WHEN YOU SHOULD COUNSEL ON THE STEP 2 CS EXAM

by USMLE Success Academy / Monday, 03 December 2018 / Published in Step 2 CS, USMLE Advice

Students commonly forget to counsel during their Step 2 CS exams… This is usually the result of not paying close enough attention to its importance. If you forget to counsel, you are risking a lot of CIS points on the exam, so let’s ensure that this never happens.

The way we’re going to ensure that counseling never gets forgotten is two-fold…

First, we need a strategy in place so that we NEVER forget to counsel on the Step 2 CS exam. The way this is achieved is at the doorway when you’re writing out your mnemonics (you should be doing this each time).

Right before you enter the room, write the word ‘COUNSEL’ at the bottom of your note as a reminder. If you tend to forget other important steps, such as washing your hands, write that out on your note as well.

Second, we need to know when it should be done, and for that we have 2 options:

1. Immediately when the patient tells us that they drink excessively or smoke cigarettes, or

2. At the very end of the encounter.

Option 1 is easiest because you do it on the spot, whereas option 2 ensures that your SP recognizes that you did in fact counsel. You could take it one step further and do it on the spot, then give them a quick reminder before exiting the room that they should consider quitting and that you’re there to support them when they do.

We tend to recommend counseling at the end for the sole purpose of ensuring that the SP remembers that it was done, however the most important thing is that you actually do it! If you’re efficient in your cases and you’ve got the time, do it on-the-spot and then give them a quick reminder at the end, but if you’re running low on time then choose either option that will ensure you remember to do it.

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