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  #1  
Old 07-06-2016
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Default Just learned I failed CS (specifically ICE)

I'm feeling hopeless. I am an American born IMG and an older student. I felt I made mistakes in my CS exam, but overall thought I did well enough. SEP and CIS were not a problem at all, but it seems I failed the ICE.

I was worried going into it because I am not a touch typist. With the new no checklist grading I knew it was important to include everything in the PN. I did run out of time on every note, but thought I had been able to include enough of the relevant information. I am certain this is where I fell short and I am worried there is no way for me to improve on this

I have tried to learn touch typing multiple times for more than 30 years and it has never stuck. I don't know how I can write an acceptable PN in the allotted time without it. Now I'm wondering if it is even worth trying to retake the exam.
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Old 07-06-2016
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It is worth taking it again. Especially if time is your only constraint. Chin up. Perhaps learn the abbreviations, cut out all extra words, use short well phrased lines. Copy paste them into the D/D. Select text, Ctrl C(copy), Ctrl V(paste).

I ran out of time on some of my PNs as well. This is they only way I got through it.

You CAN do this!
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Old 07-08-2016
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Hey, it must be hard. Cheer up. All hope is not lost. I sent u a private msg. Get back.
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Old 07-09-2016
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Default Thank you!

I want to thank everyone who has taken the time to PM me with either questions or encouragement. Unfortunately as I have not written enough posts I am not allowed to PM anyone back

To answer a couple of the questions. I took my exam in Atlanta at the end of May. I have decided not to appeal it as I have found very few reports of any appeal having a positive outcome and I don't feel it is worth it to spend $80 for a formal letter that just tells me that I did indeed fail.

I have registered and am waiting for a new permit to be processed. I'm not sure when I will schedule as I am still studying for CK and that takes priority right now.

As for how bad my notes were? I followed the order DD, tests to order, HPI, followed by PE. I used bullet style with truncated sentences in the HPI. I only used common abbreviations that were on the okay list. All of my PE had general appearance, and vitals, but some not much more than that as the last section I tackled, it was the one that got cut off when time ran out.

If anyone has more questions I will be glad to answer them, but I cannot respond to PM.
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Old 07-09-2016
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Default Appeal and Register!

Sorry this happened to you. I failed CIS so I understand your pain and shock. I think it's best to appeal no matter what. Send that out right away while registering as well. It's only 80$ and you're forking up over 1000$ for the exam. 80$ is worth the small possibility of maybe getting good news within 4 wks. I shipped mine overnight the same day that I found out. Sometimes there is a curve adjustment based on high number of appeals (I read that somewhere online), but not sure how credible this information is. Good luck and wish you the best!
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Old 07-09-2016
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Quote:
Originally Posted by mam76 View Post
I want to thank everyone who has taken the time to PM me with either questions or encouragement. Unfortunately as I have not written enough posts I am not allowed to PM anyone back

To answer a couple of the questions. I took my exam in Atlanta at the end of May. I have decided not to appeal it as I have found very few reports of any appeal having a positive outcome and I don't feel it is worth it to spend $80 for a formal letter that just tells me that I did indeed fail.

I have registered and am waiting for a new permit to be processed. I'm not sure when I will schedule as I am still studying for CK and that takes priority right now.

As for how bad my notes were? I followed the order DD, tests to order, HPI, followed by PE. I used bullet style with truncated sentences in the HPI. I only used common abbreviations that were on the okay list. All of my PE had general appearance, and vitals, but some not much more than that as the last section I tackled, it was the one that got cut off when time ran out.

If anyone has more questions I will be glad to answer them, but I cannot respond to PM.
It seems like you are sure you included most things, missing a few things here and there shouldn't cause you to fail. How many notes would you say were not complete?
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Old 07-09-2016
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Quote:
Originally Posted by RollerBladzer View Post
It seems like you are sure you included most things, missing a few things here and there shouldn't cause you to fail. How many notes would you say were not complete?
I ran out of time on all of the notes so I would say 10 of them were missing at least some portion of the PE. One case I was cut off in the HPI and had no PE written down, and there was only one case that I did not have a good idea of what the diagnosis was so included a full hx and PE but had random guesses for the DD and plan.
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Old 07-09-2016
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Originally Posted by khatijadoc View Post
Did you finish typing all the notes in time? i dont think you should take your exam until you have 35 wpm typing speed.
No, I did not completely finish any of the notes as I would have liked. That was my fear going in. As I said I am not a touch typist and in over 30 years of practice I have never exceeded about 20 wpm, I just don't see it happening any time soon.
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Old 07-09-2016
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Quote:
Originally Posted by mam76 View Post
I want to thank everyone who has taken the time to PM me with either questions or encouragement. Unfortunately as I have not written enough posts I am not allowed to PM anyone back

To answer a couple of the questions. I took my exam in Atlanta at the end of May. I have decided not to appeal it as I have found very few reports of any appeal having a positive outcome and I don't feel it is worth it to spend $80 for a formal letter that just tells me that I did indeed fail.

