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CS mistakes,I need your opinion

2K views 13 replies 6 participants last post by  geesa 
#1 · (Edited)
Hi everyone,
I just took my CS few days ago, I made mistakes as everyone I think, but also as everyone I am sick worried about my result and it's gonna be painful to wait all this time until the results. it would be great if you guys take a look and tell me your opinions.

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.

please guys spend some time on what I wrote and tell me what you think..

thank you.
 
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#4 ·
Dont worry everyone makes mistakes, Nobody can be 100 % accurate for CS & do every case perfect. And about ur diagnosis as long as u have justification that support ur diagnosis ur on the safe side, Each person thinks differently as long as it's related to case it's fine, u may get low points on those cases if the diagnosis is less likely. If u have practiced enough cases ,took all the important Hx ,counselled ur patients,wrote a good PN & closed cases,behaved professionaly ,answered patients q's I think u'll be on the safe side. The truth is exam is over Now and all we can do wait for the score.
 
#6 ·
I would say that you have 75-85 % of passing chances at the very minimum actually!. Would Not even mention my hypothetical maximum which in your case nears 95% , i guess.
You did great job, undoubdetly. And you probably did the entire Step 2 CS session much better than me. My congradulations to you!!

I will definitely stay in touch with you.

Let me know what score will come.

THANK YOU SO MUCH !
 
#10 ·
Don't worry

Well i can understand what you are going through. I was too worried **** waiting for the result. Kept replaying in my mind all the blunders i did.

I can only share the experiences i know of but u mentioned just couple of things that went haywire in your cases. I would be more interested in ur interactions rather than the content u are focusing on here.
Two true CS stories:

1. one of my study partner, literally screwed up the diagnosis in 3 cases, forgot the counseling of smoking in one and in one day of shoulder pain did examination when he shouldn't. other cases missed something in each one. Guess what he passed. Question: how come? he is really good at making patient at ease. He spent plenty of time on closure. Addressed all patients concerns and wasn't getting all technical. Also patients notes, for all wrong diagnosis he provided Right justifications. SO even though he lost diagnosis marks he was able to make it with right justifications.

Case in point 2: This gal had problem understanding two patients, constantly asked them to repeat. She was upfront about it. Can we go over this again. things like that. No time did she seem lost or freaked out what is the SP saying. Keeping calm kept asking them to repeat until "her checklist of questions" were answered. She just sticked to her script. She hardly finished her cases in time. Patients notes were rushed. Missed social Hx in one and Physical in two cases. Forgot to mention rectal exam to patient or mention it in note. She passed.

So what i can tell you with certainty. You did;t make any Red flag kind of blunders so i would say you are safe and will make through. But i know from experience you will freak out till the result day so my advice block this out for now. You have done your best and cheer up. Its Over.
 
#12 ·
Well i can understand what you are going through. I was too worried **** waiting for the result. Kept replaying in my mind all the blunders i did.

I can only share the experiences i know of but u mentioned just couple of things that went haywire in your cases. I would be more interested in ur interactions rather than the content u are focusing on here.
Two true CS stories:

1. one of my study partner, literally screwed up the diagnosis in 3 cases, forgot the counseling of smoking in one and in one day of shoulder pain did examination when he shouldn't. other cases missed something in each one. Guess what he passed. Question: how come? he is really good at making patient at ease. He spent plenty of time on closure. Addressed all patients concerns and wasn't getting all technical. Also patients notes, for all wrong diagnosis he provided Right justifications. SO even though he lost diagnosis marks he was able to make it with right justifications.

Case in point 2: This gal had problem understanding two patients, constantly asked them to repeat. She was upfront about it. Can we go over this again. things like that. No time did she seem lost or freaked out what is the SP saying. Keeping calm kept asking them to repeat until "her checklist of questions" were answered. She just sticked to her script. She hardly finished her cases in time. Patients notes were rushed. Missed social Hx in one and Physical in two cases. Forgot to mention rectal exam to patient or mention it in note. She passed.

So what i can tell you with certainty. You did;t make any Red flag kind of blunders so i would say you are safe and will make through. But i know from experience you will freak out till the result day so my advice block this out for now. You have done your best and cheer up. Its Over.
Doc:
I can't say much as appreciation to your post. You literally lifted me up. I am deeply thankful.
 
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