1. Muhammad Ali Khan M.D.

2. The Exam Overview The Exam Itself How to Prepare Mnemonics for History (made by Adnan Saleem Polani) Pearls for the Exam

3. 5 cities ( Atlanta, Chicago, Houston, Los Angeles & Philadelphia) Schedule the exam 4 to 5 months before the intended date. One year eligibility period, you have to take the exam within it. Choosing the Center and myths about them Preparation time varies from 2 to 4 weeks. Check out the reporting period at www.usmle.orgwww.usmle.org Watch the orientation video at www.usmle.orgwww.usmle.org

4. Orientation of 20 minutes 12 patient encounters An encounter includes History taking Physical Examination Counseling and Conclusion Each patient encounter is of 15 minutes followed by a 10 minute patient note

5. Book to use First Aid for CS Practicing is the key for success Practice preferably with a medical student or doctor. If not the above you can practice with anyone. If you do not find anyone then you may practice in front of a mirror. Do all cases at least twice

6. Doorway information You write down patient’s name, age & chief complaint. Write down the mnemonic. Make four differentials. Knock on the door. Address the patient by his/her name. Greet warmly, shake hands and introduce self by name. Ask the simulated patient (SP) if he/she is comfortable in the room. Drape the patient.

7. Please during the encounter, no matter what goes wrong, do not have this question mark look on your face. Just be CONFIDENT, YOU ARE GOING TO DO WELL.

8. O Onset P Progression F Frequency A Alleviating Factors A Aggravating Factors A Associated Symptoms (Depends on the DDs)

9. P Previous Episodes of this particular complaint. F Fatigue F Fever R Rash A Appetite changes (Diet and Exercise) W Weight changes S Sleep changes

10. R Review of systems (go head to toe) A Allergies M Medications P Previous medical history Previous surgical history Family history

11. Sex Sexual history (Active, Partners within last 1 year, contraception, protection etc.) S Smoking O Occupation D Drugs (Recreational) A Alcohol T Travel L Living condition A Anything else?

12. LLast menstrual period MMenarche PPeriods lasting how long RRegular/Irregular TTampons/Pads (How many ) VVaginal Discharge CCramps in abdomen SSpotting PPap Smear AAbortions PPregnancy

13. BBirth History DDevelopment History IImmunization history DDiet

14. After completing the history (say in 7 minutes), wash your hands. Proceed on to the Physical Examination after taking permission from the patient. Do the relevant system first, then if you have time you can do CVS and Respiratory system examination.

15. Be precise in your clinical methods and do not waste time, there are no findings on the simulated patients. When the 10 minute warning announcement occurs you should be half way through your examination. If you are lagging behind, speed up, you will need time for counseling and closure. Avoid medical terminology.

16. Tell the patient about your initial diagnostic impression and the tests you would like to run. Counsel the patient as required for Smoking Alcohol consumption Safe sex practices Social issues In the end ask the patient if he/she has any questions for you. Shake hands and say good bye.

17. Relax the day before the exam (do what you like & enjoy). Book a cab the day before your exam. Reach the exam center one hour before the mentioned time. HOLD YOUR NERVES. Most important thing in the encounter is to finish it with adequate counseling. It does not matter if you mess up a case or two or even three, just keep on telling yourself that you will pass.

18. Just be yourself and you will see how things click for you. Confidence is the key. You should be polite and smile (but not excessively). Show empathy to the patient. The best time to take CS is when you go for electives in final year.

19. Feeling sad or after the exam???????????? It is PERFECTLY NORMAL!!!!

20. Thank you