Step 2cs December 2018 score release

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AMG 4th year here. Decided to start this for anyone stressing during the ridiculous waiting period for step 2 cs! I made a post about some of the things I did wrong, then deleted it because no one can tell me if I failed or not. Also, people telling me to not stress because I will more than likely pass was also not helpful as we all know someone who “surprisingly” failed. I’ve been losing sleep since test day since at this point I’m convinced there’s no way I passed and wishing I can just take it over one more time. Also really bummed about continuing interviews at this point. So for anyone in my position, you’re not alone! here’s to positive thinking and relaxing thoughts until dec 12 2018!
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Guys don’t wait for the email. Go and check on OASIS (for IMGs). My score report was not up by 8:50 but it was up at 9:00 sharp! Got the email at 9:15 though. Passed!! ThankGod!
 
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Reperfused said:
Guys don’t wait for the email. Go and check on OASIS (for IMGs). My score report was not up by 8:50 but it was up at 9:00 sharp! Got the email at 9:15 though. Passed!! ThankGod!
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Nothing on OASIS or on the email :(
 
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Reperfused said:
Guys don’t wait for the email. Go and check on OASIS (for IMGs). My score report was not up by 8:50 but it was up at 9:00 sharp! Got the email at 9:15 though. Passed!! ThankGod!
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Congratulations!!!
 
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It's already 8:40am here in Chicago. How much longer should I bother waiting for the email/ score report today?
 
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If FCVS still Undetermined does that mean we will get results next Weds? Is there a chance that I can still get an e-mail from ECFMG today?
 
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dwijeshsheth said:
If FCVS still Undetermined does that mean we will get results next Weds? Is there a chance that I can still get an e-mail from ECFMG today?
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I think it'll be next week, but we didn't find out about this FCVS trick until this reporting cycle so no one really knows. I got updated on FCVS on Monday and got my score report today so I'm assuming no FCVS means no score report.
 
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88Doc said:
I think it'll be next week, but we didn't find out about this FCVS trick until this reporting cycle so no one really knows. I got updated on FCVS on Monday and got my score report today so I'm assuming no FCVS means no score report.
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Thank you. This is so annoying!
 
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F*** Monday is Christmas Eve. Talk about the best/worst Christmas ever...A lot riding on this exam! USMLE are savages
 
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Hi Guys, IMG, just got my result , failed step2 CS on my second attempt , failed ICE twice , both at ATL center. I already passed step 1 and step2 CK . I'm so depressed and hopeless guys, please give me some advices , I tried everything already , including CS prep class . Please ,help me guys !
 
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carnitine shuttle said:
Hi Guys, IMG, just got my result , failed step2 CS on my second attempt , failed ICE twice , both at ATL center. I already passed step 1 and step2 CK . I'm so depressed and hopeless guys, please give me some advices , I tried everything already , including CS prep class . Please ,help me guys !
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First off, I'm sorry man this test is just the worst. I'm retaking and still waiting on results so trust me I feel your heart ache. You could try practicing your note, differentials, and PE. I would take the test again at another site. I've heard Chicago and LA are chiller but that could be a biased view. Have someone check your note and how you do PE. Hope that helps.
 
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Received my report and failed ICE. Passed the other 2 components with high performance in both. Please I need suggestions on how to work on my ICE.
 
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got official fail today. CIS passed high performance. ICE was so borderline! even had some ticks in the higher performance, all borderline shaded and one too many ticks in low performance.
 
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medicabcde said:
Received my report and failed ICE. Passed the other 2 components with high performance in both. Please I need suggestions on how to work on my ICE.
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how is your physical exam? i heard now that SPs no longer checklist your H&P only physical. for my test i know mine was very weak and contributed to my fail.
 
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Singhp03 said:
First off, I'm sorry man this test is just the worst. I'm retaking and still waiting on results so trust me I feel your heart ache. You could try practicing your note, differentials, and PE. I would take the test again at another site. I've heard Chicago and LA are chiller but that could be a biased view. Have someone check your note and how you do PE. Hope that helps.
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Thanks for replying and for your advice. For the notes , I thought everything was Ok , I had 3 DD for the majority of them . This 2nd failure hurts me a lot , I don't even know where to start but I will definitely try one more time at a different center. Good luck for your result , I truly wish you the best.
 