I have registered and am waiting for a new permit to be processed. I'm not sure when I will schedule as I am still studying for CK and that takes priority right now.

As for how bad my notes were? I followed the order DD, tests to order, HPI, followed by PE. I used bullet style with truncated sentences in the HPI. I only used common abbreviations that were on the okay list. All of my PE had general appearance, and vitals, but some not much more than that as the last section I tackled, it was the one that got cut off when time ran out.

If anyone has more questions I will be glad to answer them, but I cannot respond to PM.
I am in the same boat as you! and my stars were on borderline. So i am not sure where I failed on my ICE part. Always had enough time left. Asked my patients all the questions. advised. listened. closed. did all the PE. Typed all the notes properly. I am in shock. Those i helped to practice passed but i didnt. It ruined my week and my CK studying I read in a post that guy had a success after rechecking so i am going to go ahead and do that...just for my piece of mind! also, I am going to ask them where i failed...if they can atleast give me a break down
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Old 07-09-2016
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Originally Posted by annamanaguchi View Post
Sorry this happened to you. I failed CIS so I understand your pain and shock. I think it's best to appeal no matter what. Send that out right away while registering as well. It's only 80$ and you're forking up over 1000$ for the exam. 80$ is worth the small possibility of maybe getting good news within 4 wks. I shipped mine overnight the same day that I found out. Sometimes there is a curve adjustment based on high number of appeals (I read that somewhere online), but not sure how credible this information is. Good luck and wish you the best!
I heard that too. I will fax mine on monday too. Thank you for being positive!
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Old 07-10-2016
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Originally Posted by lovepeace View Post
I am in the same boat as you! and my stars were on borderline. So i am not sure where I failed on my ICE part. Always had enough time left. Asked my patients all the questions. advised. listened. closed. did all the PE. Typed all the notes properly. I am in shock. Those i helped to practice passed but i didnt. It ruined my week and my CK studying I read in a post that guy had a success after rechecking so i am going to go ahead and do that...just for my piece of mind! also, I am going to ask them where i failed...if they can atleast give me a break down
What do you mean stars were borderline? Any stars in the lower performance at all? Anything you can think of that might have caused a drop in performance at all?
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Old 07-10-2016
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Another pointer. Not all cases need 3 D/D. 2 is enough for some (I have done this). So you could possibly cut down on time there.

Mavis Beacon is the program used to learn to type.
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Old 07-10-2016
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Quote:
Originally Posted by lovepeace View Post
I am in the same boat as you! and my stars were on borderline. So i am not sure where I failed on my ICE part. Always had enough time left. Asked my patients all the questions. advised. listened. closed. did all the PE. Typed all the notes properly. I am in shock. Those i helped to practice passed but i didnt. It ruined my week and my CK studying I read in a post that guy had a success after rechecking so i am going to go ahead and do that...just for my piece of mind! also, I am going to ask them where i failed...if they can atleast give me a break down
Sorry to hear, I wish you luck on your appeal. From what I have researched they will not expand on any details of grading as it is part of there "confidential algorithm." If my research is wrong and they do indeed let you know I would appreciate if you update me.

You bring up a valid point. I assume I failed on the note because I ran out of time, but I very well could have been marked down on the information gathering and/or exam. I felt confident in these areas, but we don't really know how they grade them.
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Old 07-10-2016
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Originally Posted by RollerBladzer View Post
What do you mean stars were borderline? Any stars in the lower performance at all? Anything you can think of that might have caused a drop in performance at all?
majority of my stars were in the borderline grey bar. I am in shock! Honestly I am not sure where i went wrong in ICE part. Perhaps differential and work up? but how bad it could be that i failed my whole damn exam. you know what i mean, i doubt it worth like 50% of ICE! I was not cocky. I knew my material. I practiced over 3 months whereas I know people who did not pass step 1, no idea of differential or work up and I helped them, they managed to pass with good stars!
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Old 07-10-2016
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Originally Posted by mam76 View Post
Sorry to hear, I wish you luck on your appeal. From what I have researched they will not expand on any details of grading as it is part of there "confidential algorithm." If my research is wrong and they do indeed let you know I would appreciate if you update me.

