS in 1 week! I have been crazily studying because I have a few weeks off before I leave for Puerto Rico to start some electives. I always heard that the best time to take CS is right after your Internal Medicine Core or after an ER elective because you have a lot of experience taking full histories and doing physical exams so it's natural at that point. I do feel morning report as I mentioned above helped prepare me for CS. I will post about my experience afterwards in a week!