COMLEX COMLEX Level II PE 2017

[RockDoc28]

Hi everyone!

I couldn't find a thread about the 2017 COMLEX Level II PE so I thought I'd start one-- please comment a link to an official thread if one exists already.

I am starting to study for it and wanted to hear more about how the day went, what you used to study, etc. For confidentiality/ not getting kicked out of future COMLEX test reasons, some topics I'm looking for include:

• Did you feel rushed during the testing, or did you have enough time?
• What resources did you use to prepare and did you feel like they did a good job?
• Any tips on writing notes you picked up along the way that you feel helped you save time?
• Any technical difficulties on test day?
• Where did you stay/ travel tips.

A list of topics to AVOID include:

• Any detail about a patient case you saw on test day
• Any detail about a patient case your friend saw on test day
• OMT techniques you used on test day

Just to give a little more warning (even though I know you're all very good at not revealing improper info), here's the statement from the NBOME.

Alright, let's get this thing started!

---

Members don't see this ad.

 

[jrlob91]

I just remember that (unlike the MCAT) once you start taking a COMLEX or USMLE exam, barring a medical emergency or act of God, you can no longer withdraw.

I’m pretty sure at the end of board exams you get an option to not actually send your test in, but it would be idiotic to do this because who wants to sit through two step ones? This isn’t an option with the PE though I don’t think.

 

[ortnakas]

I’m pretty sure at the end of board exams you get an option to not actually send your test in, but it would be idiotic to do this because who wants to sit through two step ones? This isn’t an option with the PE though I don’t think.

Nope, there's no option to void at the end of Step 1/Step 2 or Level 1/Level 2.

I guess maybe you could just ghost mid-exam, and that might cancel your score, but the repercussions for "irregular test behavior" are probably worse than the alternative.

 

[jrlob91]

Nope, there's no option to void at the end of Step 1/Step 2 or Level 1/Level 2.

I guess maybe you could just ghost mid-exam, and that might cancel your score, but the repercussions for "irregular test behavior" are probably worse than the alternative.

Hmm

 

[KarmaIsTruth]

I just remember that (unlike the MCAT) once you start taking a COMLEX or USMLE exam, barring a medical emergency or act of God, you can no longer withdraw.

Okay. = (

 

[ananasmed]

Just to keep this thread alive... got my results today, passed the exam. Definitely thought I failed and had nightmares for days after the exam replaying all of the (extremely dumb) things I did wrong/omitted.
I've never been a weak student on OSCEs or on rotations, so just trust your gut and previous performance. Cheers to being one step closer to done with the NBOME!

ETA: score was released on the first day of the date range, ~8:30AM CST.

 

[KarmaIsTruth]

Just to keep this thread alive... got my results today, passed the exam. Definitely thought I failed and had nightmares for days after the exam replaying all of the (extremely dumb) things I did wrong/omitted.
I've never been a weak student on OSCEs or on rotations, so just trust your gut and previous performance. Cheers to being one step closer to done with the NBOME!

ETA: score was released on the first day of the date range, ~8:30AM CST.

I am having nightmares. = (

 

[KarmaIsTruth]

Bump.

 

[1358]

Hey guys, anyone take the PE and receiving scores in the next week? Day 1 of the window was today, still anxiously waiting.

 

[Uafl112]

Hey guys, anyone take the PE and receiving scores in the next week? Day 1 of the window was today, still anxiously waiting.

didn't get anything back. anxiously waiting as well

 

[1358]

didn't get anything back. anxiously waiting as well

Still nothing =(

 

[Dr. Jigsaw]

It will probably be the last day

 

[Indirect&Passive]

My score was posted on NBOME, no email yet.

 

[Uafl112]

Scores up. Passed it

 

[1358]

Scores up. Passed it

Congrats! Me too!!

 

[KVBane]

I was one of those classic, I thought I failed. I was told by my practice patient to wash my hands again, because I touched my white coat after washing my hands before doing the exam, so I immediately thought I failed. But I didn't. If I can do it, so can all of you. Good luck my doods

 

[cheeseydoc25]

Type A personality looking for reassurance from those who wont just sugar coat things for me.

