USMLE Forums banner
Status
Not open for further replies.
1 - 20 of 100 Posts

·
Ex-USMLE Forums Staff
Joined
·
753 Posts
Discussion Starter · #1 ·
Many of us just get puzzled by the possible outcome of our CS performance. And often we start to remember how many mistakes we had right after we leave the center.

So, it becomes very worrisome for us and that is compounded by the fact that waiting for the CS results is usually a couple of months process and not just three to four weeks as in the case of the written Step 1 and CK.

So let's start a thread where each one of mentions what mistakes he had in his CS exam and then to mention whether he/she passed or failed.

Here's my example:

Mistakes:
-Did not wash my hands in one case.
-Did not have time for closure in one case.
-Forget several questions to ask in a case of chest pain.
-Forget to mention pelvic exam as the first work up in the patient note.
-Did not get the diagnosis in one case.
-Forget to offer a glass of water when the lady coughed in front of me.
-Forget to auscultate the abdomen in abdominal examination.

Outcome:
-Passed
 

·
Registered
Joined
·
741 Posts
Here's my mistakes

Mistakes:
-Did not have time to finish the physical examination in two cases.
-Missed several differential diagnoses to mention in the PN in 3 or 4 cases.
-Did not show empathy when the lady cried.
-Was considered rude by one of the SP when I asked about impotance
-Did not do percussion in any respiratory exam.
-Did not do minimental exam in a case of dementia

Outcome:
-Passed
 

·
Registered
Joined
·
4,342 Posts
Here's my mistakes

Mistakes:
-I was dragged out of the patient's room by the instructors because of time finished and I stayed there!
-I missed several differential diagnoses, at least in three patients
-I forgot to drape the SP in one case
-I forgot to counsel about safe sex and STD in one case
-Did not ask CAGE questionnaire in two cases

Outcome:
-Awaiting results!
 

·
Registered
Joined
·
4,342 Posts
Many mistakes but I passed

Mistakes:
-Did not have time to do physical examination in the first case
-Did not mention diabetic follow up in the plan of one case
-Did not mention ophthalmoscopy in a case of diabetic retinopathy
-Did not do ophthalmoscopy in case of trauma
-Forgot to ask about baby's growth and milestones
-Forgot to ask menstrual history in a woman SP
-Forgot to ask social history in two cases
-Forgot to give closure in once case
-Did not do abdominal exam in a fatigue case
-Did not do vibration and touch in a lower limb neuro case
-Did not examine the thyroid in a depression case
-Forgot to mention urodynamic studies in a case of incontinence
-Forgot to ask about drug allergy in once case
-Asked silly questions in several cases
-Did not show adequate empathy and rapport in a case of sexual assualt
-Forgot to mention rectal exam for the SP in case of urinary retention

Outcome:
-Passed! Can you believe it :happy:
 

·
Registered
Joined
·
236 Posts
Can you top that?

I had a strange fit of indifference during the exam, I felt that some mistakes I did were on purpose:
- I wore gloves in the middle of the PE in one case
- I did not ask about drug allergy in 4 cases
- I did not ask about menstrual history in 3 cases
- I did not write the abnormal vital signs in 2 cases
- didn't do mental status exam in 2 cases
- Forgot to counsil a patient about smoking + Pot smoking, another patient I forgot to counsil about smoking also.
- Forgot to tell a patient that I need to do a pelvic exam and forgot to write it in the PN, another patient I forgot to tell about rectal exam but I wrote it in the PN
- Forgot to ask about a severity defining aspect in a pediatric patient, a very imp question
- I missed the major diagnosis in 2 cases, one of them was really obvious, and in the 3rd one I put as the 2nd or 3rd DDx
- Forgot to show sympathy in one patient.
- Forgot to do a knee exam in a patient.
- I was in a very terrible state, so I am not sure what I forgot to do else.

So there you go, I am waiting for the results, and if I really did pass, I don't know who is going to fail!!!!
 

·
Registered
Joined
·
58 Posts
wish I had read this before my CS!!!!! :) would have saved me many sleepless nights as I waited for the result..well anyways, since I passed, I can now enlist my own mistakes, and u guys can feel better by reading them!

- came out of the room in 6-7 minutes..
- stared at the patient for maybe 30 seconds when she said doc is my baby going to be alright? and then said , I don't know...
- said er...er...er....um..maybe.
- was almost unable to control laughter when one pt said something funny unintentionally
- made an SP yell by poking an otoscope in her ear.
- I was in the middle of my closing when the bell rang in one case, so I was like-oh no! now I have to go!
 

·
Registered
Joined
·
21 Posts
HI ,my mistakes

I think I did several mistakes in the exam

1. I always use gloves and did not wash my hands.

2. When I was about to start the PE the SP told me could you please put my cell phone in the table, I took the phone and put it on the table, and then I did not change my gloves again!
3. When I was doing abdominal examination I forgot to pull out the footrest and noticed that at the end of the examination, I said I'm really sorry about that and the patient was having abdominal pain.

and several other mistakes that I don't want to think about them anymore

Let's see if they pass me or not!
 

