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How To Study and Pass The USMLE Step 2 CS On Your First Try (Top 11 Tips)

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This is a guest post by Eric Brown who is a standardized patient and advises students at NYCSPREP with their Clinical Skills course. In this post, he provides his top tips on how to study, prepare, and pass the USMLE Step 2 CS exam which students take towards the end of medical school.

Take it away Eric!


Many medical students love the USMLE Step 2 CS, where they interact with standardized patients and diagnose their “problems”.

The play-acting element makes this test quite interesting, but that doesn’t mean it’s easy to pass.

And even though you can take it again if you fail, clearing it the first time around gets closer to your goal of a medical career!

Here are 11 easy ways to prepare and ace your Step 2 CS on the first go:

Understand Your USMLE CS Score:

Familiarity with the scoring system and pattern for Step 2 CS can help you plan your study effectively.

The test is divided into three parts, each scored pass/fail, and you need to pass all three to pass the USMLE Step 2 CS:

SEP, or Spoken English Proficiency

This assesses your command of the spoken English language, measuring clarity, pronunciation, word choice, and how easily patients can understand your questions or statements.

ICE, or Integrated Clinical Encounter

This assesses your skills in terms of collecting and interpreting data during physical exams, and rates the content on the Step 2 CS patient note you feed in after the physical exam.

CIS, or Communication & Interpersonal Skills

This assesses your communication and soft skills, including how well you provide information to patients, whether you put them at ease, helped with making decisions, etc.

Avoid Multiple Resources

Relying on too many study resources will just leave you overwhelmed. The only primary resources you really need are mentioned in the following tips!

Use First Aid To Pass The USMLE Step 2 CS

This book includes detailed sample test cases for every major disease in America, perfect for practicing with other students.

Go for the latest edition, since it’s updated once in a while. Get it here.

Step 2 Clinical Skills (CS) Content Description and General Information – Written by the authors of Step 2 CS, this manual covers content, scheduling, scoring and everything else you need to know about the test. Get it here.

Opt for “Live” Practice

Rather than practicing over a video chat or phone call, work on sample test cases in person with other medical students, family members and friends.

This way, you can try out your communication and interpersonal skills before facing standardized patients during the actual test.

Use a Step 2 CS Timer

Since the official test will be timed, with 15 minutes allotted to interacting with the patient and another 10 minutes for typing your note, practice with the same limits.

Using a timer to simulate the real exam will help you develop a focused approach, manage time better, and beat stress.

Practice with Flash/Note Cards To Pass the USMLE Step 2 CS

Practice the long cases in First Aid for USMLE Step 2 CS with a partner at least twice, and then create flashcards or note cards for all the cases.

Include the patient’s name, age, primary complaint and vital signs on each of these cards, shuffle them and practice again.

Read the Mini Cases

Instead of skipping mini cases, read them as often as possible and go over them again a few days before the exam.

Mini-cases can help you with differential diagnosis, so you stay in control even if the patient’s condition isn’t what you first thought it might be.

Create a Blue Sheet Template

Without a clear and organized Blue Sheet, passing the USMLE Step 2 CS will be difficult.

Create a template and use it with every practice case, and either search for Blue Sheet mnemonics online or create your own to help you memorize which details need to be recorded.

Use Robes or Patient Gowns

During physical exam practice sessions, ask your partner to wear a hospital gown or robe so you can seek permission for lowering, untying and shifting the gown.

This will help you remember to ask these questions as well as become more comfortable with them.

Be Courteous & Respectful

Treat your practice sessions the same way you would the official test, by building a doctor-patient relationship during each case.

Smile and make eye contact with your “patients”, listen carefully to what they say and don’t interrupt while they’re speaking.

Practice Typing Up Notes

You may type fast, but you also need to be accurate on your notes since the exam doesn’t have spellcheck!

Typos and errors will be penalized, so use the official USMLE note template and a timer after each case to practice typing patient and case details.

Simulate a Full USMLE Step 2 CS Test

Step 2 CS can be tough if you haven’t developed the stamina for it.

To prepare for the real thing, select 12 sample cases you found most difficult and perform them a few days before the exam, with the same time limits and allotted breaks that you would face on exam day.


There you have it! Thank you Eric for providing us important tips on how to study, prepare, and pass the USMLE Step 2 CS exam

Comment below if you have any questions. Below you can learn more info about Eric and how you can get in contact with him for more assistance.

Until next time my friends…


Author Bio:
Eric Brown is a standardized patient (SP) who lives in New York and advises NYCSPREP with their Clinical Skills course. He has a BA from a liberal arts college in the northeast, where he majored in the theatrical arts and business (he credits the first for his ability to simulate real patients). He’s amassed years of experience as an SP and keeps up to date with CS exam expectations, trends, and developments. When the Phillies are in town, Eric considers it his duty to support his home team. He won’t be seen without his trusty catcher’s mitt on these occasions and prides himself on having caught more than one foul ball with it. If you have any questions about standardized CS exams or courses at NYCSPREP, email Eric at [email protected] or visit www.nycsprep.com.

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