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  #1  
Old 06-15-2013
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Arrow CS Pass-My mistakes and advice

Hello everyone.. I have been freaking out so much about the result as each and every single soul does post exam..And waiting for 2months wasn't that easy at all..But reading others mistakes here on forums and seeing so many others going thru the same helped me to calm down lil bit. So i thought its my turn to share.. Infact i dont know which of these are blunders and which are okie..

The mistakes i think i did:
-Forgot to ask obs hx in one case where it was necessary.
-Forgot to counsel abt smoking,alcohol etc in 1 case.
-Forgot to ask few relevant HPI q in 2 cases.
-Ran out of time in 1 PN,i cudn't complete half of Hx part though i finished PE,DD,workup there..
-Wrote only 1 DD for 1case,only 2 DDs for another.
-In 2-3 cases i think 1 out of my 3 DD's was the least possible DD.(Had no time to think,jus filled it up whatever came to mind related to CC even though there was no other positive hx)
-Forgot to order most important immediate workup in 1case.
-Fumbled in 1 case as i was nervous.
-Cudn't counsel well abt my workup and DD in 1 case.Ran out of time
-Cudn't answer SP's challenging Q well in the end in 1 case.Ran out of time.
-Forgot to pull out leg extension in 1case,didn't dim the room light for ophtalmoscopy ex.
-sumarized hx and my findings after PE and before my counselling..shud have done it after hx but was running out of time for PE.so went ahead with PE first in all cases before summary.

Guess most of my mistakes are related to hx and PN so I got borderline on ICE..Higher on SEP,CIS.

Things i did right:
-Introduced myself and addressed them well,smiled,washed hands,spoke slowly and clearly,draped well in all cases.
-Asked them if i can sit and write down notes.
-Used transition sentences.
-Repeated things if not clear and requested them to repeat when they weren't clear.
-Requested fr every examination,undraping,told them each and every thing what im doing and what im lookin for sometimes( like leg swelling etc.)
-Thanked them for walking and after my system ex.
-Asked them for any Q and concerns,twice for each case.Most of them did have another Q when asked 2nd time.!
-Prasied them for giving up smoking,following gud lifestyle in HTN etc.
-Counselled every pt with HTN both controlled and uncontrolled.
-Showed my empathy and reassurance.

Advice:
-No matter what u study and hw u prepare,the way u deal that each 15min encounter is the key..Before u realize all the encounters gets over so so fast..
-Practice well to be confident..
-I was nervous for 1st 1/2 cases,felt bad that i wasn't doing well but i took deep breath and calmed myself for the rest..
-Its common to realize few mistakes when u are still inside the room/while typing PN.Make sure you dont repeat same mistake in next cases..
-I typed in this order: DD-workup-PE-Hx. Somehow i feel it helped me as i took time to think what to put as DD.workup was based on whatever DD..PE wont take time as u wont have many positives..So i used the rest of my time in elaborating HPI..ran out of time in only 1 PN.


THANK GOD i passed. thanks to my study partner nd ppl here for ur posts..GOOD LUCK to all waiting for results..hope u all pass..
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The above post was thanked by:
achistikbenny (06-20-2013), adeelacheema (06-16-2013), aknz (06-15-2013), Dr. Mexito (06-17-2013), Faith1130 (06-17-2013), ifss (06-16-2013), Kaizen (06-17-2013), raja5 (06-15-2013), Ramukaka (06-17-2013), Sparco (07-03-2013), usramt (06-16-2013), venky2600 (06-15-2013), water (06-16-2013)




  #2  
Old 06-16-2013
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Thanks for the experience and congrats. What is the key to good history taking? We should try to finish in about 6-7 mins but I'm having some difficulty. Is the key in asking open ended questions? If so, can you give examples please. I don't know many other than the "tell me more about your cc" Do you think asking the q's in FA for each case is sufficient for HPI? Thanks.
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  #3  
Old 06-16-2013
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Hello..Yes i used only that one "can you tell me more abt it" after CC..It works..As u get most of the positives related to cc..You can use " do u have ANY bowel complaints", "ANY urinary complaints" like that..If they say no then u dnt have to ask each and every symptom specifically related to bowel and bladder..Though u have to ask specifically for ROS..for eg headaches,chest pain,dyspnea like that..Yes FA is more than enough..sometimes u may not remember or no time to ask all those q they give on FA..thats alright..Just dnt forget imp q related to CC..Eg:wt,bowel,cold intolerance ets when u think of thyroid in fatigue case.. Practice again and again..HX wont be problem..Infact doing PE in time is a bit difficult in few cases..Do focused PE..