Recently took PE, overall, went pretty good, but had some big mistakes (in my opinion):
-one case was rushing to make sure I got to the PE, missed everything after HPI/ROS (PMH, PSH, meds, alls, SH)
-missed FH in one, missed allergies in one
-one case was completely unsure of diagnosis, spent a ton of time on the HPI/past stuff, rushed PE, gave quick workup and return plan
-forgot to counsel twice
-missed a few physical exam things that I probably should've done
-didnt document a few things that I actually did
-2-3 differentials were iffy

-everything I missed like subjectively or counseling, i put in the plan that "would...... (whatever i forgot)"

I'm pretty sociable, and had conversations will all of the SP's about their condition or lives. I spent minimum of 2 minutes going over A/P, and was in the room for the 2 min warning on every patient. Humanistically, I was able to emmpathetize pretty well I thought. Just "biomehcnically" and connecting the dots I had mental farts.
Things I always did:
-wash hands (before shaking, before PE)
-draped appropriately
-ask for permission to do each exam
-listen on skin, at least 3 posterior posts for lungs, and did all 4 anterior for heart on everyone
-talked with patients at length for challenging diagnosis
-gave return plans to everyone

this 8 week wait is brutal, just need someone to help cool my anxiety. appreciate it.

 

[KVBane]

I think you did fine. This test is more of a test on communication than anything else, and it looks like you communicated properly. You passed.

 

[cheeseydoc25]

I think you did fine. This test is more of a test on communication than anything else, and it looks like you communicated properly. You passed.

Thanks for the reply, I really appreciate it.

 

[cheeseydoc25]

Don't forget to articulate what you are doing, why you are doing it, and what you are finding. Explain your findings and and how they lead you to presume a working diagnosis, vs. why it CAN NOT be <insert differential diagnosis>. People who can't communicate well are the ones who fail this thing, not the students who simply forget to do something.

I think I did this for the most part. There were 2 cases that I was iffy and had no idea what the actual diagnosis was, so i explained the tests I was ordering and why I was ordering them, but didnt necessarily give a definitve diagnosis.

 

[cheeseydoc25]

This is 100% acceptable. Think about real life.. if you walked into an ED right now with a bee sting they would probably get Troponins and CT-Angiogram. Jk. But seriously, working something up and explaining rationale is what the standard of care is, so rest assured knowing the people that design the PE are well aware of this. Your Pass vs. Fail is more determined by the language you use, your manners, your humanity, than anything organically "medical". You'd have to put your stethoscope on their skull and say "your heart sounds normal" to fail the clinical part.

I really appreciate your replies, have helped the anxiety calm down a lot, seriously. Thanks!

 

[Uafl112]

Type A personality looking for reassurance from those who wont just sugar coat things for me.

Recently took PE, overall, went pretty good, but had some big mistakes (in my opinion):
-one case was rushing to make sure I got to the PE, missed everything after HPI/ROS (PMH, PSH, meds, alls, SH)
-missed FH in one, missed allergies in one
-one case was completely unsure of diagnosis, spent a ton of time on the HPI/past stuff, rushed PE, gave quick workup and return plan
-forgot to counsel on one social item
-forgot to counsel on a medical problem
-missed a few physical exam things that I probably should've done
-didnt document a few things that I actually did
-2-3 differentials were iffy

-everything I missed like subjectively or counseling, i put in the plan that "would...... (whatever i forgot)"

I'm pretty sociable, and had conversations will all of the SP's about their condition or lives. I spent minimum of 2 minutes going over A/P, and was in the room for the 2 min warning on every patient. Humanistically, I was able to emmpathetize pretty well I thought. Just "biomehcnically" and connecting the dots on the social counseling parts I had mental farts.
Things I always did:
-wash hands (before shaking, before PE)
-draped appropriately
-ask for permission to do each exam
-listen on skin, at least 3 posterior posts for lungs, and did all 4 anterior for heart on everyone
-did OMT on those where indicated (did not do OSE on everyone); good OMT response from pt's
-talked with patients at length for challenging diagnosis
-gave return plans to everyone

this 8 week wait is brutal, just need someone to help cool my anxiety. appreciate it.

I think my experience was the same for the most part and I still passed. sounds like u didn't do so hot on that one case where u didn't get anything after HPI, but I also had a case that I similarly botched. Theres nothing u can do about it now, but I think you passed.