·
Registered
Joined
·
127 Posts
These are the mistakes that I can remember..

Mistakes:
1. On my first and third cases, I forgot to do CVS and Resp exam (the Patients CC was not related to these two systems, but still...)
2. Forgot atleast 2 important DDx
3. Forgot to do psoas and obturators sign (it was necessary)
4. Was empathetic, but not sure if it was enough
5. Didn't mention DRE and dont think I wrote it down either

Outcome:
Passed, see my thread
 

·
Registered
Joined
·
390 Posts
These are the mistakes that I did on my CS exam :
1. forgot to record the result of cardiac ascultation in one patient note, I did the PE but I forgot to write it...so stupid !!!! (it was necessary)
2. forgot to ask family history in one case
3. forgot to mention pelvic exam during closure in one case
4. never asked CAGE questions (I dont know if it's necessary because most SPs drink only 1-2 beers on weekend)
5. forgot to do abdominal examination in one case (it was necessary)
6. forgot to ask delivery history when it was very important to rule out some differential diagnosis
7. asked one SP to repeat his answer because I couldn't pick up what he said (it was too fast for me)
8. didn't give enough empathy to one patient with some personal problem in their life
9. did mistake when summarizing patient's history in two cases (the patients corrected some points in my summary )
10. forgot to put the vital sign in one patient note

That's what I can think of now, there will be more coming up......ahhh...I think will fail this exam
 

·
Registered
Joined
·
7 Posts
Mistakes
- forgot to do thyroid examination in a case of fatigue .
- still asking history when 5 min left, so I've to rush physical exam and closure.
- forgot to copy vital signs in 1-2 PN.
- didn't counsel for smoking cessation in 1 case.
- one SP asked me some questions during examination and then i answered his questions and did the closure the same time. So forgot to finish my physical examination. :eek:

and there are many more that I can't remember of now because my exam was on 29th April.

Outcome:
Passed

Comment:
I posted this because I feel thankful to those who posted in this thread.
after my exam I felt very frustrated, having the flashback of all the mistakes I have done. But after I found this thread, I feel much relieved.

good luck to every one !
 

·
Registered
Joined
·
12 Posts
Mistakes:
- I forgot to ask about rash in a ped case, after leaving the room I realized it could be relevant to the Dx
- one patient refused to answer my question about sex Hx & I couldn't convince her too
- forgot to ask about menst Hx in 2 female pt
-I couldn't finish PE in 2 neuro cases, especially one of them was the 1st case, so I had to say "I'll be back as soon as I get the test results, nice meeting u" & leave, although I didn't give any idea about the DDx or Ix !!
- my closing was pretty much the same in all the cases, I gave the 1st 1 or 2 DDx, draw blood for lab tests,imaging studies, I never gave any details about the Dx work-up, that's why I got the lowest performance in information sharing skills, so I would really recommend that u spend more time in closing, even if u have to cut PE short.
- I forgot to counsel about coffee & energy drinks in a relevant case.
- I missed an obvious Dx, should have been the first in the list
- in 2 or 3 cases I had less than 5 DDx & Ix.
- There was a case I had no clue what the Dx was, I asked all the questions possible, I had to go with a close one.
- I was very nervous so I couldn't fake empathy in most cases, I was always thinking about the Hx & what PE I have to do,couldn't look at the clock, coz I thought it would be inappropriate.

Outcome:
PASSED !! sooo happy !! :))
 

·
Registered
Joined
·
752 Posts
My Mistakes

I took the exam on July 5th in Chicago. The night before, I had fever and chills I was sleeping all day. I thought I wouldn't make it, but in the morning I felt much better, although I had some nausea, and couldn't have a good breakfast. Anyway, here are my mistakes:

- I forgot to take out the footstep in almost all abdominal exams. I don't know why, but I just forgot.
- did not counsel a patient who smoked 2 cigars a day.
- my PE was not really complete as in FA for instance, but I don't understand how anyone would be able to do it in such short period of time, but I did good closures in all cases.
- I had very similar cases (2 abd. pain, 2 depression), and my PN for them were pretty similar; I don't know if it's my fault, though!
- forgot to add a speculum to the otoscope before examining!
- in one case, I rephrased something the patient said which was not correct, and he corrected me! he seemed kind of pissed!
- forgot to do psoas, obturator, Rovsing maneuvers for RLQ pain.
- forgot to offer the "suicide contract"; i.e. make the patient promise me that he'll call his family or the office in any case of suicidal thoughts or plans.

Outcome:
result not out yet.
 

