WARNING:: LONG POST!

Hi guys, this page has been so invaluable in my prep and I wanted to say thank you to everyone who answered any of my questions and I want to give back to this community for those who are still on this journey.

Test Center: Chicago, I loved it, SPs were great, played their part well, they weren't always "nice", but I kept in mind that they have a part to play so I didn't take it personally.

I did not take any courses because
a)I could not afford it and
b) I don't think it's necessary. If you find good SPs that aren't afraid to dish out constructive criticism, you should be ok.

Study time: I studied for about a month, I was lucky to have dedicated SPs that I met with almost every day and who would give me honest feedback on where I can improve.

Study materials: FA! Obviously :D I also did cases from Amboss and some from the Kaplan book. Kaplan was very complex and on the real exam I did not find my patients as complicated as in the Kaplan book. I recommend you do a few cases from there to practice time management because their cases are long. I also had note cards with mnemonics that I jotted down from different sources, and I will upload my file with them. I also made note cards of different Chief Complaints with possible DDx, physical exams and workups. I typed the notes for EVERY case I practiced.
My typing speed is normally around 65-70 wmp, let me tell you, on exam day I turned into my grandma with a keyboard. :D Try to find the correct ways to describe physical findings and believe me when I tell you, the SPs WILL have physical findings.

Now here are some of my personal pro tips for test day:

-I tried to be out of the room by 12 minutes because the keyboard at the test center was different from mine at home and I personally found it difficult to "compose" my PN and type it out in 10 minutes. My notes were VERY short and to the point and I always started from the DDx and Work up, then PE, and finally HPI. The Drs checking your PN are "intimately familiar with the case" (according to USMLE website) so I wanted to make sure they knew I ran out of time on HPI (which the SP documents what you've asked), rather than on DDx and look like I couldn't come up with differentials or workup or PE.

• My physicals exams were TO THE POINT, super focused. Took 2-3 minutes max. I ALWAYS started with the most relevant PE, for example, shortness of breath? I did full pulmo first and foremost, then whatever else I deemed necessary like CVS and maybe extremities. Only neuro and MMSE took longer.

• On the patient note I copy/pasted the vitals. Started typing from Ddx and workup, then PE, then HPI at the end.

• CLOSURE!!! I can't stress this enough. Skimp on the PE, but do NOT miss closure.
As I said on another post, this is a real human with a real problem before you.You don't show empathy for repeatedly apologizing to the SP that they are ill, you show empathy by asking questions and responding in a way that makes them feel heard and validated. If they are afraid they have cancer for example, inquire why they think so? Tell them you can see they are worried about this, so it's the first thing you'll rule out. When mentioning different tests, ask if they know what that is or explain in layman's terms.

• I never used the word cancer even if it was my first diagnosis. I always said they could have (second non cancer ddx or third non-cancer ddx), but I also want to run let's say a CXR to rule out something potentially more serious. I did this with my actual patients in my practice, because I don't want my patients to spend the next few days scared shitless they might be dying :)

• Counseling: I know a lot of sources will tell you to counsel during closure, but I counseled the second they told me they smoke/drank/did drugs. I also asked screening tests here and there and counseled getting those. Some of my patients actually told me they want to quit and I said this: "That's great, I'm glad to see you want to take better care of yourself. How about today we figure out what's going on with your current complaint, and then we can meet up again in a week or two to come up with a plan together that will help you quit (smoking/drinking/whatever)?"

• Challenging questions: If you didn't get any on a case that is GOOD NEWS! It means you answered before they could even ask. I had a few cases like that.
For the rest - keep it VAGUE! You haven't run any tests yet, you have no idea what they have/if they will get better/whatever (don't say it like that, I think FA has fantastic examples of how to answer challenging questions, review them.)

• Last but not least: STAY CALM! I'm a nervous test taker and I had a nervous breakdown the morning of the exam, but managed to transform the anxiety into excitement because I get to do the thing I love and it showed. I had A LOT OF FUN during this exam (people who were with me on test day said I was crazy for "enjoying" an exam haha), something I can't say about the other 2 steps. I enjoyed talking to the SPs and getting to know them. You will make mistakes! Don't let that derail you! I forgot to wash my hands for 1 encounter, and remembered halfway through PE. I said "Oops, I don't think I washed my hands, I'm very sorry, let me do that right now!" and my SP smiled and said "It's ok". I forgot to ask some questions and remembered after leaving the room. I just reminded myself that it's not fatal and to focus on the next case.

Ok that's about it. If anyone else has any questions, post them in the comments and I will do my best to answer them! :) I hope I was able to help some people that still have the test and I wish you all luck on this exam and on your journey to residency! :).

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