 

[cheeseydoc25]

I think my experience was the same for the most part and I still passed. sounds like u didn't do so hot on that one case where u didn't get anything after HPI, but I also had a case that I similarly botched. Theres nothing u can do about it now, but I think you passed.

thanks for the reply, this wait is brutal. I try to remind myself that I hopefully did some good things. But then you can only think of all the bad things, like poor differentials, crummy history, etc. Whereas, I know myself, and others that struggle in the post-PE phase, have to realize its big picture things they focus on. Sure I messed up that one case, and probably would fail if the PE was just on that one case, but thats also something I couldve gone back in and done in 'real life'. I've been told 'failure'-esque things are mistakes that people make that are unacceptable (putting things they didnt do), or character traits that need to be corrected prior to residency. So i just try to reassure myself ot hose.

 

[Mir2zapine]

Type A personality looking for reassurance from those who wont just sugar coat things for me.

Recently took PE, overall, went pretty good, but had some big mistakes (in my opinion):
-one case was rushing to make sure I got to the PE, missed everything after HPI/ROS (PMH, PSH, meds, alls, SH)
-missed FH in one, missed allergies in one
-one case was completely unsure of diagnosis, spent a ton of time on the HPI/past stuff, rushed PE, gave quick workup and return plan
-forgot to counsel on one social item
-forgot to counsel on a medical problem
-missed a few physical exam things that I probably should've done
-didnt document a few things that I actually did
-2-3 differentials were iffy

-everything I missed like subjectively or counseling, i put in the plan that "would...... (whatever i forgot)"

I'm pretty sociable, and had conversations will all of the SP's about their condition or lives. I spent minimum of 2 minutes going over A/P, and was in the room for the 2 min warning on every patient. Humanistically, I was able to emmpathetize pretty well I thought. Just "biomehcnically" and connecting the dots on the social counseling parts I had mental farts.
Things I always did:
-wash hands (before shaking, before PE)
-draped appropriately
-ask for permission to do each exam
-listen on skin, at least 3 posterior posts for lungs, and did all 4 anterior for heart on everyone
-did OMT on those where indicated (did not do OSE on everyone); good OMT response from pt's
-talked with patients at length for challenging diagnosis
-gave return plans to everyone

this 8 week wait is brutal, just need someone to help cool my anxiety. appreciate it.

I literally did the exact same thing that you did in your first bullet point of mistakes. The pt was just not forthcoming and a little angry and for whatever reason it made me nervous, so I jumped right to the exam after doing the HPI and ROS. And this was a case in which a thorough Meds/Allergies/Family hx/Social hx/Medical hx/Surgical hx absolutely mattered and would've directed my treatment plan. I acknowledged it in the subjective box with something like "Would have asked about yada yada yada". Other than doing what might be labeled a high velocity maneuver (not OMT, and I promise it was indicated!), this was my number one worry. I passed. You did too. Looking back, one thing that isn't said in these forums that is important to passing is communicating to the patients in some way that you prepared for this exam and that you're giving a ****. It's okay to be a little nervous because it shows that you recognize the high stakes. I have an absolutely unverified suspicious that those who fail are often the ones who lack enthusiasm (probably not the right word, but you know what I mean).

 

[TheOther]

Did the scores just post on the website or did you get an email notifying you?

Edit: scratch this. Got the email. Passed. Drink time.

 

[cheeseydoc25]

Did the scores just post on the website or did you get an email notifying you?

Edit: scratch this. Got the email. Passed. Drink time.

Same!

 

[PEthrowaway]

To any future person who is looking for some crazy reassurance that they passed: I passed! I know it's been months since I've posted, but I noticed people rarely came back and updated if they had passed or not. So even though I found out last November (or December?) that I had passed, perhaps it will provide some solace to those who are in my position looking feverishly for people who made as many stupid mistakes as they did.

 

[Stephanopolous]

Does anyone know if performing a summary statement after the hpi is a required thing? Our school teaches us to do this but it takes extra time and I’m trying to work on my timing in the room so I don’t run short.


Sent from my iPhone using SDN mobile

 

[jrlob91]

Does anyone know if performing a summary statement after the hpi is a required thing? Our school teaches us to do this but it takes extra time and I’m trying to work on my timing in the room so I don’t run short.


Sent from my iPhone using SDN mobile

Definitely not required, in real life or on the PE lol

 

[cheeseydoc25]

i hate to post again in this thread since its a little bit older... but a friend just took the PE and is freaking out about this and he doesnt have SDN account, figured id post for him.

