USMLE Forums - View Single Post - Passed CS on 1st Attempt
View Single Post
  #1  
Old 06-24-2013
Faith1130 Faith1130 is offline
USMLE Forums Scout
 
Steps History: 1+CK+CS
Posts: 55
Threads: 4
Thanked 50 Times in 21 Posts
Reputation: 60
Smile Passed CS on 1st Attempt

Sorry for the delay in posting. But I wanted it to be a very good post where it's used as a guidance for others.

About myself:

- I am a 4 yr Carib medical student, currently finishing up clinical rotations. I completed my 2 yrs of basic sciences in the caribs.

Prep time:

- When I got my ticket back, I was half way through my Surgery rotation in March, and paranoid that I won't get a date till later June, as soon as I got my ticket I registered to take my CS on May 7th at Chicago center. Was a bit disappointed when I had to settle for the afternoon session, but I think it worked out for the better.
- Was a bit scared to prepare while on my surgery rotation, but I instantly started to look for a sp. And I found one we started with the big cases. It was great for the first 2 weeks, until she came to Chicago to prepare with a friend of hers. So In total my prep time was about 6-4weeks on and off, spent about 4hrs everyday.

How I prepared:

- Initially, I thought to know the minicases well, and then use the big cases off of FA to test myself. But I talked to a friend of mine who took the exam and she had to focus on the big cases and get used to the flow of things and timing yourself. So I did just that. Since my sp bailed on me, and I didn't have time to find another one, I used my husband as my standardized patient. Which I think worked out great for me, because he's not from the medical background, so he made me simply a lot of things.
- Since I was doing my surgery rotation, as soon as I got home I practice 2-3 big cases from FA on him...in timed mode almost everyday. There were days I did really well, and days when I was terrible went over my time...but my only mistake was I didn't practice PN from the start. If I had I think I would have been more confident with it.
- I started to practice PN when I had 3 weeks left till my exam.
- When I started to type my PN I realized I was having a hard time coming up with my DDx...so realized that I need to know my Minicases...So then for a week I stopped practicing on my husband...and I started to look for a sp for minicases, but really didn't have much luck, so I took note cards, and wrote every minicase out and basically quizzed myself. And I am glad I did this because coming up with DDx, workup...and supporting it with positives and negatives made it easy.
- As I went along the minicases, I started to realize that, I should have first did a couple of minicases and should have had my husband quiz off of those minicases by doing the big cases of those CC...I think that would have worked better...and if anyone where to ask me I'd give them that advice. I tell them to look at some minicases first and then practice those by doing the big cases, and the PN....
- I used the usmle practice PN page to practice typing my PN...and that was very similar to the one on the actual exam. The only thing I'd suggest is to practice on a keyboard, and not on laptop, because I had a difficult time adjusting with the keyboard.
- Seriously guys read the FA...its all you really need if your english is good...you really don't need any review course or anything.
- For the PEs I did look at the CSE videos..but only some esp. for the neuro exam. and I youtubed some if I wasn't convinced with the CSE videos, and honestly that's all you need. So say that the CSE videos are horrible, to a degree I think they are, but if someone wants to get just get a feel for what the exam/encounter will be like...then yes I think the CSE videos are good. If any one of you guys are from a Carib school had ICM,and you guys had a mock exam...then I think they prep you well on the island if you remember those. I honestly used my island experience from ICM..and the mock exam I had.
- Also don't forget to time yuorself... I used the 10min warning..and then 13mins...and for PN...I used the 8 min warning as my 10mins...and guys PRACTICE PRACTICE PRACTICE!!!
- A lot of ppl are concerned about the CIS portion...FA also has tips for this...right at the start of each big case...they have written what the SP should expect...and in their it tells you that if the patient is coughing did they offer tissue or glass of water...so if this guys it common sense. I was once reading a post from a different forum right before my exam..and they wrote it beautifully...imagine the SP is your mom or dad...and how would you treat your parents...you'd want your parents to get the top most level of service or care...so if you ask them to walk across the room make sure ur their to assist/spot them....
- A lot of ppl asked if they should wash their hand or wear gloves...I wore gloves...it saves time..and whenever I am nervous I have cold hands...so it added that extra barrier...also guys if your going to wash hands and your hands are cold...apologize for cold hands...its these simple manners they are looking for...I smiled...said sorry a lot...commended them if they weren't smoking,drinking,doing drugs...counseled them immediately if they did drink/smoke/drugs...or any other alarming lifestyle...I was just recently married 6 months ago... so I even talked about how I hope to go as many years of marriage as them. I had someone who told me they have everyone healthy in their family so I told them about how I have a grandmother who's 95..and is completely healthy...I was real with them and told them about my personal life..even though anything they said was scripted...but I guess that's why I got high performance on the CIS...This is exactly what this other person wrote in a different forum...that half through his exam...he just started to talk to the patient...you just get so comfortable that you just start talking to them...and that's exactly what happened to me.