You bring up a valid point. I assume I failed on the note because I ran out of time, but I very well could have been marked down on the information gathering and/or exam. I felt confident in these areas, but we don't really know how they grade them.
Thank you. I sure will. It ruined my CK prep. I just cant let myself move on from this set back! *sigh* honestly for the amount we pay, the least they can do us is tell us where we went wrong. I heard they are obligated to fail 1 in 10 students? I am not sure how true this is. But majority of my group, there was 24 of us, were american med students...perhaps they were excellent and I was not!
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Originally Posted by lovepeace View Post
majority of my stars were in the borderline grey bar. I am in shock! Honestly I am not sure where i went wrong in ICE part. Perhaps differential and work up? but how bad it could be that i failed my whole damn exam. you know what i mean, i doubt it worth like 50% of ICE! I was not cocky. I knew my material. I practiced over 3 months whereas I know people who did not pass step 1, no idea of differential or work up and I helped them, they managed to pass with good stars!
I'm sorry to hear that, I am also freaking out thinking of all the stupid mistakes Ive made in ICE component. Did you have any stars above the higher end of borderline? All your stars can't fit in borderline so where are the remaining ones?
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Originally Posted by RollerBladzer View Post
I'm sorry to hear that, I am also freaking out thinking of all the stupid mistakes Ive made in ICE component. Did you have any stars above the higher end of borderline? All your stars can't fit in borderline so where are the remaining ones?
for SE and CIS, I have one star at the high end of the higher performane. For ICE, I have I have 6 in borderline box and 5 in lower performance side. Never knew this can result in failure, ruined my life. ugh
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Old 07-10-2016
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Originally Posted by lovepeace View Post
for SE and CIS, I have one star at the high end of the higher performane. For ICE, I have I have 6 in borderline box and 5 in lower performance side. Never knew this can result in failure, ruined my life. ugh
Unfortunately, I believe the max number of stars you can have in the borderline area is 3. The rest must be in the higher performance. I say this as i know a couple people who have failed with 4 stars in the borderlines and the rest above. Each section is graded independently and you just have to pass all three sections. Doing well in one cannot help another.
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Old 07-10-2016
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Unfortunately, I believe the max number of stars you can have in the borderline area is 3. The rest must be in the higher performance. I say this as i know a couple people who have failed with 4 stars in the borderlines and the rest above. Each section is graded independently and you just have to pass all three sections. Doing well in one cannot help another.
I don't think this is true, I believe you need to have at least one star above borderline, so I think you were only off by a star to pass
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Old 07-10-2016
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Quote:
Originally Posted by RollerBladzer View Post
I don't think this is true, I believe you need to have at least one star above borderline, so I think you were only off by a star to pass

that's what I heard too it sucks! I always thought ICE is one of my strongest
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Old 07-10-2016
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that's what I heard too it sucks! I always thought ICE is one of my strongest
Anything specific you can think of at all? Did your DDx have support? Documented everything properly?
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Old 07-10-2016
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Originally Posted by RollerBladzer View Post
I don't think this is true, I believe you need to have at least one star above borderline, so I think you were only off by a star to pass
What you are describing is my score diagram. 4 below, 6 in, 1 above borderline. This is definitely NOT a passing score and I have a classmate who has it shifted over 2 spaces so, 2 below, 6 in, and 3 above and that is also a failing score.
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What you are describing is my score diagram. 4 below, 6 in, 1 above borderline. This is definitely NOT a passing score and I have a classmate who has it shifted over 2 spaces so, 2 below, 6 in, and 3 above and that is also a failing score.
wow, now I am extremely terrified
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Originally Posted by RollerBladzer View Post
wow, now I am extremely terrified
Does this mean you can't have any below borderline to pass?
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Originally Posted by mam76 View Post
What you are describing is my score diagram. 4 below, 6 in, 1 above borderline. This is definitely NOT a passing score and I have a classmate who has it shifted over 2 spaces so, 2 below, 6 in, and 3 above and that is also a failing score.
Do you mind posting a screenshot of ur report? or sending me a PM. Not that I don't believe you, I'm just interested in seeing this
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Old 07-10-2016
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Originally Posted by RollerBladzer View Post
Does this mean you can't have any below borderline to pass?
Sorry, I would rather not post my score report for public view and I am still not permitted to send PM.

