how's it going guys it's a sign and

Joseph from IMG coaching and the topic

of today's video is about the USM elite
we're going to talk about how its
structured when to take each and every
part of the exam and a lot of the
excuses that people end up coming across
that caused them to either delay the
exam not do well all these different
things so enjoy yo should I get rid of
this eyeglass no they looked up and
we're good so the best time to sit step
one is just after you finished all your
clinical sciences the most medical
students this will be at the end of your
second year usually you'll have about
six six to eight weeks vacation now
you're gonna be tempted you'll be so
attempted to take that time off and go
travel somewhere go and some like
vacation or something like that but you
don't want to do that that is the last
chance you have for a big block of time
to to handle that exam and that's really
what you're gonna need if you want to
succeed at it so do not push it back
make sure that you do it in that
vacation between second and third year
anything you want to add on that
something yeah I would say that you're
never gonna have enough time to do step
one after your clinical rotations start
because a lot of actually in addition to
that a lot of schools will not even let
you start your clinical rotations
till you've completed step one so no
rest for the weary as far as that goes
and when you hit your clinical rotations
you're going to be doing those while
simultaneously studying for step two and
that consists of two parts you have your
step to CS and your step 2 CK now the CS
is more of a practical exam where you're
doing what a doctor does and you're
seeing 12 cases 12 different patients
who are actors like they call them pas
or patient actors or something like that
and your job is going to be to greet
them to take their history and physical
right a patient no diagnose what they
have and give them closure and all these
things so that's a day long exam and CK
is very similar to step one in the sense
that you're taking it in a Prometric
center just like you did for step one
it's nine hours long it's extremely
difficult you feel those nine hours yeah
no joke this is a marathon so ya better
be prepared for that exam you better
have done a couple practice nine hour
exams otherwise feel the burn yeah
you're you're not gonna know who you are
at the end of that but that's normal so
what I suggest to anybody who I'm
talking to or advising about it is you
don't want to study for both of them at
the same time if you chase two rabbits
you lose both of them so for CS I would
say buckle down for five to six weeks
and study for it extremely hard and
ideally it would be during an outpatient
rotation or any sort of rotation where
you're seeing a lot of patients and
you're getting you getting to get those
reps in you're getting to practice your
clinical skills you're doing your
history and physicals your practicing
writing patient notes or something a
good example of a rotation to study for
CS is something like Pediatrics internal
medicine family medicine emergencies
well emergency medicine if you're in a
row
where they're allowing you to write a
lot of patient notes and an example of a
not-so-good rotation to practice for CS
during is surgery or jury or even
psychiatry I mean you're not really
doing a lot of history and I mean you're
doing a lot of history taking but you're
not doing much physical examination
during your psychiatry rotation so I'd
say you know going back I mean wrapping
up the seer stuff and going back to CK
I'd say another pro tip you know I got
to the game late I didn't do C I didn't
do step one until way into my third year
around the air but what helped for me is
as soon as I finished doing step one I
went straight into CK I didn't take a
break that period of my life was like
six months of non-stop hustle every
single day getting up at 4 a.m. like you
wouldn't believe it getting up before I
am studying go into the hospital coming
home sleeping and doing that for six
months and and the reason I did that is
because CK builds off step one so much
death and a lot of it's it's very
similar so you can ride that momentum
from step one and you can make things
easier on yourself a big part of doing
well on CK is having that foundation
from step one I mean on my own exam I
had at least 20 or 30 questions that
were very very similar to what I had
seen on step one the only difference not
going into CK a little bit is that it's
not as cut and dry as step one is so
when step one may ask you what does this
bacterias membrane consists of and you
know that it can only be one thing
because that's what it says in the text
CK is not like that you're not going to
have a very easy time finding one
resource and CK that's able to just be a
one-size-fits-all t-shirt and give you
each and every explanation doesn't work
like that a lot of times it's what's the
next best step in management what's the
next best step in diagnosis and I'm just
going to throw in a little tip in here
when there's a question about what's the
next best step in management you want to
think like a family doctor in a rural
of America where there's not that many
resources maybe maybe there's not a cath
lab there maybe there's not a lot of
nuclear scans so basically the principle
that you want to go into those questions
with is what's the cheapest yeah
quickest and least invasive thing that
you have to do your physical exam is
always the best one if it's the yeah I
mean physical exam could be an answer a
lot of times a lot of times in
pediatrics and OBGYN especially you guys
will see this in your NV mes a lot of
times it's reassurance what's the next
best step in management reassurance like
if a child comes in and we're not gonna
go into this too deeply right now
because we're talking about the USMLE
structure but if a child comes in with a
fever of 104 point one and has a they're
gonna describe it as he has an episode
where his eyes roll back into his head