When listening to heart and lungs, he untied the gown with permission... listened to 6 posterior spots, 2 anterior.
For heart, he slid steth under gown for aortic, pulmonic, tricuspid. then for mitral, asked for permission, but put his steth through the arm hole of the gown. he said no one blinked an eye like didnt think it was weird at all.. but concerns are
1. didnt necessarily have them lower the gown to see aortic, pulmonic, and just with permission with steth under gown
2. went through arm hole of the gown and not through side

just hoping to give him some reassurance since he thinks im sugar coating things for him.

 

[Stephanopolous]

It was on skin he should be fine

 

[cheeseydoc25]

thanks that what i said to.. like as long as it was on skin, youre good. but sometimes you need a stranger to tell you the same thing

 

[Stephanopolous]

I totally get it I walked out of there thinking what the heck just happened

 

[crazyboi1993]

I took my PE in March, in PA, walked out thinking it was actually very fair, and tbh some parts were kind of easy. That worried me, because I though I might have failed, or something, bc the stories I hear, was not what I had happened. Everything was straight forward. Luckily I only had to wait 3.5 weeks for the score, and passed. It is very straight forward, and just treat it like a normal patient interaction.

Some tips:
- Watch Kauffman videos, read the book, and his soap notes. This helped out a lot
- Dr. Weston's videos are really good for counseling stuff, because I had stuff asked about it.
- I suggest counseling patients during when your asking social history, so it flows better, and you don't forget when discussing plan. Dr. Weston does an excellent job with this, and TBH made the encounter really well.
- Discuss plan while doing OMM technique, so you don't run out to do it I only did 3 OMM , and they were very basic af, that worried me too. You will know when its indicated
- Hand sanitize once you get in the room, before you start the exam, drape everyone, do physical. (Whenever u touch feet, re handsantize). Help with each positional change, laying them down, and putting them back okay. Ask permission to undo gown. Ask if they are comfortable, or ask them if this is okay. Say sorry my stethoscopes cold, always sympathize with them on everything (someone died, or they are stressed about something). Always smile, and make good eye contact. Exaggerate and show emotion. When you leave, make sure they understand the plan/assesment, thank them for coming in today, ask if they have any questions, ask if they need a note or excused letter, or if you need to contact someone or tell a significant other whats going on. hand sanitize when you leave the room
-PAY ATTENTION to your setting. If your in a ER, don't say, well Im gonna call an ambulance, etc. If they are an ER, you are gonna CONSULT GI or Surgery, if in Outpatient, its refferal
- Practice soap notes. I am very fast typer, and barely finished each time. I worked backwards, did A/P first, then Objective, and Subjective. Save vitals for last they are so annoying to do. I finished all my soap notes with like legit 5-10 seconds left. If I forgot to do anything, I mentioned in Plan, will do next visit- did not address it this visit (I had patients w/ high BP, like many but didn't even mention it to them, but mentioned in my plan, will recheck on next visit)
- Do Focused PHYSICAL. Always do HEART and LUNGS on SKIN, and one additional pertinent body system. DO RECHECK BP its a waste of time.
- Dont freak out. Those 8 hours felt like 8 minutes. I actually thought it was pretty easy, and did not run out of time on any case. If you hear the 2 minute bell, immediately stop, and go to your closing, if your doing OMM, talk about it while doojng it.

Relax, and don't let the "I think I failed" stories on SDN get to you. Be confident in yourself!

 

[cheeseydoc25]

I took my PE in March, in PA, walked out thinking it was actually very fair, and tbh some parts were kind of easy. That worried me, because I though I might have failed, or something, bc the stories I hear, was not what I had happened. Everything was straight forward. Luckily I only had to wait 3.5 weeks for the score, and passed. It is very straight forward, and just treat it like a normal patient interaction.

