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  #1  
Old 06-19-2016
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Default Anxiety after CS

I took cs recently before taking ck. I am recalling so many mistakes and I can't concentrate studying for ck. Most of my mistakes are in the ddx and work up plan. For example:

-wrong ddx in at least 2 cases
-ordered some diagnostics test that were not necessary in the moment for 3 cases. At the same time didn't counsel about prevention or anything in these cases, just explained my ddx and the test I will order.
-Most of the cases with 1 or 2 Ddx, only positives to justify the ddx and sometimes little information about the ddx
-Forgot to order ekg ( very important to confirm the diagnosis)


I think all other components are ok. I worry only about the ddx and work up plan in the note. Any similar experience with passed attempt? Any feedback?
If only 65% is needed to pass ICE, do you think that messing up in those sections is a reason to fail? Does anyone knows how are the points distributed in the patient note?

Last edited by 32722; 06-19-2016 at 06:24 PM.
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chanduM (2 Weeks Ago)




  #2  
Old 06-23-2016
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Hopefully you have passed.
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  #3  
Old 06-23-2016
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Quote:
Originally Posted by crisamuche View Post
Hopefully you have passed.
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  #4  
Old 07-06-2016
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I passed!
Higher performance
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  #5  
Old 07-06-2016
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Quote:
Originally Posted by kepg View Post
I passed!
Higher performance
congrats, your mistakes were extremely minor so that was never in question
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  #6  
Old 07-06-2016
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Default Congrats

Quote:
Originally Posted by kepg View Post
I passed!
Higher performance
Congratulations!!! I knew you would pass. Everyone makes mistakes the day of the exam but all that matters is that you passed. Super happy for you
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  #7  
Old 07-17-2016
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Default which exam center ?

which exam center ?
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  #8  
Old 07-18-2016
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After several days of thinking about my errors I finally came up with a list that, for now, seems to be all i can remember i screwed up on:

1. Ran out of time to write the tests i'd order for 1 patient
2. Put CT and Xray of head when i meant spine
3. accidentally wrote an incorrect abbreviation for a differential (cant specify due to USMLE rules)
4. forgot to do a few key physical exam maneuvers i.e. heaves, thrills, pmi, when required
5. didnt ask anyone about quality of life being affected/in what way its affected them i.e. didnt ask if affects sleep or work, etc, never said im sorry about their chief complaint, i would just kinda throw in random apologies and sorries when it fit throughout the case or say things like we'll definitely try to help you now, thats the goal, we'll definitely try to get this fixed for u asap, i'll keep u in the loop, ill tell you the results as they come, etc etc etc
6. had 1 awkward moment with a patient that was unexpected during a left lateral decubitus pt said well this is awkward but i apologized right away for it
7. Didn't document things like scars or tattoes but mentioned it to the patient
8. was running out of space multiple times on the HPI so if say a person didnt smoke, drink, etc... i deleted those things from HPI so i can fit something more pertinent, so basically seems like i asked an entire social history but will not get credit for doing so because ran out of space to fit in other things and the things i did ask will not be known now even thought they were done
9. multiple differentials seemed off to me, some i could not think of more than 1 because felt so obvious, other times (possibly 2-4) was completely boggled by what to even put down as first one, and other times something i should have put on the list, i didn't and didnt realize it after, just kinda hoping the ones i kept still can fit the HPI, etc.
10. never put pertinent negatives into the differentials
11. several patients during the encounter (maybe 2) i forgot to ask a key question that would have lead to a certain better test being ordered aka the patient gave clues to something i, in my ever lasting nervousness and anxiety did not pick up on as hey buddy u may wanna ask about this or inquire about that.
12. I never summarized the HPI/physical findings, i just did the closure and told them what I think it can be/why i think its that/what tests id order/why id order them, not sure if doing a closure but not a summary will kill
13. Provided counseling for whoever i thought needed it for things like alcohol... but in case like alcohol i forgot to say the CAGE results... again something i did that won't be in note
14. didn't put in vital signs for every patient... probably had em all for only half and some of them i just put in w/e i thought was actually pertinent
15. Few times wrote "non-medical" terminology
16. scared **** out of patient by saying cancer.... but obviously wiggled around it saying its not for sure we have to run tests, etc etc
17. when i did my abdominal exam... instead of pulling from the bottom... i figured if the patient is already ungowned for the cardiac/resp exam, may as well help them lay down and just pull gown down a little more and do abdomen
18. didnt ask every female about their obgyn history, menopause etc, only if it was needed (or so i thought)
19. lot of my physical exams seemed kinda weakish, i did the typical heart/lungs... +s1/s2 no murmurs rubs gallops regular rate rhythm clear to ausc bilaterally (never wrote no wheezes rales or rhonchi tho whoops)
20. Forgot cn 11 on one patient and 8 on an
other
21. Forgot to ask birth hx and development in peds case
22. Forgot to ask about medication compliance for a pt that obviously needed that question asked ...but that was a case i screwed up completely head to toe...
23. Phys exams were very basic usually i.e. rre s1s2 no mrg and clear to ausc bilaterally for heart/lungs
24. Feel like maybe half my dx were wrong

Im definitely gonna remember other things... but as it stands... it seems like i failed ICE or CIS or both
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  #9  
Old 09-06-2016
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Last edited by 32722; 09-06-2016 at 02:47 PM.
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