Step 2 CS

General Information
The Clinical Skills evaluation of Step 2 is handled by the CS examination. It consists of a timed series of simulated patient evaluations wherein the student is expected to cover the essentials of history-taking, physical examination, and patient documentation. Students are allotted a set amount of time with the patient (15 minutes) during which they are meant to perform the necessary aspects of the patient interview and examine them. After the 15 minutes have elapsed, the student physician is to proceed to a computer station to write a brief SOAP note on the encounter.

Students can typically expect their 12 patient encounters over the course of the day to feature at least one telephone interview, during which there is no physical exam possible, and the assessment is focused purely on the history and SOAP.

For Saba students, one is required to have taken and passed the Kaplan CS Simulation prior to taking the exam proper. The practice CS may only be scheduled after a set number of rotation weeks have been completed, and must be scheduled through the Clinical Co-ordinator. SUSOM is expected to cover the cost of a first-time examination (it has been factored into tuition prices), but repeat exams are the responsibility of the student and must be paid for out-of-pocket.

Day of the Examination
Students are expected to arrive in professional attire and white coat; For male students, this includes the stipulation is that a tie and collared shirt be worn. Nothing beyond a stethoscope is required in terms of medical equipment, as reflex hammers, ophthalmoscopes, tuning forks, and any other tools will be provided by the testing center.

Students are also provided with a clipboard and blank paper on which to record patient notes. As per security requirements, these papers must be discarded after the patient encounter is complete.

Initial Information
Students may expect to receive the relevant vital signs for the scenario prior to entering the patient room. This information also includes the Chief Complaint, and any special instructions for the particular patient (e.g. that there is no physical exam necessary, or that you are meant to convey results of a biopsy).

Approach to the Patient
The first step of the assessment is for the student to introduce themselves as the physician, establish the patient's preferred form of address, and initiate the interview by getting the patient to state the reason for their visit. Simulated hand-washing (via provided hand-washing stations) is also necessary.

SOAP Notes
The resultant note of the encounter is typed into a pre-fabricated template provided by the testing center, where the student is expected to summarise the relevant findings from the physical exam and history, including the pertinent negatives that may be required, depending on the diagnostic scenario (e.g. lack of rebound tenderness if attempting to rule out the likelihood of appendicitis).