How to type the PN:

- As far as the PN... guys I used the format as it is in FA big cases... I did type in ALL CAPS...and this was actually a last minute change I had made on the day of the exam...for some reason I felt it looked better when I wrote in ALLCAPS...so I went with that..someone wrote that oh if you write in all caps then you're telling the grader that you're a IMG or FMG...its the same rumor as the SPs will know that your a FMG or IMG or AMG...I don't think any of it is true.... I think what is true is how you present yourself to the SP...if you don't look or sound confident then yes its a problem... but if you believe in yourself...then they will believe you..and they do keep a good poker face....I was able to crack some with jokes here n there...but they went back to their serious face... but you have to watch out for that... bc then u know you have nailed the CIS part...
- I did do a focused PE...so even when I types my PN...it was focused first... ofcourse if I had time I organized it system wise... but I did write VS: WNL...except BP: 140/90....I avoided typing WNL...and actually wrote out what I palpated/heard/precussed....
- Also about the CIS guys...I haven't read much on ppl mentioning this...but I hope you guys are telling the SP what you're going to be doing before you do it...because that even applies to real practice..esp. if you're going to look into their ears...listen to their heart and you need to untie their gown...so make sure to ask permission and tell them what you're doing... after all it their body...would u want a stranger touching your abdomen just like that...
- the order of which I wrote my PN: DDx + supporting +/- findings, workup, HPI, PMI, PE....I did have a case and there was a lot of PE I wanted to type...so I typed my DDx...but forgot to type my workup...and I didn't realize it till the end when the time was up...and I had to click submit... but hey that was the only major I made...I also couldn't spell a herb....but hey I passed .
- About the + and - findings to support the DDx...this is the way I approached it...FA has an explanation why a certain DDx is most likely...and they even tell you why it might not be the top most DDx...I honestly used those to support myself...and for a lot of them I used the CC as my support for DDx....you will hardly has a positive PE finding...so for the PN...make sure you know the NORMAL...increases typing speed...also yes abbreviations are good...but only use them if you're sure..if you're not its best to spell it out...

EXAM day:

- NERVOUS AS ANYTHING!!! Stomach tied into knots...didn't want to eat anything....cried a lot....but again...the other post I keep talking about from a different forum..they wrote to talk to other students...it'll calm your nerves..which is totally true....
- Encounters....found them already draped so asked them if there is anything else I do to take them more comfortable in the room...
- My first case I was nervous but as soon as I read the doorway info...it was an easy case...I was so happy..and by then end of the night....I just got so comfortable...I just talked to them normally as if I would with my family..or some of the pts during my clinical rotations...
- Before I walked in...these were the things I did... I wrote down if its MR. Smith or Ms. Smith... this way I got the male/female part covered...I wrote CC... location...if its ER/ED/phone/clinic...any alarming vitals... my mnemonics...I honestly... used LIQORDSSAAA...PAMHUGSFOSSWAEDT...and some additions here and there based off the things I used to forget when I practiced on my husband... so I think this something you to come up with on your own... Someone I knew who took the exam long time ago...she told me something that made sense to me as I did my minicases...she told me make sure you ask all the systems questions associated with the CC...for example...suppose a pt comes in with chest pain...don't just automatically think its MI or angina...it could be a GI problem like angina of the esophagus that could mimic (btw this is just an example..it doesn't imply anything towards the exam). So I think when you do minicases it covers this so that you know to ask better questions... other things I wrote was PEs that I knew I should do..esp if its neuro...and if I already knew the DDx I wrote those down too... I honestly spent a good minute outside before I walked in....spend this time guys...bc once your in your just with them....you don't have time to think....and if you blank out its shows as lack of confidence...and you don't want to show your weakness.... At the end of the day...I feel if you have prepped well and don't show weakness...you will pass and do great...

I might have missed things here any there to type...so if anyone has questions pls don't hesitate to ask...I know how you all feel...I went not so long ago when through all this...and did it all with the help from forum members...GOD and my husband...whom I owe a lot of thanks to...GOD and my husband went through a lot with me...and with them, I wouldn't be here...so guys pls ask away...
Reply With Quote
The above post was thanked by:
add1 (06-24-2013), Ahuizotl (07-10-2013), aknz (06-24-2013), beka-CTS (06-24-2013), booboo123 (07-07-2013), ChicagoGrad (07-09-2013), Dr Pepper (03-03-2014), eveli55 (07-05-2013), geo82 (07-05-2013), hepevirus (06-25-2013), hypermedic (06-25-2013), leene1982 (06-24-2013), MedicalExaminer (06-24-2013), menatallah Elgohary (11-30-2014), Novobiocin (06-24-2013), ronney (07-09-2013), venky2600 (06-24-2013), water (07-05-2013)