GOOD LUCK..
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  #4  
Old 06-17-2013
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i screwed up 2 cases, sort of blanked out and messed the differentials...missed a point in PN in one case
other 10 cases were ok...
am really worried now...
are 2 bad cases enough for failing???
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  #5  
Old 06-17-2013
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Dnt worry much..U just messed up few DD on 2cases..its okie as u did the others well.And no one knows which are the 2 cases they dnt grade..so cant comment on that..Good Luck with result..
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  #6  
Old 06-17-2013
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Quote:
Originally Posted by usmleprep_sr View Post
Hello everyone.. I have been freaking out so much about the result as each and every single soul does post exam..And waiting for 2months wasn't that easy at all..But reading others mistakes here on forums and seeing so many others going thru the same helped me to calm down lil bit. So i thought its my turn to share.. Infact i dont know which of these are blunders and which are okie..

The mistakes i think i did:
-Forgot to ask obs hx in one case where it was necessary.
-Forgot to counsel abt smoking,alcohol etc in 1 case.
-Forgot to ask few relevant HPI q in 2 cases.
-Ran out of time in 1 PN,i cudn't complete half of Hx part though i finished PE,DD,workup there..
-Wrote only 1 DD for 1case,only 2 DDs for another.
-In 2-3 cases i think 1 out of my 3 DD's was the least possible DD.(Had no time to think,jus filled it up whatever came to mind related to CC even though there was no other positive hx)
-Forgot to order most important immediate workup in 1case.
-Fumbled in 1 case as i was nervous.
-Cudn't counsel well abt my workup and DD in 1 case.Ran out of time
-Cudn't answer SP's challenging Q well in the end in 1 case.Ran out of time.
-Forgot to pull out leg extension in 1case,didn't dim the room light for ophtalmoscopy ex.
-sumarized hx and my findings after PE and before my counselling..shud have done it after hx but was running out of time for PE.so went ahead with PE first in all cases before summary.

Guess most of my mistakes are related to hx and PN so I got borderline on ICE..Higher on SEP,CIS.

Things i did right:
-Introduced myself and addressed them well,smiled,washed hands,spoke slowly and clearly,draped well in all cases.
-Asked them if i can sit and write down notes.
-Used transition sentences.
-Repeated things if not clear and requested them to repeat when they weren't clear.
-Requested fr every examination,undraping,told them each and every thing what im doing and what im lookin for sometimes( like leg swelling etc.)
-Thanked them for walking and after my system ex.
-Asked them for any Q and concerns,twice for each case.Most of them did have another Q when asked 2nd time.!
-Prasied them for giving up smoking,following gud lifestyle in HTN etc.
-Counselled every pt with HTN both controlled and uncontrolled.
-Showed my empathy and reassurance.

Advice:
-No matter what u study and hw u prepare,the way u deal that each 15min encounter is the key..Before u realize all the encounters gets over so so fast..
-Practice well to be confident..
-I was nervous for 1st 1/2 cases,felt bad that i wasn't doing well but i took deep breath and calmed myself for the rest..
-Its common to realize few mistakes when u are still inside the room/while typing PN.Make sure you dont repeat same mistake in next cases..
-I typed in this order: DD-workup-PE-Hx. Somehow i feel it helped me as i took time to think what to put as DD.workup was based on whatever DD..PE wont take time as u wont have many positives..So i used the rest of my time in elaborating HPI..ran out of time in only 1 PN.


THANK GOD i passed. thanks to my study partner nd ppl here for ur posts..GOOD LUCK to all waiting for results..hope u all pass..
Hey really nice post. Hope to post something similar when I PASS. Just a question for you. How did you type your PN? Was is it the same format as the way it was in FA? Bc I think that's the only other major thing I am worried about. Hoping that my PN is good enough to pass the ICE portion. I did it the way FA has it. I am hoping that's sufficient.
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  #7  
Old 06-17-2013
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Steps History: 1+CK+CS
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Yes FA format is gud enough..GL with the result..
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The above post was thanked by:
Faith1130 (06-17-2013)



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