The article below about clinical skills and the physical exam really caught my interest.

In reading all social media sites looking for information about clinical skills and the Step 2 CS exam, I found a terrific blog about doctor-patient communications!  Go here to find Mind the Gap: Patient Physician Communication. The title of the current article is so good, I will re-post it here: Effective Communications between Physicians and Patients is not Optional…And cannot be Delegated Away.

Physicians as educators. I don’t mean teaching medicine in an academic setting, I mean as educators in each and every interaction with a patient, simulated or otherwise, in a Step 2 encounter, or in your practice.

n the USMLE Step 2 CS exam, the physical examination is part of the Integrated Clinical Encounter (ICE) and is scored by a checklist filled out by the standardized patient.  Although it has been said that the physical examination contributes only about 20% to the ultimate diagnosis, the physical exam still remains as an important data gathering instrument in patient care. 

On the Step 2 CS exam, the candidate walks into 12 different rooms and greets 12 different patients over the course of the eight hour exam. This of course mimics what practicing physicians do every day.

Obviously, if you don’t listen to your patient, or your standardized patient, with an open mind, you will miss cues and clues from your standardized patient.

Students ask us all the time; how do I pass this exam? What is the key? What can I study and then execute?Unfortunately, there is no algorithm for passing the exam, the practical exam. You are dealing with a human being. You can’t just follow a list, or go in with a set bunch of questions.

In continuing our exploration of Patient Centered Interviewing, another terrific article at Mind The Gap — Patient-Centered Physicians Have Lower Diagnostic Testing Costs.  That patient centered interviews are smart financially might surprise some readers, because in general, medical students and doctors may think that a patient centered interview might take more time.