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A Standardized Patient’s View on Med Student Patient Encounters in Step 2 CS

A patient's point of view, looking at a doctor A patient's point of view, looking at a doctor

As Standardized Patients (SPs), we go through different stages with you on your journey to be a medical practitioner. We can be huge assets as we help you become the best medical practitioner you can be.

The importance of SPs in Step 2 CS

SPs play a central role in the USMLE Step 2 CS exam for medical students who want to become residents or fellows in the US programs. They mimic real patients in a simulated setup. The patient-doctor encounter is what you may see in a real doctor’s clinic. An SP has to evaluate the medical student as per the technical and qualitative checklist, which the instructors then review and grade. USMLE Step 2 CS measures the student’s ability to obtain the SP’s medical history and perform a physical exam with a strong emphasis on how well the student communicates verbally as well as non-verbally. Step 2 CS also assesses the student’s ability to make the SP feel comfortable, express empathy, make good eye contact, etc.

Here are a few things I would want all the medical students undergoing USMLE Step 2 CS to read before they have a patient encounter. Have a look: 

1. We want you to do well

We invest a lot of time to prepare for each case. Background stories are created for our characters as patients. It’s a lot of work as the program coordinator and the SPs spend days on a case to make it perfect by analyzing it and identifying the loopholes. We put in a lot of effort to fine-tune the answers we plan on giving you as a response to your specific questions because, through our interactions, we want to give you feedback that can help you improve your clinical skills.

2. We pretend, but you need to take us seriously

The best way to crack Step 2 CS is by treating your SP as a real patient. You may know that we are actors, but that doesn’t mean that you take these encounters less seriously. Don’t ask questions that indicate that you are not treating us as actual patients. Don’t lose focus of the program and the encounter.

3. We do not lay traps

If you see us not responding in the way you expect, that’s probably because you are not asking the right questions. The faculty expects you to ask us specific questions and not just general questions. Your questions and our responses are a process to help you organize your thoughts and think critically. The bottom line here is that if you want specific answers from us, you need to ask specific questions. No tricks, no traps, we are just doing our part.

4. We’re all about the connection

It’s easy to make a connection with us when you are relaxed and present. We relate better to your humane side. Engage us at a personal level, make us feel comfortable, and show us that you care. With an encounter so warm and satisfying, we are bound to feel rewarded.

5. We’re not guinea pigs nor dummies

Yes, we are not real patients, we are just pretenders. However, be gentle when you deal with us. Just be your normal self and examine us exactly how would you examine someone you care about. Be kind, patient, and warm. 

6. We all learn through experience

It’s okay if you mess up with an SP encounter. It’s just an exercise anyway and is practice for you before you see real patients. What’s important is the learning you take from these exercises and implement them to build your medical practice. With every exercise or experience with a patient, standardized or real, you are getting better.

A job of an SP may sound easy, but it’s not for everyone. So, the next time you have a patient encounter with an SP, remember these points and you’ll sail through your assessment.

Originally from Philadelphia, Eric Brown is a resident of New York, where he works as a standardized patient (SP) and advises NYCSPREP with their Clinical Skills Course. With many years of experience and industry insight into all things SP-related, he helps students ace their CS exams by simulating patients they will work with. He also remains up to date with expectations, trends, and developments in CS exams, to help NYCSPREP keep its course current. In his free time, Eric likes unwinding by watching baseball and can be found at the game when the Phillies (his home team) are playing. If you have any questions about standardized CS exams or courses at NYCSPREP, email Eric at [email protected] or visit

To go beyond the USMLE Step 2 CS & COMLEX Level 2 PE, we’ve created an entire physical exam series to teach you the skills that will be essential in your everyday life as a healthcare provider. You can view the first video on the pulmonary exam here! As always, you can find more content on our website at and keep up with us on our social channels @onlinemeded!