Mini CPX Info and FAQs

The Mini-CPX is a five-hour examination administered towards the end of the second year of the Practice of Medicine curriculum (March).  This examination is composed of both standardized patient encounters and computer-based exercises.  The goals of this assessment are to evaluate your history and physical examination skills, patient interaction skills, communication (oral presentation), clinical reasoning, and overall knowledge. It is also a means for you to identify skill areas on which to focus prior to entering clinical clerkships. Successful completion of the Mini-CPX is a requirement to complete the Practice of Medicine course. Students who do not attain an overall passing score on the exam will be identified for remediation.

Preparing for the Exam

How do I prepare for the Mini-CPX?

The Mini-CPX is a cumulative exam, so the best preparation is to have been actively prepared and participating for your sessions in POM throughout the first and second years of medical school.

Where is the Mini-CPX held?

We are located in the Goodman Immersive Learning Center, on the ground floor of the Li Ka Shing Center for Learning and Knowledge on the Stanford University School of Medicine campus.

What do I need to bring to the Mini-CPX?

All you need is: (1) professional dress, including white coat; (2) a stethoscope; and (3) yourself.  All other medical supplies will be provided in the examination rooms. You will not be permitted to bring pocket guides or other “cheat sheets” into the exam. You will not be permitted to bring cell phones or other electronic devices into the exam.

What is the structure of the Mini-CPX?

There are four focused H&P stations with a standardized patient, with a brief post-interview exercise. There are also four inter-station exercise stations, consisting of multiple parts including but not limited to interpreting diagnostics or physical exam findings. One inter-station is an oral presentation to faculty. Each patient encounter is 18 minutes.

During the Exam

Do I need to take a blood pressure during every encounter?

No, you do not need to take a blood pressure every time – but you should if you think that you need to based on the clinical situation.

Do I need to do a heart and lung exam on all patients, regardless of chief complaint?

If you think that it is the most relevant exam based on the patient. Prioritize according to the chief complaint – in “real life” encounters, a cardiopulmonary exam would be performed on all patients, but keep in mind that the Mini-CPX is a time-limited examination.

Am I expected to discuss management issues with the patient, in addition to doing their H&P?

We cannot tell examinees specifically what to do in the encounters, but you may wish to share your thoughts with the patient about what is going on and what you’d like to do.  Each case is different, so it is not possible to say that “you must do X…” for each one.  What we usually tell examinees is that you are the provider during this encounter – so counsel and share information and next steps when it’s appropriate.

What type of oral presentation can I be expected to make?

The Q5 mid-quarter assessment/oral presentation is a good gauge. You should be able to present an entire history and physical examination, and then summarize and explain your thought process and next steps in the management.

Will I be given paper on which to take notes? Can I write out a template on this notepaper before an encounter? Will I have time to write notes or gather my thoughts after a patient encounter?

Scratch paper will be provided for you – you cannot bring your own. You can write out a template on the notepaper given you if you would like. You may take notes during the patient encounter, but will not have time after the encounter is over to write out notes. All scratch paper will be collected after the examination is over.

These are just actors, right?

Not necessarily. For some exercises/exams, we hire professional actors for cases that involve simulations of exam findings or emotionally charged scenarios. Sometimes, however, we use real patients with real histories and physical exam findings. Remember that all standardized patients are people – and you should treat them as your patients, not as actors.

After the Exam

Will I get feedback on the Mini-CPX?

Yes. After the entire class has completed the Mini-CPX, you will receive detailed feedback from the patient encounters along with your score reports.

What happens if I don’t pass the Mini-CPX?

When a student does not pass the Mini-CPX, s/he is required to develop and successfully complete a remediation plan with the E4C advisor in conjunction with POM prior to entering clerkships.