It is my understanding that the majority of Xs must be above borderline, with no more than 3 on the shaded area, so yes that means none below.

Freaking out over it if you have already sat the exam will do no good. Just focus on other things until the score report comes in. You can't do anything to change it at this point.
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Originally Posted by RollerBladzer View Post
Anything specific you can think of at all? Did your DDx have support? Documented everything properly?

nothing at all. that's the worse part
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Old 07-10-2016
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Sorry for your results .. Im very much worried about my ICE portion one case i couldnt diagnose even my PE part completely blank and other case my investigation part blank and the 3rd one i missed the main ddx . Some other cases i forgot to do imp PE like ROM . Plz tell me your mistakes and will i fail ICE . Rest of the cases i did well and diagnosed well .
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Old 07-10-2016
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Originally Posted by tiakumkum View Post
Sorry for your results .. Im very much worried about my ICE portion one case i couldnt diagnose even my PE part completely blank and other case my investigation part blank and the 3rd one i missed the main ddx . Some other cases i forgot to do imp PE like ROM . Plz tell me your mistakes and will i fail ICE . Rest of the cases i did well and diagnosed well .
When you say diagnose, did you leave the diagnosis section blank or you just weren't sure about the "correct" diagnosis? I honestly don't think investigation part is worth much, think bulk is in DDx, then PE, then HPI. Missing main ddx isn't huge deal if you supported ur ddx. Check out my thread if you want to see some bad mistakes
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Old 07-10-2016
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1.1st no case i put 3 ddx among them i think one is less likely ryt other 2 ddx wrong and in that case my PE completely blank,
2. 2nd no case.. I put only 1 inv that was less likely correct b/c ran out of time so didnt hv time to write the other inv
3.3rd no case .. i put 3 ddx and 3rd no ddx will be the 1st one other 2 got wrong .
4. 4th case did every thing motor, sensory, pulse, reflex, special test , inspection palpation but forget to do ROM but my ddx and inv and HPi totally ryt .
5. Rest of the cases my ddx and inv, PE and hpi went good
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Old 07-10-2016
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Quote:
Originally Posted by tiakumkum View Post
1.1st no case i put 3 ddx among them i think one is less likely ryt other 2 ddx wrong and in that case my PE completely blank,
2. 2nd no case.. I put only 1 inv that was less likely correct b/c ran out of time so didnt hv time to write the other inv
3.3rd no case .. i put 3 ddx and 3rd no ddx will be the 1st one other 2 got wrong .
4. 4th case did every thing motor, sensory, pulse, reflex, special test , inspection palpation but forget to do ROM but my ddx and inv and HPi totally ryt .
5. Rest of the cases my ddx and inv, PE and hpi went good
I had some trouble understanding what you wrote, but it doesn't sound like you should fail. If you only left a section blank in 1-2 cases you should not be failing if everything else in other cases are good. Also forgetting to do one pe maneuver out of 6 in a system is fine lol
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Old 07-10-2016
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I am so sorry you did not pass the exam.
From what I gathered from what you wrote, I would say you can pass quite easily with a little bit of effort.

1. 20 wpm is insanely slow. That can easily be increased. First, buy a keyboard similar to the one used in the exam. Do not practice on the laptop keyboard. Place your fingers correctly i.e left on asdf and right on jkl;. Go to one of those typing practice websites like http://www.typeonline.co.uk/typingspeed.php
And look at the keyboard and type. Practice for around 20 minutes everyday. Make sure you maintain that standard typing posture(the thing I mentioned earlier). This is very important because that's how your brain learns the positions of each alphabet. Also, correct spelling mistakes then and there during practice. Speed increases when you reduce mistakes too. Start from today. In 3-4 months you will see a drastic improvement.

2. You cannot afford to have no idea about the DDs. As long as you are somewhere in the ballpark, you should be able to pass. Learn FA inside out. That's your bible. Practice all cases on someone( preferably someone who has given the exam) using a timer. Learn the DDs for all cases, especially the mini-cases and the reasons for the DDs as well.

3. Finally the order in which you type. I don't know if anyone has told you about this. Start with the DDs and reasons first. Next is investigations. Once that is done, complete the PE. Use shortfroms as much as possible. Finally the History. While typing Hx- Type only once sentence of HPI initially. e.g: 46 yo M c/o lower back ache x 3 days. Complete the rest of the hx and then come back to HPI and complete it. This is because completing rest of hx is more important than a detailed HPI.
Time for each: DDx: 3 minutes. Inv- 1 min. PE- 2 minutes. Hx-3 minutes. Practice this way.