Some tips:
- Watch Kauffman videos, read the book, and his soap notes. This helped out a lot
- Dr. Weston's videos are really good for counseling stuff, because I had stuff asked about it.
- I suggest counseling patients during when your asking social history, so it flows better, and you don't forget when discussing plan. Dr. Weston does an excellent job with this, and TBH made the encounter really well.
- Discuss plan while doing OMM technique, so you don't run out to do it I only did 3 OMM , and they were very basic af, that worried me too. You will know when its indicated
- Hand sanitize once you get in the room, before you start the exam, drape everyone, do physical. (Whenever u touch feet, re handsantize). Help with each positional change, laying them down, and putting them back okay. Ask permission to undo gown. Ask if they are comfortable, or ask them if this is okay. Say sorry my stethoscopes cold, always sympathize with them on everything (someone died, or they are stressed about something). Always smile, and make good eye contact. Exaggerate and show emotion. When you leave, make sure they understand the plan/assesment, thank them for coming in today, ask if they have any questions, ask if they need a note or excused letter, or if you need to contact someone or tell a significant other whats going on. hand sanitize when you leave the room
-PAY ATTENTION to your setting. If your in a ER, don't say, well Im gonna call an ambulance, etc. If they are an ER, you are gonna CONSULT GI or Surgery, if in Outpatient, its refferal
- Practice soap notes. I am very fast typer, and barely finished each time. I worked backwards, did A/P first, then Objective, and Subjective. Save vitals for last they are so annoying to do. I finished all my soap notes with like legit 5-10 seconds left. If I forgot to do anything, I mentioned in Plan, will do next visit- did not address it this visit (I had patients w/ high BP, like many but didn't even mention it to them, but mentioned in my plan, will recheck on next visit)
- Do Focused PHYSICAL. Always do HEART and LUNGS on SKIN, and one additional pertinent body system. DO RECHECK BP its a waste of time.
- Dont freak out. Those 8 hours felt like 8 minutes. I actually thought it was pretty easy, and did not run out of time on any case. If you hear the 2 minute bell, immediately stop, and go to your closing, if your doing OMM, talk about it while doojng it.

Relax, and don't let the "I think I failed" stories on SDN get to you. Be confident in yourself!

i took it last year.. and i agree that it is straight forward in some regards. you can practice all you want, which is good to form habits, but just to be fair being in the PE and then doing OSCE's at your school do not feel the same. Failing an OSCE at school is a slap on the wrist, the PE carries so much more weight. But i do agree that practicing will limit the chance for errors because you get into a routine.

hand sanitizer before touching patient, i think once is enough. most do it right when you walk in. draping everyone is smart, i did that, many of my friends did too, it just prevents getting caught up in the moment and forgetting.

Get into the habit of just saying everything youre doing, framing it as a question. "I'm going to do an abdominal exam, is that ok?" "Im going to untie your gown to help me listen to your heart and lungs, is that alright?"

during my PE, i told an ER patient i was gonna call an ambulance, i felt like a total ditz. so yeah, pay attention, nerves can take out.

counseling during the SH is definitely what id recommend as well, i forgot at the end of the encounter to bring back up say smoking cessation.

 

[PossibleEMapplicant]

Darn reading this just spikes up my anxiety. I hate waiting for the score to come out. Anyone know what the hard and firm failures of PE might be?

 

[samac]

i took it last year.. and i agree that it is straight forward in some regards. you can practice all you want, which is good to form habits, but just to be fair being in the PE and then doing OSCE's at your school do not feel the same. Failing an OSCE at school is a slap on the wrist, the PE carries so much more weight. But i do agree that practicing will limit the chance for errors because you get into a routine.

hand sanitizer before touching patient, i think once is enough. most do it right when you walk in. draping everyone is smart, i did that, many of my friends did too, it just prevents getting caught up in the moment and forgetting.

Get into the habit of just saying everything youre doing, framing it as a question. "I'm going to do an abdominal exam, is that ok?" "Im going to untie your gown to help me listen to your heart and lungs, is that alright?"

during my PE, i told an ER patient i was gonna call an ambulance, i felt like a total ditz. so yeah, pay attention, nerves can take out.

counseling during the SH is definitely what id recommend as well, i forgot at the end of the encounter to bring back up say smoking cessation.

Once is not enough if you’re staying on the side of caution. Use it once before you shake the patient’s hand and before you start the physical. You contaminated yourself by touching your clipboard. Don’t waste time washing your hands.
Also just a side note, for the love of god don’t waste time rechecking vitals. You’re welcome to say you’ll have someone recheck them, but don’t waste the time in the exam. You have to use what you’re given as correct so it doesn’t matter. You finish early? Cool make it an extra good note.

