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Tell me about the CSA.


The CSA comprises of test cases that you would commonly encounter as a physician in the USA.

The cases reflect a balance of Internal medicine, Surgery OB/GYN, Pediatrics, Psychiatry and Family medicine.

On a typical day the morning starts at 8.30am and finishes at 3.30pm. A candidate will encounter eleven standardized patients SPs and will be scored for only ten cases. The eleventh case is used for research purposes.

On the day of the examination you are required to attend no more than 30 minutes before the start of the exam. You are isued a card with the photograph of yourself and your candidate number. There is an on-site orientation.

The following are some of the areas that are covered in the orientation.

1. Only the following are allowed inside the testing area: a pen, a clip board with sheets of paper (provided by the ECFMG), your photo ID and any valuables you brought with yourself.

2. Once inside the testing area, each candidate stands in front of the door. When you hear "examinees, you can begin your work now", you can lift up the paper that covers the door information. The door information gives the name, age and sometimes occupation of the patient, the purpose of visit to the doctor, the place i.e. doctors office or emergency department etc and the vital signs (pulse, BP, temperature, and repiratory rate)

3. Each encounter will allow the examinee to interact with SP for 15 minutes and 10 more minutes to write the patient note. When the candidate is with the SP for 10 minutes there will be an announcement saying "examinees, you have 5 more minutes to finish the encounter". This will allow you to adjust your encounter accordingly. Then again at the end of the encounter there will be another announcement saying "examinees please stop your work".

4. If you finish your history taking and physical examination before the allocated 15 minutes you can leave the room at any time but you cannot go back in again.

5. As soon as you leave the room the SP will start to answer the questionnaire which assesses your performance.

6. You are not permitted to do breast, genital and rectal examination. If you think these examinations are essential for the diagnosis you should write them in your diagnostic work up.

7. If there is a situation, which involves exposing an area as part of your other examination you are permitted to do so. For example when you do the cardiovascular examination on a female, for the purpose of auscultation of the apex beat you can ask the SP to remove the bra, if you think it is necessary.

8. When you do the physical examination, you must pay attention to patient's modesty and ensure that that this aspect is not neglected, eg, inform the patient when you want to remove the gown and adequately draping the patient etc.

9. You must wash your hand either before or after the examination etc.

10. You will have ten minutes to write the patient note. You should not write beyond the margins, as the computer will not pick it up when the patient note is scanned.

Good luck!!