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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 06-24-2015
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Default For those who are scared - my experience - read

I took my exam on May 11th in Philly.
I'm an IMG and have been studying for Step 1 as well.
I took the CS cause I really needed to move forward.
When you're an IMG and cannot practice here despite being a physician it makes you really miserable sometimes lol

Anyway, I passed. I was so so scared.
I used FA and Kaplan but only the introduction and physical.
I practiced with 2 friends, 7 cases/day.

I used mnemonics from this video and they helped me to cover ROS even when I was anxious, stressed and had no idea what was going on.


https://www.youtube.com/watch?v=AE0Xu6OF6ss

My mistakes:
1. I misdiagnosed one patient. I put 3 so so diagnoses but missed the very imp one.
2. I put NKDA even tho the pt was allergic to penicillin.
3. one pt I didn't know what was going on.
4. I ddn't ask about job sometimes.
5. I didn't ask about LMP consistently.
6. I had only a few cases with physical findings I could put as a justification.
7. I used a few non-medical terms: pain with urination instead of dysuria etc,
8. And...
I didn't summarize HPI to anyone!!!
I didn't counsel on weed + ETOH, weed and... HBP!
I might have said something about energy drinks and exercise here and there but don't even know if they count it as counseling.
I never asked:how is it affecting your life?
9. when I was putting gloves I asked only: Is everything okay? Other than your complain? Something like that.

10. I was very nice. I always said sorry and thanked for the exam. Tied the gown back. Didn't forget about the leg rest.
Most of them liked me. Two of them were literally laughing during the encounter and our conversation Never rushed them. 2 open ended questions. Always looked in their eyes, always talked, was very confident. Answered their questions.
11. Always closed. Made sure they knew I'm there for them and asked if they understood.
12. I didn't put HEENT and ophthalmoscopy results in a note even though i had performed it and it was warranted.
13. I didn't palpate sinuses (it was important).
14. I missed a few maneuvers: esp JVG and some parts of cardiac exam (it was mandratory)
15. i didn't catch with one of my patients (difficult one).

I didn't sleep even 10 minutes the night before! I'm this neurotic type lol who gets too tensed to fall asleep :P

Yet, I did it.

My English is very good though. I speak fluently despite being from Europe.

I had tons of mistakes. I passed with comfortable margin. Not even borderline.

I'm writing this post because I know how stressful it is.
I was checking forums like crazy.

You will pass too!

Last edited by agi1804; 06-24-2015 at 07:48 AM.
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Ainat (06-24-2015), ICUinWonderland (06-27-2015), Khorreed (06-24-2015), UsmleSam (06-24-2015)




  #2  
Old 06-24-2015
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how many justificaion did you get in every case?
and is ti possible to pass with 3-4 wrong diagnosis?
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  #3  
Old 06-24-2015
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Quote:
Originally Posted by eptifibatid0991 View Post
how many justificaion did you get in every case?
and is ti possible to pass with 3-4 wrong diagnosis?
I had 3-6 justifications for each diagnosis. Also, I had 2-3 THE SAME justifications for each Dx. I added 1 or 2 more to each.
For example:
diagnosis 1 xxx ab
diagnosis 2 xxx cd
diagnosis 3 xxx ef
I misdiagnosed 1 patient 100% and 2nd one...hmmm.... I had no idea what was going on so I'm pretty sure I was wrong as well.

I also put some weird, weakly supported diagnoses as my 2nd and 3rd, which resulted in lower score.

Concluding, I passed and I wasn't borderline on ICE. So, 'm assuming you can definitely misdiagnosed a Pt a few times and still pass.
Besides, you don't know if the pt you misdiagnosed is not the experimental one.

You will be fine!
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  #4  
Old 06-24-2015
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First of all congratulations on passing,
I just took step 2 cs in LA. I've had a lot of anxiety over whether I passed or not. Here are my mistakes:

1) forgot to pull the foot stool in all abdo cases (3 cases)
2) did not perform a full neuro or mmse in a case where it was definetly required
3) may have forgot to perform a HEENT exam on a cough case as well as fremitus or percussion. This may have happened on another cough case.
4) forgot one of the patients name on entry.
5) definetly forgot some questions in each case. Two of the questions I missed may have been important. In one case I definetly missed a question important to the differential.
6)PNs were short (never maxed out HPI) may have had too short of an ROS.
7)didn't council on smoking in one case. Didn't council on weight loss/exercise on another, may have been important to the challenge question.
8) may not have showed enough empathy on some cases. Didn't always say sorry. Tried to create a rapport on most as well as partnership.
9) Didn't ask how disease was affecting life in all cases.
10) Put two to three ddxs on most cases. Had one ddx for one (may have missed an
Important question).
11) may have had the wrong differential on two cases.
12) may have repeated questions.
13) didn't mention that I was going to do a pelvic exam in the work up for one case.
14) probably missed some tests on work-up.
15) Most patients were neutral when I left the room. One lady may have been upset. Which is also worrying me.
16) Some cases I introduced myself first and then confirmed the patients the name.

Things I believe I did ok
1)introduced myself and shook hands on every case
2)tried to build a rapport on most cases as well as partnership
3) tried to be empathetic in most cases. Although I may have not been as empathetic as I should have been in all of them.
4) had reasonable diagnoses in most cases except those I mentioned above.
5) summarized in most cases may have missed one or two.
6) started with an open ended question
7) washed hands every case
8) usually explained what I was doing in my physical.
9)closed every case. Gave more than one diagnosis except for one case.
10) did PAMHUGSFOSS on all cases. Although I only asked about gyn history when relevant.
11)believe most of my notes were relatively complete although they may have been too abbreviated.

Sorry for the really long post. I've been very worried that I failed. Any feedback would be appreciated positive or negative. I just want an honest opinion. Thanks very much in advance.
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  #5  
Old 06-24-2015
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Hi
Thank you for the reply.I just got 3-4 supporting points in each case and in one peds case i forgot to ask immunization hx and i wrote immunization up to date in pt note..Is it going to hurt me a lot??What do you think?And in 3 cases i did irrelevent examination.Please give your honest opinion.I am really freaking out ...
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  #6  
Old 06-24-2015
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sometimes you may not be able to make 3 DDX due to the information you have gathered from the SP, when this happens it is always best to leave 2 ddx that you are certain of, otherwise if you pick 3 ddx you may not have enough findings for the 3rd DDX
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  #7  
Old 06-25-2015
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Default Physical examination

When reporting PE for normal lung/chest findings, is it okay to type:
LUNG: CTAB? instead of Clear to auscultation bilaterally
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