Argh, what a horrible experience!

[beponychick]

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Hi all!

Just want to vent a bit... Finished step 3 day. Really think I may have failed this thing. The questions were really challenging... people say to take this exam closer to step 2, but honestly, i felt there were a lot of clinical questions that I just had no exposure to (i am only a few months into my intern year). I seriously made guesses on so many questions. This step was way harder than step 1 and 2 .. WAY harder!

And I completely screwed up CCS. At the end of the cases during the 5 minute screen when you input all your final orders, I didn't click "end block" or whatever. I just let the time run out expecting the prompt to ask me for the final diagnosis which it didn't. So on 4 CCS cases, I did not put in a final diagnosis. How horrible is this!!??! Do you think that the diagnosis is a large part of the score? Im just soooo upset right now. I don't want to take this thing again. 🙁

 

[TexasPhysician]

I'm sure you did better than expected. Everyone comes out of Step 3 feeling badly.

CCS I believe wants you to clean up/ add final orders. The diagnosis though is not scored as I understand it.

 

[beponychick]

I'm sure you did better than expected. Everyone comes out of Step 3 feeling badly.

CCS I believe wants you to clean up/ add final orders. The diagnosis though is not scored as I understand it.

Really?? I put in my final orders, but was just waiting for the time to run out... Didn't even realize I had to click the 'end case' button to put in the final diagnosis. If I recall, on the practice USMLE CCS the screen prompted you to do this, no?. Argh.... 🙁🙁🙁

 

[TexasPhysician]

Most of my cases ended early and it forced me to end the case. I guess you could just sit and wait though. This happen to you?

 

[beponychick]

Most of my cases ended early and it forced me to end the case. I guess you could just sit and wait though. This happen to you?

Well even if the cases ended early, it still took me to the 5 minute screen. It said to finalize your orders or whatever. Then there was a button to end the case which I did not press and just waited for the 5 minutes to be up. Is that what happened to you? I'm just so confused now.

 

[asap6]

I'm sorry you dont feel like you did well, i really hope you pass!

I'm really worried for the exam as well, probably taking it in end of Dec or early Jan, about to start using master the boards and UW for it.

I did a few of the CCS cases that the provide you, and I have no idea what I'm doing. I read the explanations and i'm definitely ordering more then needed/warranted. Not sure if I'm passing the cases or not.

Do I need to remove orders when it comes to the 5 min point for final orders?

Any suggestions on what to do? how to study?


Thanks in advance!!

 

[TexasPhysician]

Well even if the cases ended early, it still took me to the 5 minute screen. It said to finalize your orders or whatever. Then there was a button to end the case which I did not press and just waited for the 5 minutes to be up. Is that what happened to you? I'm just so confused now.

You did fine.

 

[Knicks]

I'm sorry you dont feel like you did well, i really hope you pass!

I'm really worried for the exam as well, probably taking it in end of Dec or early Jan, about to start using master the boards and UW for it.

I did a few of the CCS cases that the provide you, and I have no idea what I'm doing. I read the explanations and i'm definitely ordering more then needed/warranted. Not sure if I'm passing the cases or not.

Do I need to remove orders when it comes to the 5 min point for final orders?

Any suggestions on what to do? how to study?


Thanks in advance!!

Yes, I'd like to know as well. (regarding the CCS, software, etc)

 

[TexasPhysician]

Yes, I'd like to know as well. (regarding the CCS, software, etc)

It's like any clinic scenario. If you no longer need a cardiac monitor, discontinue it. If meds are no longer needed, stop them. If the patient is being d/c'ed from inpatient, don't make them get CBCs qdaily anymore.

Almost always provide some sort of education before the case ends ( advice smoking cessation).

Be conservative. Don't ex-lap every GI patient.

Order lots of non-invasive tests.

 

[asap6]

how do you put in education?

 

[TexasPhysician]

how do you put in education?

I forget they keyword that brings up multiple options. Try words like "advise" or "inform". There is 1 keyword that brings up a list involving alcohol, smoking, ocp, side effects, etc.

 

[Knicks]

It's like any clinic scenario. If you no longer need a cardiac monitor, discontinue it. If meds are no longer needed, stop them. If the patient is being d/c'ed from inpatient, don't make them get CBCs qdaily anymore.

Almost always provide some sort of education before the case ends ( advice smoking cessation).

Be conservative. Don't ex-lap every GI patient.

Order lots of non-invasive tests.

Hey TexasPhysician, thanks a lot for the input.

The thing is, I've read here on SDN that the Primum Software and the UW software are somewhat different in several crucial aspects.

How can we go about preparing for the CSS without such discrepancies?

Much thanks in advance.

 

[TexasPhysician]

There probably are small differences. I didn't notice any big differences, and my score turned out fine. Most of my scenarios were similar to UWorld's.

I concentrated on doing an adequate physical and plenty of non-invasive tests. If there is an emergency, do orders before the physical.

I completely botched 1 of the cases, and it turned out fine. It isn't as bad as I thought it would be. Do all the UWorld cases and you will catch on.