My CS Mistakes. Houston, Feb 25th. - USMLE Forums
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  #1  
Old 03-06-2015
bushrakram's Avatar
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Stop My CS Mistakes. Houston, Feb 25th.

I seriously think that I'll flip. I did some major errors in my CS and it keeps on rebounding. Please tell me from experience if it's something pass worthy because my step 1 prep is getting hampered because of it.

- I BLOODY FORGOT TO PULL OUT THE FOOT REST IN 3 CASES WHERE ABDOMINAL EXAMINATION WAS REQUIRED. I REALLY can't imagine how pissed off would it have made the patients.
- I messed up my first case completely, wrong ddx and didn't ask for social hx in that which was the crux of the ddx!
- Couldn't counsel in two cases. In the first one had to make an excuse that my nurse is calling me we have an emergency I'll get back.
- In one case I could on only tell my impression and couldn't counsel regarding physiotherapy.
- Made a fool out of myself but counseling to the patient if he wants me to arrange a dietician for him. He was literally giving me a weird look.
- A case where the SP was too frikkin slow, forgot to warm my hands and he had to tell me that my hands were cold.
- Missed ob gyn hx in 25 y/o F and didn't ask for Menarche in all obgyn gases!
- Didn't examine lymph nodes in an exam that warranted it. Also, messed up my order of DDx. My 2nd one was supposed to be first.
- Often had to correct myself with Pt's name. Had too many moores and smiths in my head. :@
- Didn't turn off liights during fundoscopic exam.
- I don't think I was very eloquent with my answers. But none of the SPs really seemed like that were unsatisfied.
- I used "oh I'm so sorry" and "Musst be uncomfortable for you" so much that it seemed fake. The SPs were just not responding to my empathy and I suppose I had no choice but to move on.

I dunno please tell me if people pass with these mistakes. Um. D:
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  #2  
Old 03-06-2015
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Stethoscope

Quote:
Originally Posted by bushrakram View Post
I seriously think that I'll flip. I did some major errors in my CS and it keeps on rebounding. Please tell me from experience if it's something pass worthy because my step 1 prep is getting hampered because of it.
Nobody is perfect in CS, and USMLE doesn't expect us to be perfect - it looks you were a little anxious (easy to tell, I'm going to take it next month -)

Can you please tell us what resources you used for CS preparation - FA CS, UW CS, Kaplan CS lecture notes, Kaplan CS Core Cases = are the cases from book or you got some cases you have never met throughout your CS preparation. Thanks much!
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Old 03-07-2015
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I actually did FA, Neeraj, Gold standard and khalil notes. Plus my study partner and I also simulated majority of the minicases and their differentials in the last two weeks to make sure we weren't missing out anything such as anorexia nervosa, somatoform disorder and stuff. I didn't even touch Kaplan or UWorld but my mentor told me to go through it as they've 70+ cases that are tested quite often. My advice woukd be to simulate mini cases so that you know what to expect. It helped a lot.
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Old 03-14-2015
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Originally Posted by bushrakram View Post
I actually did FA, Neeraj, Gold standard and khalil notes. Plus my study partner and I also simulated majority of the minicases and their differentials in the last two weeks to make sure we weren't missing out anything such as anorexia nervosa, somatoform disorder and stuff. I didn't even touch Kaplan or UWorld but my mentor told me to go through it as they've 70+ cases that are tested quite often. My advice woukd be to simulate mini cases so that you know what to expect. It helped a lot.
Here are my mistakes, I will also be waiting in pain for the results:

1st case:
I asked the patient to repeat to me the duration of cc,forgot to order pt/ptt for his DVT, and the notes was a little disorganized(positives then negatives then positives).

2nd case: second differential wasn't medially accurate,PN a little disorganized as above.

3rd case: pt asked me for HRT replacement medication, I just answered"advances in medicine are a lot and will find what fit you,lubricants are alternative for now" this was menopause case. second differential wasn't accurate or may be completely off!!

4th case: asked the patient to repeat his medications names twice for me.didn't thank him after exam, but initially I said"may I examine you? oh thank you" I used this sentence in almost all cases but I forgot to emphasis on thanking almost all patients after PE.

5th case: second differential was not good but close. didn't ask about sex. examination was not accurately described on PN.

6th case: case of fatigue, told me she sleeps 8hrs but not enough, forgot to ask about the sleeping pattern or interruptions. i show as much empathy as possible for her depression. asked me what's the reason for my weight gain, I said due to your depressed mood but we r here for you and will help with support groups and blah blah!!

7th case: forgot to talk about his diabetes follow up although the case was something not related to diabetes at all. I asked him to repeat his medications names for me(this happened for 3 patients).

8th case: I asked the patient to lie down, although he told me at first he can't , but when I asked him he said is this necessary, then I apologized profusely and said oh no of course not, I'm sorry I will examine you while your sitting up like that.

9th case: went ok.

10th case: went ok except that while i was asking the patient about ROS i said" ok let me see what I wanted to ask you!! oh I remembered do you have any chest pain?" that was dumb I confess it!

11th case: went ok,patient notes was a little disorganized.
12th case: went fine.

I was talking in confidence with all of them,
I didn't forget to put gloves on or remove them after PE,
I did closure on all of them,
I only ran out of time once and it was only when I was shaking hands,
I didn't shake hands for two patients one of them because of wrist pain and second was due to severe pain and not feeling ok at all,
I introduced myself well, i did transition phrases,
I did focused exam on all,
I wrote only focused exam on all PN, all patient notes were not as perfect as I used to do before going to the test, most of PN were disorganized but contained 90% of the patient encounter, I didn't ran out of time on PN,
i revised few of them,
I forgot to tell one patient about their coming rectal exam,
I forget alcohol and or sex habits in two patients.

__________________
IT IS GETTING INTENSE !!
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