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carnitine shuttle said:
Hi Guys, IMG, just got my result , failed step2 CS on my second attempt , failed ICE twice , both at ATL center. I already passed step 1 and step2 CK . I'm so depressed and hopeless guys, please give me some advices , I tried everything already , including CS prep class . Please ,help me guys !
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Hey if you need help pm me. Dw you’ll get it
 
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carnitine shuttle said:
Thanks for replying and for your advice. For the notes , I thought everything was Ok , I had 3 DD for the majority of them . This 2nd failure hurts me a lot , I don't even know where to start but I will definitely try one more time at a different center. Good luck for your result , I truly wish you the best.
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Sorry your going through this. But for future references, some things I learned from my friends that had taken the test before me in regards to ICE:
1. Having 3 DDs doesn’t necessarily mean a good thing. If you put a DD for the sake of having 3, but its very unlikely, that could actually result in lower score. A lot of people I know had 2 DD for a few cases, and 1 for a few others.
2. Writing in medical terminology its a big deal.
3. For the major system of the case in PE writing more specific things its better, vs writing Heart was normal.
4. The order of your DDs and follow-up labs does matter. But putting some expensive labs when not necessary (like an MRI) could also result in a lower score.

Hope this helps, even if a little. Stay strong!


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csblows said:
how is your physical exam? i heard now that SPs no longer checklist your H&P only physical. for my test i know mine was very weak and contributed to my fail.
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Thinking back, I probably rushed most of my PEs because I wanted to finish before time ran out.
 
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Tarasoff21 said:
Sorry your going through this. But for future references, some things I learned from my friends that had taken the test before me in regards to ICE:
1. Having 3 DDs doesn’t necessarily mean a good thing. If you put a DD for the sake of having 3, but its very unlikely, that could actually result in lower score. A lot of people I know had 2 DD for a few cases, and 1 for a few others.
2. Writing in medical terminology its a big deal.
3. For the major system of the case in PE writing more specific things its better, vs writing Heart was normal.
4. The order of your DDs and follow-up labs does matter. But putting some expensive labs when not necessary (like an MRI) could also result in a lower score.

Hope this helps, even if a little. Stay strong!


Sent from my iPhone using SDN mobile
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Thanks a lot . I will try a new approach for the patient notes , I failed ICE twice, definitely something is not working for me.
 
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carnitine shuttle said:
Hi Guys, IMG, just got my result , failed step2 CS on my second attempt , failed ICE twice , both at ATL center. I already passed step 1 and step2 CK . I'm so depressed and hopeless guys, please give me some advices , I tried everything already , including CS prep class . Please ,help me guys !
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I'm sorry about your results, it's a tough exam but hang in there. Did you fail the same component of CS? If you need someone to talk to, you can pm me
 
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Sorry for the results for ones who failed ICE during this cycle. First, think about the your approach to the the encounters:
1. Is your typing speed up? Above 50 words / min may be enough though many private coaches welcome above 60/minute( are you able to type case 11 and 22 on FA in 8 to 9 minutes - case on 62 yo with hoarseness and 53 yo with intermittent dizziness, word for word) ,are you quick in copy and paste without deleting your typed work! Type your differential first , then few tests, most relevant and significant , then exam// upto this point you have used 4 to 4 1/2 minutes, dont use more on this// and then move to hx. Lastly copy and paste supporting evidence or type if fast enough . Always do GA and copy vital signs . I copied all VS into exam portion and first part of description of patient into start of HPI with the name and age and all , then give my c/o in second line medical terminology wherever possible. My coach made sure i did this and upped my typing speed even before she made me practice any case. Being an IMG , my typing was about or below 39 / minute before and my tutor was very sure I won't pass ICE with that!
2. Did you give fluent instructions during exam? If no instructions, no mark.
3. Giving instructions or telling your patient about next step helps that you are not causing discomfort trying to elicit signs. Any discomfort caused during exam like deep maneuvers is fail. Do not also repeat any painful maneuvers
4. Was in same center , and in many cases I did not have third differential but mostly were 2 yet got ICE far to the right.
5. How is your data collection: mnemonics .Be careful with ROS, let it be complete even if you have three differentials , social and family hx , sex , meds and allergies . They are not forth coming if you don't ask and may help change the diagnosis or reduce to two. 2 cases had to change DDx after fhx and around 3 cases on asking about sex hx. They are now tricky at Atlanta.
6. Do self mock exams before the exam . Did 3 times each 12 cases a day spaced with rest in between days and within 2 weeks to exam . Refine your exams, time them at max of 3 to 4 minutes. Used pillows for all my mocks but i recorded my self in a few difficult cases especially CNS exams and fatigue and weight changes. It will be well, my friends! Mocks are just like NBMEs.
7. During exam 2 students started to cry during the exam after the second encounter , they were AMGs and others tried to calm them down during the breaks. The preceptors never uttered a word. Take it serious. Even if you go for preparation courses , as an IMG you have to practice your typing and SEP many months before! I dont have AMG experience, therefore , I am not sure of their weaknesses.
 
