Are the SPs nice?

Some examinees said the SPs are very nice and friendly, and they went through the exam in a good mood. Unfortunately they failed the USMLE CS. Others said some SPs are tough and asked them to repeat the question they've asked, but they passed. The SPs are very experienced and well-trained. It is their job to deal with crowds of examinees day after day. I guess they have a clear impression that you will fail or pass after they talk to you and evaluate you. Therefore they may give you some tough time when they think you are good; and maybe very friendly when they feel you are not that great. So, do not be dominated by SPs. Do what you should do, say what you should say.

About communication skills

Communication skills is part of the CIS (Communication and interpersonal skills). CIS is a different category from SEP. Many examinees passed the CIS easily but failed SEP. Also there are others failed CIS and passed SEP. As long as some key points are taken care of and done properly, CIS is easy to pass. Standard patients (SP) pass you on CIS based on the following points:

) introduced yourself, now is your chance to show some smile
) make eye contact. Some say that they are not good at doing this, while it is just to tell the patient by your eye that you are involved in this conversation
) use patient's name Mr. Ms. Mrs.
) express empathy, never forget the patient is here to SEEK help
) conveyed nonjudgmental attitude, avoid judging words like good, great,excellent, instead use all right, okay, thank you
) drape the SP
) use open-ended and non-leading questions, and ask one question at a time

) paraphrase is said to be important to keep the conversation going
) better not interrupt the patient
) use transitional phrases

) use lay language ( imaging studies instead of CT MRI or X-ray, Electrical study instead of ECG)

) summarize history
) gave explanation during physical
) appropriate reassurance
) diagnostic impression in lay language
) discuss the diagnostic tests
) ask if patient had any questions or concerns
) patient educations

Are these difficult to do? Not at all after enough practicing. Show SP your confidence as a his/her doctor and the secret is: practice makes perfect.

two good pronunciation websites

Many people failed SEP. So English can be an issue.

http://www.uiowa.edu/~acadtech/phonetics/#

http://www.howjsay.com/

These two websites are good for self-learning.

There are many accent reduction services that can be googled. They charge big bucks but may not worth it for you. There is no general rule for everyone. Speech pathologists need to develop a treatment plan on a case-by-case basis.

USMLE CS study materials

I went through several materials recommended by the others. Personally I feel two of them are good: USMLEworld website and the book The ultimate guide and review for USMLE step2 clinical skills exam (wow, a long name).

If you just got started, I recommend the USMLEworld. It is complete with all the details from patient encountering to the up-to-date cases. Apparently this is a practial exam and it is not enough to just READ the website, you need to practice at least alone or better with partners.

The book is not just a long name, also a big book with 30 cases. These 30 cases is not even half of the cases on the USMLEworld website, but they are the most important ones. Keep in mind that in the real CS exam 90% cases are common ones and easily diagnosed. Those cases are tested again and again because CS is not a medical knowledge exam. It is a test of your manner as a medical trainee and your English as a FMG. The reason that this book can stand out of the other books is that it fits our learning curve. In each case, just like the exam, in the first place it gives you a door information and let you think what to ask and do after you go into the room. There is empty space therefore you can write down your answers. After that, a detailed answer is given to let you check out your own answers. Generally speaking you need to ask 70% of the history and physical.

There are two books that is smaller but I do not recommend. One is blueprint, which is very little book that can fit in your pocket. The other is Survival guide to the USMLE step2 CS. If you have time you can read it. Definitely you can learn some info.

One more point for Candian board examinees. The Qualifying exam 2 (QE2) is partly an oral exam. The difference from CS is that QE2 is evaluated by both the standard patient and an examiner sitting in the room. The examiners may also ask you correlated questions besides observing you. The book recommend for this exam is called OSCE study guide.

Speaking English Proficiency (SEP)

SEP is a separate category evaluated in USMLE CS. This is about your English itself, and has nothing to do with the content of your speech or your manner. People failed in this part are due to different reasons:

1. Pronunciation. Everybody has accent. Even if you do not have north American accent, it is not a big deal, as long as you can easily be understood, which is the basic requirement for a clinician. However, no matter what your accent is, you have to be accurate. This is everything about proper English, which is the way that English should sound. If you have pronunciation problems, the best way to treat is to see a speech pathologist. A speech pathologist knows how sounds are made by different organs in face, mouth and throat, therefore figures out the wrong sound organs that you used to pronounce. Different native language speakers used different organs to make sounds, therefore there is no general rule to cure everybody. You need to see a speech pathologist on a case-by-case basis rather than a English teacher in a class.
2. Words and grammar. If you read a lot in English, this should not a big problem anymore. However, when you speak out, you also need to speak with proper grammar. Otherwise, even if you pronounce right, it will still cause confusion to native English speakers.

1 and 2 gave strategies to conquer SEP. Bear in mind, language is used for speaking out and needs lots of practice. Neither speech pathologist nor ESL teacher can be your mother's tongue accompanying you. Therefore, the key to success is to find every chance to speak out.

Is Houston the best?

Houston center is so-called the easiest center for FMGs. We got to think twice before we believe some magic or easygoing personality in this center. ECFMG has standard criteria to assess the examinees in all its test centers. The outcomes of each center will be evaluated and statistically adjusted. Therefore the one who gives the final result is not Houston center, it is ECFMG.

Prepare well, behave well, speak well, then any center is the same.