First Aid for the USMLE Step 2 CS

Section 4. Practice Cases

This section consists of 44 commonly encountered cases that approximate those you might find on the actual USMLE Step 2 CS exam. Each case consists of four parts:

1. Doorway information sheet: Designed to simulate the actual information that you will find on the doorway of each examination room, this sheet contains the opening scenario, vital signs, and the tasks you are required to perform during the exam. You should read this sheet just before starting the 15-minute encounter.

2. Checklist/SP sheet: This sheet outlines information that standardized patients (SPs) will use to guide them during the interview and lists questions SPs might ask you, along with potential responses to these questions. It also includes a sample checklist that SPs will use to evaluate your performance in the areas of entrance, history taking, diagnosis, closure, and follow-up recommendations, as well as your ability to conduct a patient-centered interview.

3. Blank patient note: A blank form is supplied on which you can write your own note after you complete the patient encounter. In accordance with recent exam changes, this form includes blank matrices that you can use to outline the three most likely differential diagnoses; the history and exam findings that support each; and the initial testing modalities that you have proposed to establish a definitive diagnosis.

4. Sample patient note and discussion: This sheet includes a sample patient note for you to review after you have written your own, as well as a discussion of reasonable differential diagnoses and diagnostic tests to consider in each case.

Because the cases in this section are designed to simulate the actual exam, you will derive the most benefit by practicing them with a friend who can act as an SP. To maximize the effectiveness of these practice cases, you should also time each encounter in accordance with the guidelines provided in Sections 1 and 2 and compare each of your patient notes with those provided in the text.

For a quicker self-review, you can try to formulate a patient note after reviewing the doorway sheet and the SP checklist, and then compare your note with the sample note provided.

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