 

[cheeseydoc25]

Once is not enough if you’re staying on the side of caution. Use it once before you shake the patient’s hand and before you start the physical. You contaminated yourself by touching your clipboard. Don’t waste time washing your hands.
Also just a side note, for the love of god don’t waste time rechecking vitals. You’re welcome to say you’ll have someone recheck them, but don’t waste the time in the exam. You have to use what you’re given as correct so it doesn’t matter. You finish early? Cool make it an extra good note.

I agree that you definitely shouldnt recheck vitals... you wont have time, itll be rushed and itll take something else away.

the hand washing thing is all crap to be honest. I know people who did it right before shaking hands, and then never again; people who did it just before the PE; people who did it both. All 3 types passed. Do what you practice, if u can remember to do both, then do both. but i dont think its necessary. Thats the problem with this test, no one has any idea what is going to fail you or not.

 

[cheeseydoc25]

sorry a couple more questions for my friend... (he should make an account, i know, but this PE funk hes in i dont mind helping)

1. forgot to heart/lungs on a patient, said it wasnt pertinent because of the CC something neuro without giving details he said. and that he put it in his SOAP that hed go back and do it.
2. asked full social history, including sexual, on every person. he said no one thought much of it, but hes worried that for some of them asking sexual hx, etc. wasnt pertinent, but he just did everything to be safe, but i dont know if that was exactly safe
3. counseled patients on social hx things and they 'acted' mad, ex. ma'am your use of ilicit drugs (ex cocaine), could cause chest pain, and they said something like 'can we just focus on my pain'; again just need a stranger to help me show him that this is fine
4. OMM wasnt a full 2 minutes as recommended by some sources, did 2 treatments on each though, just had to rush because it was always at the end.

thanks SDN world

 

[crazyboi1993]

sorry a couple more questions for my friend... (he should make an account, i know, but this PE funk hes in i dont mind helping)

1. forgot to heart/lungs on a patient, said it wasnt pertinent because of the CC something neuro without giving details he said. and that he put it in his SOAP that hed go back and do it.
2. asked full social history, including sexual, on every person. he said no one thought much of it, but hes worried that for some of them asking sexual hx, etc. wasnt pertinent, but he just did everything to be safe, but i dont know if that was exactly safe
3. counseled patients on social hx things and they 'acted' mad, ex. ma'am your use of ilicit drugs (ex cocaine), could cause chest pain, and they said something like 'can we just focus on my pain'; again just need a stranger to help me show him that this is fine
4. OMM wasnt a full 2 minutes as recommended by some sources, did 2 treatments on each though, just had to rush because it was always at the end.

thanks SDN world

1. I was though to do heart and lungs on every patient on skin. If you missed one patient that should be fine and he mentioned in the SOAP thats fine. Thats what I did for BP tbh, and things I forgot to check I just wrote in the SOAP, will check next visitt

2. Its fine
3. Cousel on everything, but if the patient is there for acute pain like 10/10, counsel minimally, be like I would really like to focus on this when ur better etc, with ur permission of course. ask permission for everything, and don't make comments that could come across as judgmental for the patient. like be like, coocaine usage has been shown to cause chest pain, and can lead to adverse effects, have u considered stopping? If the patient refuses, just says, well if you ever want to talk about stopping or need more assistance, I am always here for you. I can provide you with some supplemental material and you can have that option for whenever u were ready

4. Yeah when doing OMM just discuss your assemsnt and plan, makes things easies.

 

[Nonam22]

I didnt re-tie anybodys gowns. I just pulled it back up on to their shoulders... Is this a big deal?

 

[Nonam22]

I took my PE in March, in PA, walked out thinking it was actually very fair, and tbh some parts were kind of easy. That worried me, because I though I might have failed, or something, bc the stories I hear, was not what I had happened. Everything was straight forward. Luckily I only had to wait 3.5 weeks for the score, and passed. It is very straight forward, and just treat it like a normal patient interaction.

