Major Mistakes on Step 2 CS. Worried I Failed? - USMLE Forums
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Old 11-23-2014
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Default Major Mistakes on Step 2 CS. Worried I Failed?

Hey all. I was wondering if anyone had any insight on if my mistakes will result in a fail score 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 on 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. 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, shook hands, asked open ended questions
2) Generally asked comprehensive questions.
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!

Last edited by surfermd; 11-23-2014 at 07:45 AM.
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