you know how pass USMLE?

Answer 1

Hi, you really have to prepare for this exam


Make a schedule!! Its very important that if you start with a prepared schedule to stick with it from start to finish.

Kaplan is a great resource, depends in how you learn. If you learn taking classes, then take a course with Kaplan or buy their videos. If you learn reading yourself, then buy the books.
Q-Bank is a most!! (from Kaplan)
First Aid is a most!!
They have usmle world (practice question) (much cheaper, but kaplan is better)
Try to do at least 50 question per day to practice.
Other resources are: BRS, and High Yield of every classes.

The NBME offers a series of exams to practice. They have one for free and I think it has 150 questions.

usmleforum.com and valuemd.com have a lot of inside from students from other countries.

The exam is divided in blocks of 50 question (total of question is 350). You have 8 hours ( and 1 hour of break to eat :) and clean your mind between blocks)

After the exam, RELAX!!!


Well I hope I can help you. Good luck with your exam.

GB

Bye!

Source(s):

http://www.valuemd.com
usmleforum.com

Answer 2

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Answer 3

Hi, good luck with Step 2 here are some things I think are important in taking the test. It seems that over the years the Step 2 has gotten away from its initial emphasis on medical knowledge (although this is still important - you don't want your differential diagnosis to be gout if it looks like lung cancer, for example) and more on establishing a good relationship with the SP. You need to practice with a native speaker. Reading First Aid or Blueprints is good, but you need to practice.

Be organized! Think of the USLME test in 8 steps:

1. introduction (see below)
2. history taking
3. physical exam (be sure to ask permission and wash your hands!)
4. summary of history and results of the physical exam
5. differential diagnosis
6 diagnostic work up
7. advice (smoking, condom use, diet, etc)
8. "Do you have any questions or concerns?"

Good luck and take a look at this below:


PART 1: QUESTIONS

The most important aspect of the CSA from a language standpoint is the ability to ask good questions. Let’s group them in categories:

Introductions


1. Thai family names can be a bit daunting to western ears. Use a first name if it is easier. Dr. Somchai is a little easier than Dr. Sukawatanangkul. In addition, tell the SP you are a doctor in this hospital. Don’t forget to look the SP in the eye – eye contact is very important!

2. After your name and greeting the patient by name and the obligatory handshake:

- “How can I help you today?”
- “What seems to be the problem?” (‘do not say ‘your problem’)
- “What can I do for you today?”

An example of a good intro would be:

“Hello, Mr. Smith, I’m Dr. Brown. I’m a doctor in this clinic. How can I help you today?” (hand offered for handshake)

At this point, cover the SP with the drape that should be laying nearby. Remember always to cover the patient and only reveal as much skin as is needed for the physical exam.

3. Keep this short! Your job is to introduce yourself to the SP. This is a chance to start the relationship building that is so important in this test. Do not say “Hello, Mr. Thaksin, I’m Dr. Dwight. I’m a doctor in this clinic. I will ask you some questions, give you a physical examination, offer a diagnosis and treatment plan and answer any questions. What brings you here?” KEEP IT SIMPLE, INCLUDE THE MAGIC 4 (SP’s name, your name, your job and asking about chief complaint) and be friendly!


History Taking

‘To be’ or ‘to do’?

In questioning, often these two verbs get confused. They are different and it’s important to not get them mixed up. But remember, for most information, you can use either ‘to be’ or ‘to do’ depending on how you ask the question. A good grammar book will help make this clear.

“Are you…” questions often relate to what someone is or a condition someone has. They can be used for present continuous questions:
“Are you taking any recreational drugs?”

Or they can be used for conditions:
“Are you allergic to any medication?”

“Do you…” questions often relate to actions. “Do you take any recreational drugs?” “Do you know if you are allergic to any medicine or drugs?”

Questions about ‘who, what, why, when, where and how’.

‘Who’ (family medical histories, for example):
“Does anyone in your family have this problem?”
“Is anyone in your family suffering from this problem, too?” (current ailment, such as infectious disease.)

‘What’ ( a wide variety of questions use what: “What do you do?”, “What do you eat?”, “What medications are you taking?”

‘Why’ – in addition to “Why are you here?”. ‘why’ questions are used to look for reasons SPs do things.

‘When’ – “When did you first notice this rash?” ‘When’ questions can also be “how often’ questions. For example, “How often to do move your bowels?”

‘Where’ – primarily location questions, either of a symptom, “Where is the pain?” In addition, ‘where’ questions can be used for environmental questions, such as “Where were you when you noticed this?” and “Where do you work?”

‘How’ – wanting to know reasons for an occurrence. “How did injure your hand?” Also used for time, “How often do you urinate?”; amount “How much coffee do you drink?” or “How many cigarettes do you smoke a day?”

Pain(ful) questions:

There are several questions that seem to be linked with pain and aspects of pain. First, let’s talk about ‘pain’.

Pain is a noun. (“I have a pain in my leg.”) or from you, “When did your pain begin?” or “How long have you had this pain?”

‘Painful’ is the adjective. (“My leg injury is very painful.”).

‘Hurt’ is a verb. (“My leg hurts.”) or from you, “Please show me where it hurts.” It can also be used in this way “I hurt my ear last night.” (speaking of an injury).