Some tips:
- Watch Kauffman videos, read the book, and his soap notes. This helped out a lot
- Dr. Weston's videos are really good for counseling stuff, because I had stuff asked about it.
- I suggest counseling patients during when your asking social history, so it flows better, and you don't forget when discussing plan. Dr. Weston does an excellent job with this, and TBH made the encounter really well.
- Discuss plan while doing OMM technique, so you don't run out to do it I only did 3 OMM , and they were very basic af, that worried me too. You will know when its indicated
- Hand sanitize once you get in the room, before you start the exam, drape everyone, do physical. (Whenever u touch feet, re handsantize). Help with each positional change, laying them down, and putting them back okay. Ask permission to undo gown. Ask if they are comfortable, or ask them if this is okay. Say sorry my stethoscopes cold, always sympathize with them on everything (someone died, or they are stressed about something). Always smile, and make good eye contact. Exaggerate and show emotion. When you leave, make sure they understand the plan/assesment, thank them for coming in today, ask if they have any questions, ask if they need a note or excused letter, or if you need to contact someone or tell a significant other whats going on. hand sanitize when you leave the room
-PAY ATTENTION to your setting. If your in a ER, don't say, well Im gonna call an ambulance, etc. If they are an ER, you are gonna CONSULT GI or Surgery, if in Outpatient, its refferal
- Practice soap notes. I am very fast typer, and barely finished each time. I worked backwards, did A/P first, then Objective, and Subjective. Save vitals for last they are so annoying to do. I finished all my soap notes with like legit 5-10 seconds left. If I forgot to do anything, I mentioned in Plan, will do next visit- did not address it this visit (I had patients w/ high BP, like many but didn't even mention it to them, but mentioned in my plan, will recheck on next visit)
- Do Focused PHYSICAL. Always do HEART and LUNGS on SKIN, and one additional pertinent body system. DO RECHECK BP its a waste of time.
- Dont freak out. Those 8 hours felt like 8 minutes. I actually thought it was pretty easy, and did not run out of time on any case. If you hear the 2 minute bell, immediately stop, and go to your closing, if your doing OMM, talk about it while doojng it.

Relax, and don't let the "I think I failed" stories on SDN get to you. Be confident in yourself!

why isn't there a 2019 comlex PE thread?? also, I just took mine and I am nervous because I did not help anyone tie their gowns back up. I simply helped them put their arms through and pulled it up over there shoulders after I was done listening to heart sounds.. Also, I am pretty sure I didn't reassess on at least 3 OMT cases after treating... Lastly, Im worried about only having 2 differentials on several..@cheeseydoc25 @Stephanopolous @samac

 

[TheBoneDoctah]

In the Kauffman PE Review book, it states that for assessment to number your differentials and then try and find four differentials and then do secondary differentials. However, on his videos, kidney for example, for a kidney stone, his first diagnosis is obviously nephrolithiasis, but then he lists vitamin C excess #2, and then rule out dehydration and UTI #3 and #4.

Why isn't the list set up nephrolithiasis, r/o UTI, r/o dehydration, vitamin c excess, etc?

Also, someone in my class told me that ROS is a separate section? Is this true? In the review materials, it doesn't say anything about this and that you just list ROS at end of HPI to rule in/out your ddx.

 

[drkube]

In the Kauffman PE Review book, it states that for assessment to number your differentials and then try and find four differentials and then do secondary differentials. However, on his videos, kidney for example, for a kidney stone, his first diagnosis is obviously nephrolithiasis, but then he lists vitamin C excess #2, and then rule out dehydration and UTI #3 and #4.

Why isn't the list set up nephrolithiasis, r/o UTI, r/o dehydration, vitamin c excess, etc?

Also, someone in my class told me that ROS is a separate section? Is this true? In the review materials, it doesn't say anything about this and that you just list ROS at end of HPI to rule in/out your ddx.

Vit C and dehydration should go at the end, and ROS would go in the S section of the SOAP note, after the HPI

 

[samac]

In the Kauffman PE Review book, it states that for assessment to number your differentials and then try and find four differentials and then do secondary differentials. However, on his videos, kidney for example, for a kidney stone, his first diagnosis is obviously nephrolithiasis, but then he lists vitamin C excess #2, and then rule out dehydration and UTI #3 and #4.

Why isn't the list set up nephrolithiasis, r/o UTI, r/o dehydration, vitamin c excess, etc?

Also, someone in my class told me that ROS is a separate section? Is this true? In the review materials, it doesn't say anything about this and that you just list ROS at end of HPI to rule in/out your ddx.

I can say I organized it
As HPI
All the other history
than ROS.

I listed the differentials your way. I passed.

