Anyone else have an awful CS Experience?

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doogiehowser19

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Hi guys,
I am AMG from a reputable medical school. I just took mine last week and have been feeling awful. This is how it went for me:
1 - Straightforward case. Forgot to do 1 very simple maneuver.
2 - Similar to #1. Forgot to do same maneuver as #1.
3 - Did not ask about sexual history when it would have been pertinent
4 - Had no idea what was going on so closure was somewhat messy.
5 - Accidentally told him "during your (nameless disease) episode", when I actually meant to just repeat the symptomatology. I quickly said "please disregard that, that's not what I meant. I meant x symptom." And moved on. Closed and went back to do 1 exam maneuver.
6 - Patient told me an exam maneuver was painful so I told him "please don't do that if it hurts, I will try to listen as best as I can". Closed but then asked a couple HPI type questions.
7 - Decent encounter overall. But forgot FH.
8 - Agitated seeming patient, but I thought I addressed her needs. I might have goofed up the challenge question.
9 - Decent encounter overall.
10 - Very stoic sort of patient, kept coughing. Realized afterwards that maybe I should have given water.
11 - Awesome encounter.
12 - Decent encounter overall. Again, went back to ask a couple questions after closure.

My closures were mostly about the tests I would be ordering. I never gave a full ddx, just sort of explained in simple terms "oh this could be a problem in the x so I would like to obtain imaging and blood tests". Always asked if they had questions. Tried to be comforting when possible. Sometimes, I closed and then went back to do an exam maneuver or ask a couple of HPI questions that I remembered. Not sure if this is acceptable.

For all, I felt that I ran out of space in HPI. Didn't even put pertinent negatives a lot of the time because there was no room! I always did some type of PE, but could not always fully document. Forgot diagnostic workup completely in 1 case. I put about 3 pieces of evidence under each dx, not sure if that was enough.

Preparation was First Aid 2CS. I did the cases twice with a friend. Practiced on their note software. Passed school OSCEs. Although in my recent rotations I wasn't seeing patients, so this might have worked against me. I felt that my flow wasn't what it was a few months ago, despite practicing for about a week.

Thoughts on this? I'm feeling pretty bad right now.

Praying that I pass. Otherwise this might jeopardize match for me if I have to retake it as I don't think I will have score back in time for rank lists. This is going to be an awful, long wait.
 
Update: Passed.

Everyone reading this, please don't take this exam for granted. It made me feel awful for months, just waiting and not knowing. Prepare well, take it early, and forget about it.

Congrats on passing... How was your ICE in the report??
 
I am kind of freaking out after reading so many worried posts. During my encounters, I definitely asked a ROS but when I was typing the note I just kind of tacked it onto the HPI without labeling it "ROS". I got too used to typing notes during wards like this - but it would just be like Mr. X blah blah blah blah blah. He denies any F/C/N/V/CP/SOB but endorses HA. Do you guys think this would pretty much count?
 
I am kind of freaking out after reading so many worried posts. During my encounters, I definitely asked a ROS but when I was typing the note I just kind of tacked it onto the HPI without labeling it "ROS". I got too used to typing notes during wards like this - but it would just be like Mr. X blah blah blah blah blah. He denies any F/C/N/V/CP/SOB but endorses HA. Do you guys think this would pretty much count?

The way you did is absolutely fine and preferred. If anything you're going to impress the graders. Good luck.
 
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