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Bapngo said:
Sorry for the results for ones who failed ICE during this cycle. First, think about the your approach to the the encounters:
1. Is your typing speed up? Above 50 words / min may be enough though many private coaches welcome above 60/minute( are you able to type case 11 and 22 on FA in 8 to 9 minutes - case on 62 yo with hoarseness and 53 yo with intermittent dizziness, word for word) ,are you quick in copy and paste without deleting your typed work! Type your differential first , then few tests, most relevant and significant , then exam// upto this point you have used 4 to 4 1/2 minutes, dont use more on this// and then move to hx. Lastly copy and paste supporting evidence or type if fast enough . Always do GA and copy vital signs . I copied all VS into exam portion and first part of description of patient into start of HPI with the name and age and all , then give my c/o in second line medical terminology wherever possible. My coach made sure i did this and upped my typing speed even before she made me practice any case. Being an IMG , my typing was about or below 39 / minute before and my tutor was very sure I won't pass ICE with that!
2. Did you give fluent instructions during exam? If no instructions, no mark.
3. Giving instructions or telling your patient about next step helps that you are not causing discomfort trying to elicit signs. Any discomfort caused during exam like deep maneuvers is fail. Do not also repeat any painful maneuvers
4. Was in same center , and in many cases I did not have third differential but mostly were 2 yet got ICE far to the right.
5. How is your data collection: mnemonics .Be careful with ROS, let it be complete even if you have three differentials , social and family hx , sex , meds and allergies . They are not forth coming if you don't ask and may help change the diagnosis or reduce to two. 2 cases had to change DDx after fhx and around 3 cases on asking about sex hx. They are now tricky at Atlanta.
6. Do self mock exams before the exam . Did 3 times each 12 cases a day spaced with rest in between days and within 2 weeks to exam . Refine your exams, time them at max of 3 to 4 minutes. Used pillows for all my mocks but i recorded my self in a few difficult cases especially CNS exams and fatigue and weight changes. It will be well, my friends! Mocks are just like NBMEs.
7. During exam 2 students started to cry during the exam after the second encounter , they were AMGs and others tried to calm them down during the breaks. The preceptors never uttered a word. Take it serious. Even if you go for preparation courses , as an IMG you have to practice your typing and SEP many months before! I dont have AMG experience, therefore , I am not sure of their weaknesses.[/QUOTE
Thank you for your insight. My typing speed is about 60 WPM , with that I was able to finish on time all my notes . I pass CIS and SEP , both times, but not ICE ,I guess I have some irrelevant DDs. Also I remembered , at least 2 SP kept answering no , no for almost everything I asked them, could not figure out the DDs in those cases. Hopefully , I will able to turn this around the next time.
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After failing CS twice because of ICE , using FA 5th edition and Amboss cases , what would be the best resources to prepare for CS? Should I use FA 6th edition instead of the 5th , any difference?. What else can I use to support my DDs and help me pass ICE ? any idea will be helpful , especially from those who pass with comfortable margin. Thank you guys for your input , I feel already better to tackle this exam one more time.
 
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carnitine shuttle said:
After failing CS twice because of ICE , using FA 5th edition and Amboss cases , what would be the best resources to prepare for CS? Should I use FA 6th edition instead of the 5th , any difference?. What else can I use to support my DDs and help me pass ICE ? any idea will be helpful , especially from those who pass with comfortable margin. Thank you guys for your input , I feel already better to tackle this exam one more time.
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I failed the first time due to ICE, and this is what I did differently the second time (and passed). I did all the mnemonics for ROS, but I also made sure to ask very specific questions that I could use to tease apart my top 3 differentials. Based on the SP's response to those specific questions, I spent more time and effort trying to figure out what the best top diagnosis was. Asking these specific questions in the short amount of time and trying to rule in/out differentials while talking to the patient made me realize how I underestimated and approached the exam wrong the first time. It's a ridiculous exam that I hope one day disappears, but this is what I did differently. Hope it helps.
 
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as an AMG i can tell you the AMG culture approaches CS as the "english test" even still. Any time i would tell friends or residents i was studying for cs they would ask why. I severely underestimated this test and prepared maybe 4 hours total. This was a good lesson for me to learn honestly. any AMGs that see this please treat this like any board exam. i realize now its probably the most important.
 
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carnitine shuttle said:
Hi Guys, IMG, just got my result , failed step2 CS on my second attempt , failed ICE twice , both at ATL center. I already passed step 1 and step2 CK . I'm so depressed and hopeless guys, please give me some advices , I tried everything already , including CS prep class . Please ,help me guys !
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So sorry to hear you failed twice. What are your step scores and yog. I am an img failed first attempt in sep but had boarderline performance in ice. But second time I passed with high performance in ice and cis. So you can message me so that I can help you with what I did different second time than first time. What I have realized that there are different factors for ice like good Hopi, documenting sufficient information from history,good physical examination and relevant differentials.
 
