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 video we love making these videos we you know I always 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