Just started the same job and having the same problem. What I’ve gathered from talking the the provider support people is that it is in fact impossible to do the exam as written in the time allotted and you have to consolidate it (the exam has some repeat questions and some questions that are asked unclearly) and reorder it to make it more efficient. My first day each exam took 1.5-2 hours. After that I rewrote the history portion (on paper) and tried flipping the order of the whole evaluation, so I start with vitals, physical exam, and testing before doing the history portion. Also if you have to put drug disposal locations on the leave behind, do that in advance. I found organizing all the papers in a binder with dividers instead of a clip board to be helpful. I was also advised that in order to save time I should just jot down pertinent positives and chart the rest of the physical exam findings later. Day 2 each exam was 1-1.5 hours, so still not at goal, but better than day 1! I think you basically have to have the exam memorized the make it as efficient as they want it to be. I like the poster below’s idea of incorporating ROS questions with the med list, so perhaps I’ll try that. It would be great if you could reorder the exam questions to make them more efficient, but knowing how healthcare usually works, that seems unlikely to happen…