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USMLE Step 2 CS Forum USMLE Step 2 CS Discussion Forum: Let's talk about anything related to USMLE Step 2 CS exam


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  #1  
Old 11-19-2014
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Smile Step 2 CS potential mistake

Hey all,

I know there are a lot of the I feel I messed up on Step 2 CS, but I may have made some major blunders that could hurt my ICE component.

1) For almost every case, I only had 2 ddx. I really had trouble stretching to a potential 3. For only 2 cases did I have 3 as the patient had multiple complaints. For one case, I believe I only had one
2) I didn't know we could add rows for each specific ddx, so I only put 3 pieces of evidence in the boxes below each ddx. Some were longer (complaint with many descriptors)

Do you think this will subtract a lot from my ICE score to lead to a fail. I don't have a sense of how many people always filled in 3 ddx.

Thanks
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  #2  
Old 11-20-2014
MishkaMD's Avatar
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Default

First relax and don't worry!!! There is nothing you can do....and you will keep remembering mistakes!
Second: On my CS i mostly wrote only 2 Ddx. And in one i had no idea what it was so I just "made up" one, so to speak.
As long as your primary Ddx was the best correct answer you good to go.
And for the 2 point you asked I think it should be fine....I can't tell you much about it, i guess if you didn't input some major evidences that were there you might lose some point. But thats only a small fraction of all PN!!

When i did my exam i thought....I failed for sure....I forgot many things to do to say to write to exam....but still passed good in all components.

Quote:
Originally Posted by materrel14 View Post
Hey all,

I know there are a lot of the I feel I messed up on Step 2 CS, but I may have made some major blunders that could hurt my ICE component.

1) For almost every case, I only had 2 ddx. I really had trouble stretching to a potential 3. For only 2 cases did I have 3 as the patient had multiple complaints. For one case, I believe I only had one
2) I didn't know we could add rows for each specific ddx, so I only put 3 pieces of evidence in the boxes below each ddx. Some were longer (complaint with many descriptors)

Do you think this will subtract a lot from my ICE score to lead to a fail. I don't have a sense of how many people always filled in 3 ddx.

Thanks
__________________
2015 grad , Step1-[249], Step 2CK [253], Step 2 CS [PASS(1)] , Step 3 [235], MATCHED IM 2016
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  #3  
Old 11-23-2014
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Default Worried I failed ICE...

Hey all. I was wondering if anyone had any insight on if my mistakes will result in a fail on the ICE portion of Step 2 CS?

1) Forgot neuro exam when it was the key portion of the PE. Did CV/Pulm/Abd. My patient note had a weak differential diagnoses and missed EEG as part of the work-up.

2) Forgot MSK motor strength exam on patient who had generalized fatigue.

3) Weak differential diagnoses for 4 out of the 12 encounters. Was able to support the dx with 2-3 hx or PE finding. Order wasn't the best. The third dx was probably more unlikely, but did have some signs and sx's from the encounter that could have supported it. I felt I was stretching it. I probably should have just left 2 most likely dx's.

4) Forgot to list thyroid exam and rebound tenderness on PNs, although did it during the exam

5) PN was generally well written, maybe slightly disorganized, but thorough.

6) May have performed abdominal exam repeatedly when patient was in pain, but wanted to assess for rebound tenderness.

Otherwise, I:
1) Introduced myself, smiled, shook hands, asked open ended questions
2) Generally asked comprehensive questions for the history
3) Did Pulm, cardio, abdomen on most everyone
4) Provided counseling
5) Explained differential diagnoses vaguely, provided next steps, etc.
6) Handled difficult questions to the best of my ability
7) Smiled a lot and established good rapport

Basically I'm worried that my failure to do major PE on 2 cases is the kiss of death for me? In addition to weak differential diagnoses in 4, although I was able to list supportive history and some PE findings? Everyone on the day kept saying how easy and straightforward it was, but I thought it was a little tough!
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