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In my case I didn’t do Physical exam in one patient because I didn’t read the front door information properly and misunderstood that physical exam is prohibited. Do I have a chance to fail by this
 
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Kunju said:
In my case I didn’t do Physical exam in one patient because I didn’t read the front door information properly and misunderstood that physical exam is prohibited. Do I have a chance to fail by this
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It will definitely result in a lower score, but from that one thing alone I don’t think they’ll fail you.


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Kunju said:
In my case I didn’t do Physical exam in one patient because I didn’t read the front door information properly and misunderstood that physical exam is prohibited. Do I have a chance to fail by this
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They throw away 2 cases. So only 10 count!
 
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EnigmaEri said:
Hey man, very sorry to hear that. This exam is not indicative of what kind of doctor you will be. Hence why program only care that you get it over with and not the number of attempts you have. Keep your head up. I took the NYCS course and got all the notes will get you points. PM me and we can go over things. YOU WILL PASS. Trust yourself and remember this is a bump in the road.
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i appreciate it! i think i'll have to shell out the extra thousand and do the NYCS prep. wish i had done it earlier instead of wasting time/money on other resources. i agree that it is definitely not at all indicative of what kind of resident/doctor one can be. Just been very discouraging knowing that my chances of matching after all this may be non-existent.
 
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IMlife7861 said:
Don’t let your self down. Are you failing the same component each time? Did you take the exam at 3 different places?
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failed ICE all 3 times. basically did high performance on the other two categories. worked really hard on perfecting my notes this last time. typed up all the cases from FA and a good number from amboss and other sources and was doing just fine. test day was a whole different story. had very difficult/random cases. had one where the patient was deliberately messing with me during the interview. can't give info on here but i'm sure you get the picture.
 
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csblows said:
got official fail today. CIS passed high performance. ICE was so borderline! even had some ticks in the higher performance, all borderline shaded and one too many ticks in low performance.
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Same! I think someone was kind to me because I JUST passed ICE like by two tick marks or something.
 
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Friend just failed CS. Took mine in November and now I’m worried. For one patient all I did was counsel/discuss/physical exam without cardiac/lung and never got any social/family/etc. it was a patient going through physical abuse and I felt that was more important than checking boxes. Basically I totally screwed up this encounter but documented appropriately and stated I would obtain at follow-up appointment. Differentialvwas basically only abuse from what I remember. How screwed am I from this one case..
 
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chromuffin said:
Friend just failed CS. Took mine in November and now I’m worried. For one patient all I did was counsel/discuss/physical exam without cardiac/lung and never got any social/family/etc. it was a patient going through physical abuse and I felt that was more important than checking boxes. Basically I totally screwed up this encounter but documented appropriately and stated I would obtain at follow-up appointment. Differentialvwas basically only abuse from what I remember. How screwed am I from this one case..
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You definitely don’t have to be perfect, I suspect you could totally botched a case or two and still pass. But there’s literally nothing you can do about it right now. Maybe pretend you’re waiting on the pathology from your tumor biopsy rather than your score; at least you’ll have something to show for your worry (more empathy).
 
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As promised, here was my experience: Passed Step 2 CS. Took it in philly on 9/10. AMG. Score was released in the second week of the reporting period at 11am EST. Permit disappeared after 9pm EST the preceding Sunday. FCVS stated pass on Monday morning.

ICE had several stars in borderline, while CIS and SEP were high performance. I found this strange because I felt that my notes and differentials were all of high quality, and was definitely more concerned about CIS coming out of the exam. Perhaps I was dinged on physical exams, because I only prioritized what I thought was absolutely necessary (did not listen to heart/lungs at all stations, minimal exam maneuvers at some stations) and focused more on thorough histories, "tell me your concern" type questions, and closures. Although this does give me confidence in the conclusion that this exam is sort of bulls*** because I behaved exactly the way I do in my hospital's ED (in terms of history, exam, and workup) and am consistently praised in that setting for thoroughness.

I went through about 30-40% of FA in the days prior to taking the exam and practiced 2 cases with a partner the day before. Most of the practice I did was in my hospitals ED/wards floor in the weeks prior to the exam (Sub Is).

Mistakes I remember making (although probably made quite a few more than this):
1) forgetting to provide tissues to a pt that was upset (was such an obvious act, i had trouble taking it seriously)
2) nearly laughing at a patient who told me a very ridiculous history (but i course corrected quickly)
3) running out of time on one station and not being able to close the encounter
4) forgetting to ask key history questions at 2 stations (realized while i was writing the HPI)
5) not copy pasting vital signs into all of my notes
6) providing vague closures at a significant number of stations
 
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For people that passed, in your work up, do you only write investigations only for the differentials you made? Or you can also write investigations for other differentials the patient could have even if they're not among the 3 you wrote?
 
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medicabcde said:
For people that passed, in your work up, do you only write investigations only for the differentials you made? Or you can also write investigations for other differentials the patient could have even if they're not among the 3 you wrote?
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What do you mean by "write investigations"?

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