Maybe you have equipped yourself with all the tools that you need to bring success in your USMLE steps, especially in the communication area; but did you know that you also need to avoid certain comments and questions?

Are you confident to undertake USMLE Step 2 CS? A particular common statement may be taken as constructive by your patient, but will be taken differently by another. There are certain comments and questions that tend to impede effective communication and that should be avoided in most situations such as the following:

Using Clichés. A cliché is a stereotyped, trite or pat answer. Most clichés tend to indicate that there is no cause for anxiety or concern or they offer false assurances. They tend to be interpreted as showing a lack of interest in what has been said. The only useful purpose a cliché can serve its purpose is to break the ice in your Step2 CS to begin conversations. For example, a common question is, "How are you?" Even though it could start a conversation, the comment can still cause a problem if the person has reason to suspect that the doctor is not sincerely interested in how the patient feels.

The following are some examples of common clichés that are usually best left unsaid because they tend to impede effective communication. Consider yourself warned for better USMLE step scores.

• Everything will be all right.

• Don't worry. You will be just fine in another day or two.

• I am your doctor. I know what's best for you.

• Cheer up. Tomorrow is another day.

There is another type of cliché that makes a sweeping generalization that does not necessarily apply to a specific patient. This type also tends to cut off communication and makes the person feel as though he is just another insignificant being. Consider these examples:

• Doctor: Men tolerate pain poorly. That must be why you are complaining of such severe pain.

• Doctor: Everybody is afraid of surgery. Why should you be any different?

• Doctor: You teenagers are all alike. You aren't being cooperative because you want to defy authority.

These kinds of comment rarely promote communication with patients to whom they are addressed, as well as using comments to give advice. Giving the patient advice often implies that you know what is best for the patient. It denies the patient his right to make his own decisions and a right to his feelings. Giving advice also tends to increase the patient's dependence on his health caretakers. However, advice does have a rightful place when it is requested and the person giving the advice has expert knowledge that the patient does not have. Prepare for USMLE step 2 by polishing your communication skills.