Exam Center: Houston Exam Date: 11.August.2006 Result: Passed Weeks for Result: 8 My Experience: As an IMG, I always feared this USMLE component the most ! Every Step examination brings anxiety, but as you struggle with your computer with Step 1 and CK, there's no problem besides a cold sweaty person. Just imagining being confronted with real people (the SP's) and knowing I was going to be video taped made me feel very anxious. And to spice things a little more, the day of my exam I arrived 40 minutes late ! Thought that was it for me (1200 bucks for the exam, another large sum for the airplane ticket, all to the garbage can). Anyway, I found Houston Testing Center to be very friendly (they let me take the test anyway. I think they were waiting for me to show). The exam was designed as it follows: 5 encounters - break (lunch) - 4 patients - break - 3 patients. All the proctors were very friendly, the overall atmosphere was really reassuring. That day we were 23 persons, with 3 or 4 IMG's (including myself). My Advice & My Errors: There's a terrific entry 'bout how to confront the standard patients already posted in DigitalDoc Cs blog. What would I add? Simply try to think of this exam as a practical one. If you face a difficult case, don't think of it throughout the entire examination. This would take down your confidence and attention. Just remember, if it was tough for you, it sure will be tough for everyone. My advice, if you're an IMG, is to practice your spoken english more than anything else !. I did not practice physical exam, and I mean NO physical examination practice. If you're already a doctor, you can save time if you concentrate on your patient encounter first. I remember just reviewing a text of physical exam 2 days before the CS. Again, I must say, spoken English is of capital importance, as I had 3 or 4 patients that posed many questions during the physical exam. Remember, you have 15 minutes to meet the patient, take a note, do a physical and do counseling. If your english is not so good I recommend to take a clinical rotation before. Another advice, know well the testing center location ! Just to avoid that stressful feeling of being late. My errors... well, although I really ENJOYED the exam and was really calm after that, I panicked as I recalled missing the VITAL SIGNS in the first 5 patient notes. Thank God they were normal!. My advice, always copy down the vitals on your notes. As time passes you will probable remember many things you could have written (or typed) for your patient notes, bringing anxiety again as you wait for your results. Don't panic! It is very difficult to come with a complete patient note in a 15 minute patient encounter and 10 minute patient note. Just be logical with your initial diagnosis and for your workup, ask for things to confirm or exclude your diagnosis. My Stay / Cost / Travel to Center: I stayed at Texas Medical Center with a friend who is a PGY-1 at UT (Houston). Name : NochiMD

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