Anyone still just "walk in" to CS?

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herewego

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So many of my friends who graduated said you just "need to speak english" in order to pass CS. Does anyone still just walk into this thing? I've been on audition EM rotations for the last 3 months, so I'm used to assessing/writing notes quickly. But between 3 audition rotations and CK, I'm just so burnt out from studying.

Anyone have any thoughts on just "walking in?"
 
If anything i would just read the first few pages in first aid for CS. it is about little tips and tricks to get all the random points. i don't think you need to like review cases and all that stuff that is also in that book.
 
I haven't gotten my score yet (that's next Wednesday, so take my advice if you want), but if you're an American allo student, just be sure to read the first part of First Aid. The book looks big, but it's actually a quick read. The book gives you a heads-up about how to answer "difficult questions" and how to specifically format your note/teach you which abbreviations you can use in the note. Also, unlike the SP's/TOSCEs at my school, Step 2 patients, according to FA, can fake symptoms, i.e. blow hard when you auscultate their carotids to mimic a bruit or not breath on auscultation to mimic pneumonia
 
It is strictly forbidden to mention any content of the test or patients you encountered, so all I can say is, that in my opinion, you would be unlikely to ever encounter a positive physical finding besides a psych issue or pain. This leads me to believe that (1) the physical exam isn't that important for passing and (2) it's a stupid test because every one of your patients is malingering. They can't have any objective physical findings to correlate with any of their history, unless those findings can be faked, in which case they are malingering, which in itself is a totally separate diagnosis that you should theoretically be able to pick up on (oh so it hurts for me to even slightly touch your elbow? You didn't seem to mind when I banged on your triceps tendon 4 times. -- this is an example scenario, not a real case I encountered). In that case, the diagnosis is not tennis elbow, it's malingering. The review books tell you that patients cannot lie. This is, clearly, not the case. It's acting -- The whole thing is a lie! The appropriate way to test us is to have us examine real patients. This is what we do in medical school and internship. If a US medical school and residency programs graduates us (obviously based off of our experiences with real patients), that should be good enough, but for some reason, they can't be trusted, and the better way to make sure we will be good doctors is to send us across the country to pretend with fake patients on a $1500 exam.

Again, just my opinion.

I'm not sure if this directed at me or directed at FA, i.e. since one should not share cases, there is no way FA would be able to know what can or cannot happen. If it's the former, I'd just like to say that I am in no way discussing patients I had during the exam; I'm just reiterating what FA said.
 
So many of my friends who graduated said you just "need to speak english" in order to pass CS. Does anyone still just walk into this thing? I've been on audition EM rotations for the last 3 months, so I'm used to assessing/writing notes quickly. But between 3 audition rotations and CK, I'm just so burnt out from studying.

Anyone have any thoughts on just "walking in?"

Study for it, they upped the passing threshold because of that NEJM article recently calling them out for charging for a useless exam. They are going to fail more AMG's now.
 
Study for it, they upped the passing threshold because of that NEJM article recently calling them out for charging for a useless exam. They are going to fail more AMG's now.

According to the USMLE website, the new changes will result in a 3% reduction in the pass rate for US allo students. Since the pass rate is usually 97-98%, the new rate should be about 94-95%. For reference, the pass rate for allo students for Step 1 is 93-94% and 96-97% for CK.

http://www.usmle.org/announcements/default.aspx?ContentId=110
 
It is strictly forbidden to mention any content of the test or patients you encountered, so all I can say is, that in my opinion, you would be unlikely to ever encounter a positive physical finding besides a psych issue or pain.

Negating your rant about all the actors malingering, I will say that you can have positive physical exam findings that can change your differential. For instance (not based on an actual scenario I had), you may have a patient with RUQ pain (which can be easily faked), and might be suspecting some sort of cholecystitis. But when you do the exam, you see a scar (not faked), which you ask about. Turns out the 'patient' had a cholecystectomy 10 or whatever years ago that didn't come out in the surgical history (maybe because you didn't ask, maybe because the patient forgot, as both are real-life scenarios), so your differential has changed.
 
Definitely study, even if it's a few days before the exam. Like others have said, FA is actually really easy to read and it will help refresh your memory in generating a differential for many many common chief complaints. My friend and I were able to basically get through most of FA during the plane ride and another couple hours the night before the exam.

Another big reason to study a little is that god forbid you fail, do you really want to pay yet another $1200 plus potential travel expenses because you risked walking in due to burnout?

I'd also consider what kind of prep you have had at your school like OSCEs and other assessments using standardized patients and if these would at all be similar to CS. Good luck!
 
Absolutely-- study, friends 🙂

Even if CS is simple, straightforward and all of those other things I've heard from my peers (and I'm sure you've heard from yours) ... the truth is that a fail on CS can really derail your otherwise pristine record. It is a high stakes exam and it is a licensing examination. I would take it very seriously and not let chance control your fate.

I passed CS. I read first aid (about 75% of it) carefully. The only thing I wish I had done was play around with the patient note form online on the NBME website -- that would have spared a lot of exam-day frustration for me.

Best of luck all.
 
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