·
Registered
Joined
·
39 Posts
Mistakes:

1. in my first case the patient kept describing things in detail no time for closure. had to make emergency exit.
2. almost cases did not do extra physical exam other than mentioned.
3. many times listed imp n most likely ddx as 3 or last
4. kept writing extra ddx as 6. lol
5. summarized a finding incorrectly one time n patient got pissed

Results:
awaited
 

·
Registered
Joined
·
50 Posts
My mistakes

  • Screwed up the first case completely, no counseling, no closure.
  • Kicked one of the SPs by mistake when I crossed my legs while sitting. (apologized a hundred times)
  • Was not able to reach the final diagnosis in 3 cases.
  • Didn't do the complete physical on most of the patients.
  • Ran out of time in 3 cases.
  • Did not answer one of the patient's question correctly.
RESULT-
Passed with high performance
 

·
Registered
Joined
·
7 Posts
my mistakes

should have changed my sleep wake cycle 2 weeks earlier so that i would not have felt sleepiness in first few cases
1. first case disaster...cudnt even complete PE
2. did not have time to close in 2nd case
3. did not counsel in 3rd case
4. twice the proctor came in and dragged , and warned if i repeat she will report
5. became hopeless by 4th case and dragged myself along
luckily the lunch break gave some hope to reorganize myself
then was able to smile ,talk like a fren to remaining 7 SPs
5. even then missed 2 clear cut diagnoses
6. did not mention p/v and p/r exams
7.my spoken english was a complete nuisance but even 2 SPs had worse english than mine...i had to make them repeat thrice what they said in two cases....they seemed to mind...
8. do not want to give this exam again even if i have to..
so i suggest u to quickly reenergize urself from the very first case...being informal yet professional will help....no need to overrespect this exam....
but honestly i dont think i will pass....
 

·
Registered
Joined
·
47 Posts
Worried about mistakes

Mistakes

1. My 1st case was disaster and 2nd case was bad
2. Total 2 cases no closure at all and 1 case NO complete PE
3. Here and there forgotten some small things in data gathering
4. Wrote 7 DD's in few cases(more worrying)
5. No counselings in 1-2 cases
6. Closures just did average. Spent less time and was in hurry
7. Forgot to mention PE findings i did in PN in about 2 cases..off course minor things

Total 4 cases not did well and remaining 8 cases did ok. This is what i felt after exam. But as days are going more n more mistakes are getting in to mind.Good things are good introduction and heart/lung auscultation in all cases

In few cases i wrote 7 DD's without thinking that its exceeding 5 DD

what i mean is in some cases i wrote 2 DD in 1 column...so got total 7

Example: xyz/abc

above is example of 2 DD's in 1 column

I know that we can write less than 5 DD's and acceptable but what about more than 5 DD's..I also wrote more than 5 Labwork in all cases but am not worrying about labwork bcz sometimes we need more than 5 lab orders

my only worry is more than 5 DD's

Anyone who wrote more than 5 DD's and still passed with high performance in Patient notes.

thanks

OUTCOME: Awaiting for results

My general advice: For exam just read standard books and follow ECFMG/USMLE orientation material of CS. Off course practice makes you perfect/comfortable.

NOTE: DO NOT ask me exam cases and exam center. As a responsible doctors we all should respect NBME guidelines.
 

·
Registered
Joined
·
51 Posts
crazy

ok guys, let me say i did better w/ practice than the real thing, that's how tensed i was:
Mistakes:

  • 1st 3 cases i didn't put gen appearance on the PN (so i missed pts on that)
  • wasn't able to shake hands w/ a patient who was holding her side due to pain
  • may have sounded too technical or medical at times
  • forgot to ask questions here and there for every case!!
  • in ALL my sexual hx transitions, i forgot to mention CONFIDENTIALITY!! (bummer!!)
  • for obgyn, I asked for LMP etc but not MENARCHE!! points off again!
  • there were 3 patients in which I forgot to ask SH: civil status, job, smoking...
  • didn't close 2 cases (knocked on to get out)
  • didn't do a complete exam in most of the cases
  • didn't understand some of my handwriting so i had a hard time transcribing it to my typed PN.
  • forgot verbalize the need for rectal exam

i did so much better during practice.. i tried to keep my nerves cool, but looks like i did a bad job on it

:sorry: i will find out 2nd week of august if they'd put me off the hook for this
 

·
Registered
Joined
·
7 Posts
should have changed my sleep wake cycle 2 weeks earlier so that i would not have felt sleepiness in first few cases
1. first case disaster...cudnt even complete PE
2. did not have time to close in 2nd case
3. did not counsel in 3rd case
4. twice the proctor came in and dragged , and warned if i repeat she will report
5. became hopeless by 4th case and dragged myself along
luckily the lunch break gave some hope to reorganize myself
then was able to smile ,talk like a fren to remaining 7 SPs
5. even then missed 2 clear cut diagnoses
6. did not mention p/v and p/r exams
7.my spoken english was a complete nuisance but even 2 SPs had worse english than mine...i had to make them repeat thrice what they said in two cases....they seemed to mind...
8. do not want to give this exam again even if i have to..
so i suggest u to quickly reenergize urself from the very first case...being informal yet professional will help....no need to overrespect this exam....
but honestly i dont think i will pass....
results:
lord's supreme mercy on me
just pass.....(all performances low)
 
1 - 20 of 100 Posts
This is an older thread, you may not receive a response, and could be reviving an old thread. Please consider creating a new thread.
Status
Not open for further replies.
Top