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Old 12-03-2014
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Default CS - 1st time fail. 2nd time pass. Difference?

Hello all!
I have been a silent visitor for way too long on this site. Thought it's time for me to contribute my experience. For starters, I am currently a medical student from a caribbean medical school.

My first CS experience in June 2014 was at Philly center. I did fairly well in my Step1 (>240) and my shelf exams so I went in with decent prep and a lot of confidence. The experience was awesome, felt great. Was able to finish the notes on time, closed every single case within 13 minutes average. But somehow in August when my results came out I was absolutely shocked to find out I failed ICE! the scary part was I had no freakin' clue wat i did wrong!
I was depressed beyond words and quite lost! My friends, family and mentors at my hospital were puzzled since I was undoubtedly one of their best students. So after several weeks of adjustment disorder I picked my self up to study for my upcoming CK exam in August which was not easy to concentrate on. Thankfully my family was ever so supportive and encouraged me through that entire time. When my school finally cleared me for a retake in September there was obviously no spots until January 2015 so I booked a spot for January knowing that there is no way I will have my score back before rank list. However, every night I used to spend hours rechecking for an open spot to prepone the exam and finally a spot opened up in Cali in October. I immediately purchased the latest first aid for CS 2015. I realized this edition of the book was much more advanced than the 2014 version and noticed that my patient notes were probably the section that i did bad on. Afterall, with the lack of feedback on this exam all we can do is guess where we went wrong. I practiced on average 8 timed cases per day with my dad and my fiance. Starting with the full cases first this time and saving the mini cases for night time reading. I also purchased the Uworld just to have extra cases to practice from. By the end of the 3 weeks time that i had I went through all the cases from FA and uworld at least once and my weak ones like psych twice.
I also changed my PN writing from essay type to bullet point format and also increased the amount of pertinent positives and negatives I gave for each case. I'm not the fastest typist so had to judiciously time my self from bottom to top in the PN. Kept PE for the end.
Come exam day, I took 2 days off from my current rotation in NJ and arrived 1 day before the exam. I tried to relax the day before but just to add to my anxiety my Step 2 ck score was being released that day. Not checking the score was not an option for someone as paranoid as me so I checked it and thankfully it went ok (>230). That gave me some added confidence in the midst of all the anxiety. And I got a decent 4 hours sleep before the exam day.
On the exam day I was literally the only foreign student there and all these AMGs were so relaxed and chatty. I kept to my self since I was in no mood to socialize. Overall the exam experience was HORRENDOUS compared to my first CS exam.
1. I was flustered but kept my composure and did the right PE but didn't have time to close properly.
2. Went ok but talkative lady and I had a hard time keeping up with all the information she was giving so had to ask her to repeat stuff and asked questions even during the PE
3. Nice patient and did ok
4. Difficult patient took forever to answer each question and looked pissed off!
5. Phone case went decent
Lunch break. I was pretty broken and realized I had to up my game if I am to get a pass this time around.
6. Good acute case. Nailed it. Out in 13 minutes.
7. Patient was good but I was so distracted I asked the patient if he smoked and he said yes doc, for 30 years. I wasn't paying attention and said, "that's wonderful!" Patient looked shocked and i immediately realized what i said. I started to play the sarcastic card and said obviously I'm joking and had to go over board counseling him! I thought that definitely cost me the exam.
8. Realized after i walked out of the room that I should've explored his occupation further because answer was diagnosis was based on that!
9. Tricky hidden cardio case. Completely wrong closure but corrected in PN.
10. Trauma case - did ok but patient looked unsatisfied and made him move his injured limbs multiple times.
11. Patient was a horrible actor. She had no interest being there. Went ok.
12. Patient was nice. Did ok. Felt good.
Overall I felt my notes were not the best. Wrote bullets for HPI and very short HPIs too. I hear people using up all the space in writing and I had at least 100 words to spare but wrote all pertinent positives and negatives. For every case I made sure I did the basics. For history didn't miss PMFHUGSFOSS for any patient, was smiling, played the sympathy game very well. Used sanitizer before PE, ungowned and regowned everyone. My only concern was probably didn't close as well as i should've had in most cases.

Outcome - got score today. After 2 months of mental torture and depression - PASSED with flying colors in all sections. Moral of the story - keep calm and carry on. Also, learned that I prematched today in my top choice program. IM residency - Here I come! Good luck guys. Feel free to message me with any questions.
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The above post was thanked by:
ainiluey (12-03-2014), anu4usmle (01-29-2015), citadel08 (01-29-2015), Kimchi (12-03-2014), lili435 (12-03-2014), MedicalExaminer (12-04-2014), seniortaker (12-03-2014)

Old 12-04-2014
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Congrats. Where did you take it the second time around?
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Old 01-02-2015
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Exactly, where did you take the exam the second time
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Old 01-22-2015
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took it in Cali as i mentioned in the thread
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