and he has a shaking movements for about
a minute so your voice sounds like a
febrile seizure
yeah that sounds exactly like a federal
agent oh you're gonna want to think that
this trial is epilepsy and to put it
like kind of China is epilepsy or or put
them on anti-epileptics right away but
that's not the right answer a lot of
times it's reassurance and how does that
fit into that principle that I just
talked about
it's reassurance is the cheapest thing
because you don't have to do anything
besides reassure them it's the quickest
thing and it's the least invasive and
it's the right answers we'll see number
all right answer it's a febrile seizure
so back to CK it's a it's extremely
important to get all this stuff done and
not waste time trying to do two things
at once so do your CS first and clear it
because there's only a few times during
the year that you can take it
CS is administered in I think five
cities just off the top of my head two
of them that I'm gonna name our
Philadelphia Chicago Los Angeles Houston
Houston and yeah I'm not sure if there's
one in New York or not but yeah so these
cities are the ones that are gonna are
gonna be hosting that exam so you want
to do this and do it right the first
time because I know we talked about
doing well on your exams are at the bare
minimum passing them on the first time
but for CS it's so important and if you
fail that matter I am sorry that is like
the biggest red flag you will ever have
I mean because think about a program
director his fear is he's going to get
some for B IMG that doesn't speak
English and has terrible bedside manner
so if you get that if you get that fail
on CS the test of your bedside manner
the test of how will you speak English
I'm in tough luck man you you better
have some great contacts you better
rotated there and have proved yourself
because it's gonna be difficult for you
I mean that's probably the exam that
program directors have the least
sympathy for any applicant failing out
of any of the out of any of these step
exams because it's not like you can give
the excuse that oh I'm not a good
multiple-choice test taker or I'm not
good under pressure or anything like
that it's a practical exam you need to
just be able to you need to be able to
execute on on seeing these patients and
diagnosing them so make sure make sure
that you do extremely well on on that
because failing that is I mean a
professor of mine told me that failing
CS is like the kiss of death for for any
IMG applicant and it's kind of true all
right so let's say to us about it let's
hit up like the number one excuse I
think the pushing back steps especially
CK everyone always thinks that the more
rotations they get under their belt the
better they'll be prepared you know what
I'm gonna push it back to the end of my
third year end of my fourth year because
by then I would have had the experience
I would have seen more patients I'll
have more reference experiences under my
belt and only then will I be ready to
sit the exam and I'm gonna be in an
advantage because I've seen more this is
not the case at all these tests do not
test whether or not you are a good
doctor these tests tests that you can
pass the test that you can take a test
and pass it so what what yosef means by
that is that if you're in more and more
rotations and you're not taking CK you
are getting more reference experiences
but those are not referencing those are
just reference experiences for your life
those are not reference experiences that
are gonna help you accomplish that
immediate goal right in front of you we
only have CK
and the only reference experience you
really want receipt ck to nail it is you
waking up at 4 o'clock in the morning
and sitting at your desk and crushing
out 2 or 3 question banks and then
marking them that is it I mean that is
how you pass step 1 and step 2 multiple
choice questions watching videos doing
like a Kaplan video doing like a
doctor's and training whatever ground a
resource you want to do watching those
videos designed specifically for those
tests and then doing the question banks
and the nvme and all of that that's
what's going to get you I would agree in
the sense that doing questions is
probably unequivocally the best way to
learn new information and you do want to
be doing as many questions as you
possibly can for all of these exams and
I know we skipped over this but we
covered step one step two CS step 2 CK
and step 3 is what you take after you've
graduated and ideally you've already
gone into a gotten into a residency
program by the time that you've written
it so that's kind of like a big deal
right I mean it's a moss it's in your
and you wanna you want to pass it if you
have already gotten in you don't want to
kill yourself and take months and months
and months off to get like a 260 on step
3 that doesn't that's not a good use of
your time
but yeah so step 2 step 3 is very
similar to step 2 CK in the sense that
it covers the same clinical knowledge
but there's an added there's an added
component CCS aware of there's cases
where you have to sort of determine
where or how much time has to go by
before you order a certain test or what
to do at at what time and it's a lot
more precise in the set in the timing
sense then CK is so that's step one
through step three for you guys and yeah
that's that's about it so don't make
excuses
I mean kinda anyone anyone who comes up
with an excuse is in my opinion is not
really taking it very seriously because
someone in a worse position than you has
gotten through it and has done extremely
well so there's no reason
- I mean like it's just white noise that
guys like Joseph and I will tune out and
just laugh at your face like it's not
seriously it's not important you need to
overcome any of those rationalizations
and those excuses that your mind gives
you and just execute those handle inking
just keep taking action and you guys
will do it
alright so hey I hope you enjoyed this
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