And finally good luck! Follow this and you are golden.

Ref: Did the same and passed with high performance in all 3.
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Old 07-11-2016
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I am so sorry for your Fail in step 2 Cs. I passed it even if I have got a low English level (b2 actually but not certainly advanced). I was very anxious during my test and the first case was a complete disaster... I run out of time. When I sat down to type my notes oh my gosh I wasn't able to type my notes. I did my best guessing the most likely diagnosis. I think I made a lot (not kidding) of spelling mistakes and I didn't include all the information gathered in my PN because I was not completely sure I had understood what the actor had told me. Anyway these information were not relevant. Sometimes I omitted some information because I didn't know how writing them. Crazy, I know . Anyway I passed my test with high sep/ high ICE and surprisingly I touched borderline performance in CIS ( I thought it was my best part). I think I was lucky, but maybe I passed ICE despite my shitty notes, because I asked actors everything and I included all positive findings in my DD, maybe also the negative ones to support my diagnosis. I used abbreviations to speed up and I wrote a good and complete PE and workup. So my advice is: improve your typing (you can do that) and focuse on your PE/DD/workup. You have to repeat it absolutely. I took it in Chicago ( good center with good actors).
Good luck!!!!
PS: also Datson gave u great advices.
I was able to complete my notes at home but on my real test day I was slower, I had to rush making a lot of spelling mistake. If you are not a fast typing do a lot of training...If I passed step 2 cs everyone can succeed!!!

Last edited by hopefedina; 07-11-2016 at 03:46 AM.
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Old 07-11-2016
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I hear you I failed in the CIS skills and was shocked since I was kind with my patients and followed all the guidelines for passing that component was actually scared of the SEP and ICE component but excelled at those . I send the recheck but I know that that's a waste of money . I want to study again but its really hard with these bad news
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  #35  
Old 07-11-2016
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Quote:
Originally Posted by cgr2000 View Post
I hear you I failed in the CIS skills and was shocked since I was kind with my patients and followed all the guidelines for passing that component was actually scared of the SEP and ICE component but excelled at those . I send the recheck but I know that that's a waste of money . I want to study again but its really hard with these bad news

you are not the only one Don't worry. Let me know if you get a positive news from recheck. I heard more people send in a request, more likely they change the curve or something!
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  #36  
Old 07-11-2016
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Just to clarify:
I had 2 x's on the low, 6 on the borderline, 3 on the higher for ICE and CIS.
Two x's on the higher side with one asterisk for SEP.
I passed.
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Old 07-11-2016
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Quote:
Originally Posted by SONE View Post
Just to clarify:
I had 2 x's on the low, 6 on the borderline, 3 on the higher for ICE and CIS.
Two x's on the higher side with one asterisk for SEP.
I passed.

Thank you for that!
Appreciate it!
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  #38  
Old 07-12-2016
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Originally Posted by lovepeace View Post
you are not the only one Don't worry. Let me know if you get a positive news from recheck. I heard more people send in a request, more likely they change the curve or something!
Sure but i am not getting my hopes up
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  #39  
Old 07-12-2016
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Quote:
Originally Posted by cgr2000 View Post
Sure but i am not getting my hopes up
I read in a forum that someone had a pass after recheck because many wrote in and they end up changing the curve...not sure how much of it is true!
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Old 07-12-2016
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Hello:

I was in a similar position. I didnt pass the ICE and I was just floored. I thougt it was all over. I spoke to my family and my colleagues and decided to try one more time. This time I prepared more and took a course. It was hard to get over the fact that I didnt pass. I was scared but reviewing and drilling cases, I went in and passed.

Do not give up! Ever!! There is a light at the end of the tunnel!! I wish you the best!!
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  #41  
Old 07-12-2016
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This is what worked (just enough, I didn't get stellar scores) for me:

I read Kaplan's Core cases front to back.
Practiced typing the patient's note on the USMLE official mock format as I read First Aid. I tried to do it without reading it first and it helped a lot.
I didn't have time to practice PE at all so I had to remember stuff I reviewed when I was a med student (I graduated from a non clinical speciality residency at my home country last year) on the spot and I bet it looked underwhelming.
So I guess a little practice with the keyboard (I used the PCs at my significant other's university instead of my laptop keyboard), forcing your brain to remember stuff and PRACTICING (that liiiiiiiiiittle thing I lacked) will be helpful.
I am here to help you if you need anything.

Last edited by SONE; 07-12-2016 at 11:08 PM.
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