USMLE Step 2 CS OSCE Exam has 12 OSCE stations with two breaks in between. You will have 15 minutes for each patient encounter and 10 minutes to record each patient note. If you do not use the entire 15 minutes for the patient encounter, the remaining time will be added to the time you have to record the patient note.
The USMLE Step 2 CS OSCE Exam session lasts approximately 8 hours, and two breaks are provided. The first break is 30 minutes long; the second break is 15 minutes long. You may use the restrooms before the exam and during breaks. A light meal will be served during the first break, and there are vending machines available for drinks.
Your USMLE Step 2 CS OSCE Exam includes a very small number of unscored patient encounter OSCEs, which are added for pilot testing new cases and other research purposes.
As USMLE Step 2 CS OSCEs are 15 minutes long, most stations will require more than one task to be completed, e.g. history taking and physical examination, or, history taking and counselling.
In USMLE Step 2 CS OSCE Exam, you will be assessed to the same clinical skills and communications skills which are evaluated in other Objective Structured Clinical Exams (OSCEs).
The testing area of the USMLE Step 2 CS OSCEs clinical skills evaluation center consists of a series of examination rooms equipped with standard examination tables, commonly used diagnostic instruments (blood pressure cuffs, otoscopes, and ophthalmoscopes), non-latex gloves, sinks, and paper towels. Outside each USMLE Step 2 CS OSCE Exam room is a cubicle equipped with a computer, where you can compose the patient note.
Before the first patient encounter in USMLE Step 2 CS OSCEs, you will be provided a clipboard, blank paper for taking notes, and a pen. The examinee instruction sheet gives you specific instructions and indicates the patient's name, age, gender, and reason for visiting the doctor. It also indicates his or her vital signs, including heart rate, blood pressure, temperature, and respiratory rate. You may encounter patient problems or conditions that suggest the need to confirm or re-check the recorded vital signs and/or perform specific maneuvers in measuring the vital signs. In USMLE Step 2 CS OSCEs, you may also encounter a case in which the examinee instructions include the results of a lab test.
In USMLE Step 2 CS OSCE Exam, you should interact with the standardized patients as you would with any patients you may see with similar problems. The only exception is that certain parts of the physical examination must not be done: rectal, pelvic, genitourinary, female breast, or corneal reflex examinations. If you believe one or more of these examinations are indicated, you should include them in your proposed diagnostic work-up.
The USMLE Step 2 CS OSCE Exam, you should perform physical examination maneuvers correctly and expect that there will be positive physical findings in some instances. Some may be simulated, but you should accept them as real and factor them into your evolving differential diagnoses. You should attend to appropriate hygiene and to patient comfort and modesty, as you would in the care of real patients.
With regular patients in a normal clinical setting, it is possible to obtain meaningful information during your physical examination without being unnecessarily forceful in palpating, percussing, or carrying out other maneuvers that involve touching. In USMLE Step 2 CS OSCE Exam, your approach to examining standardized patients should be no different. SPs are subjected to repeated physical examinations during the USMLE Step 2 CS OSCEs; it is critical that you apply no more than the amount of pressure that is appropriate during maneuvers such as abdominal examination, examination of the ears with an otoscope, and examination of the throat with a tongue depressor.
Immediately after each USMLE Step 2 CS OSCEs patient encounter, you will have 10 minutes to complete a patient note. You will be asked to handwrite or type on a computer a patient note similar to the medical record you would compose after seeing a patient in a clinic, office, or emergency department. You should record pertinent medical history and physical examination findings, as well as your initial differential diagnoses. Finally, you will list the diagnostic studies you would order next for that particular patient. If you think a rectal, pelvic, genitourinary, female breast, or corneal reflex examination would have been indicated in the encounter, list it as part of your diagnostic workup of the patient note part of USMLE Step 2 CS OSCE Exam.