The linked questions for the CSA for pain are pretty straightforward and if you use them, you should be able cover the checkpoints for pain on the CSA exam. They are:

1.“How long have you had this pain?” (duration)
2.“Where is the pain?” or “Can you show me where the pain is located?” or “Can you show me where it hurts?” (location)
3.“Can you describe the pain?” or “Can you tell me how it feels? Does it ache or throb?” (quality, such as aching, burning, throbbing) I think that using the “Can you describe the pain?” is better as it is an open ended question. If the SP acts as if he or she doesn’t understand, then give some examples.
4.“Has it moved or spread?” or “Has it spread anywhere else?” or “Is it only located in this area?” (pointing or indicating painful area) (radiation)
5.“On a scale of 0 to 10 with 10 being the most painful, how would you rate the pain?” (severity)
6.“What makes it better?” or “What can you do to make it feel better?” (alleviation)
7. “What makes it worse?” (aggravation) These two, 6 &7, are linked and should be asked one after the other.
8.“Is it getting worse?” or “Is it feeling better?” (progression)
9.“Is the pain constant, or does it come and go?” (constancy)
10. “Did it come on suddenly or was it gradual?” or “Was the onset gradual or sudden?”
11. “When you get/have this pain, are there any other symptoms that you get?” (associated symptoms)

Ill contacts- If you need to ask if the SP has been in contact with anyone with a specific disease, the question is:
“Have you been around anyone with (disease name) or similar symptoms.”
or (especially with children)
“Has (use child’s name here) been around anyone who is sick at home or at school?”


The Physical Examination


GENERAL COMMENTS AND SUGGESTIONS

I’m an English teacher but in my 57 years, I’ve had several operations, had several hospital stays (including Japan where you need to take your own chopsticks to the hospital if you are an inpatient!), seen doctors hundreds of times and studied grammar. (Yeah, I know, but this mix works for the CSA.)
I’m not a doctor, you folks are doctors. But I know how I want doctors to talk to me and I know what I want to hear. The clinical aspect of the CSA is your field; the communication part is mine. Hear are some general suggestions for helping you with the test:


1.Good speaking and listening skills. Go to a school, find a tutor, talk to foreigners. Practicing your English skill is paramount!
2.Maintain a positive attitude while taking the test. Don’t get angry, don’t get distracted. Practice! You can’t fake knowledge of English and it is very important to watch and listen carefully to the SP as everything the SP does has meaning. Get the history, do the examination, counsel and advise the patient as if he or she was a family member. And remember this is an act! You must think like an actor!
3.Maintain eye contact! Don’t look around the room; patients like to think (SPs, too) that you care about them. It is important to develop a rapport with the SP. Some examinees ( i.e., you) have not done so well because they did not listen carefully and did not show the SP that they cared about the SP’s problems and concerns. This is very important! And don’t repeat questions. Listening skill means just that: listening. If you ask for information you have already gotten from the SP it looks like you were not listening.

4.Keep your questions orderly; think about grouping your questions: pain questions, personal habit questions (smoking, drinking, eating, using recreational drugs), sexual questions (sexual activity, sexual partners with regard to sex, number and frequency), questions about medication.

5.Be sure to counsel about smoking (“Mr. Smith, you need to quit smoking. We have a smoking cessation clinic here at the hospital that can help you quit smoking.”), drinking (look at the CAGE questions) and unsafe sexual activity (Mr. Smith, you must use a condom every time you have sex to prevent sexual transmitted disease and HIV.)

6.DON’T FOR GET TO ASK FOR PERMISSION FOR CERTAIN EXAMS, SUCH AS HIV TESTS, UNTYING THE SP’S GOWN AND DOING THE PHYSICAL EXAMINATION ITSELF!

The Short Answer Part….

Sometimes the SP will ask you “What’s an EKG?” or “What’s Parkinson’s?” You need to give a 10 second response to these questions. Here are some examples:

1. “What’s an ultrasound?”, “What’s a sonograph ?”
“It’s like an x-ray but it uses sound waves to get a picture of your abdomen ( or wherever). It doesn’t hurt and only takes a few minutes.”

2. “What’s an EKG?”
“It’s a test that gives us a picture how your heart is beating. It doesn’t hurt and only takes a few minutes.”

3. “What’s Parkinson’s?”
“This is a disease of your neural or brain functions that affects your movement. It is something we need to watch very carefully.”

4. “What’s a colonoscopy?”(or gastroscope or anything else you insert to look at a patient’s internal stuff)
“We insert a small fiber optic tube into your (wherever you insert it). It’s attached to a camera and it lets us see what’s going on in your (whatever). It may be a little uncomfortable but we will give you something to make you feel better. It only takes a few minutes.”

5. “Do you think it’s (disease name)?”
With this one, I think two approaches are ok:

If you think the SP may have the problem: say, “There’s a chance because you have (history item, “your father had colon cancer”). But we’ll know more when we get the test results back.” SHOW THE SP YOU CARE ABOUT THEM– LOOK LIKE YOU ARE CONCERNED ABOUT THEIR WELL BEING!

If you think the SP may NOT the problem: say “I don’ t think so because your symptoms are different from (whatever). But we’ll know more when we get the test results back.”

NEVER, EVER SAY, “DON’T WORRY.”!!