 

[cheeseydoc25]

In the Kauffman PE Review book, it states that for assessment to number your differentials and then try and find four differentials and then do secondary differentials. However, on his videos, kidney for example, for a kidney stone, his first diagnosis is obviously nephrolithiasis, but then he lists vitamin C excess #2, and then rule out dehydration and UTI #3 and #4.

Why isn't the list set up nephrolithiasis, r/o UTI, r/o dehydration, vitamin c excess, etc?

Also, someone in my class told me that ROS is a separate section? Is this true? In the review materials, it doesn't say anything about this and that you just list ROS at end of HPI to rule in/out your ddx.

I forgot to do a separate ROS section.. like i included it in my HPI.
i did the ddx like u (i even for one cases only had one real ddx then fam hx, social hx things).

just my 2 cents, from people that have failed from my school is pretty tell tale reason why they did, one kid literally just dropped the gown and exposed breasts of every female (obviously in bra but still), another ran out of time and the proctor knocked and he told them to come back in a minute. just like things where you say 'come on no way', but yes these things happen.
mistakes are going to happen on your PE, i made some things i thought were really bad - others told me otherwise. my friend forgot to expose an MSK xomplain she lost her mind, but turns out quite a few people have forgotten that and its all good. others have even forgotten OMT on a case an passed. Practice makes routine, it doesnt make perfect. My friend was worried she made a mistake she wasnt cognizant of... the thing is, when youre stressed u may do silly things but you do habitual things as well, so practice, and yes youll still make mistkaes but youre not going to be forgetting huge sections are a robot either.

 

[TheBoneDoctah]

I forgot to do a separate ROS section.. like i included it in my HPI.
i did the ddx like u (i even for one cases only had one real ddx then fam hx, social hx things).

just my 2 cents, from people that have failed from my school is pretty tell tale reason why they did, one kid literally just dropped the gown and exposed breasts of every female (obviously in bra but still), another ran out of time and the proctor knocked and he told them to come back in a minute. just like things where you say 'come on no way', but yes these things happen.
mistakes are going to happen on your PE, i made some things i thought were really bad - others told me otherwise. my friend forgot to expose an MSK xomplain she lost her mind, but turns out quite a few people have forgotten that and its all good. others have even forgotten OMT on a case an passed. Practice makes routine, it doesnt make perfect. My friend was worried she made a mistake she wasnt cognizant of... the thing is, when youre stressed u may do silly things but you do habitual things as well, so practice, and yes youll still make mistkaes but youre not going to be forgetting huge sections are a robot either.

I guess my real question is how the NBOME wants the ROS listed and if we have to do a full 10 point ROS?

I’m saying that in the PE review books Kauffman doesn’t have a separate ROS section. He just says “admits nausea, vomiting, chills. Denies headaches, loss of vision” and they are always related to the CC. For example, a normal ROS you would always asked about psych symptoms, but for the PE, if someone comes in for ear pain are you still doing a ten point ROS?

 

[samac]

I guess my real question is how the NBOME wants the ROS listed and if we have to do a full 10 point ROS?

I’m saying that in the PE review books Kauffman doesn’t have a separate ROS section. He just says “admits nausea, vomiting, chills. Denies headaches, loss of vision” and they are always related to the CC. For example, a normal ROS you would always asked about psych symptoms, but for the PE, if someone comes in for ear pain are you still doing a ten point ROS?

No, don’t do a 10 point. I did 3.

 

[crazyboi1993]

HPI, then list ROS. I honestly did ROS based on the chief complaint. Always start with systemic (such as an fevers, chills, unintentional weight loss, etc), then tailor it to the chief complaint. If its abdominal pain, wanna ask n/v/d/c, and surrounding symptoms such as change in urination, etc. Its a focused exam, so try think in ur mind what to ask and tailor it to chief complaint.

U can pretty much do Assemsnet anyway, but obviously right Nephrolithias first, and vitamin C excess (the patient certainly has that, so you would probably put it after). Since ur suspicion is low for UTI, and are just r/o, I would put it last. In honestly, u can prob get away with not even writing vitamin C excess. Just try to include latest 3. With number 1 being what you think, and then the least important ones.

GoodLuck

 

[TheBoneDoctah]

Does anyone still have access to Kauffman vids? Wanted to see if it’s worth buying?

 

[IntheClouds4ever]

Does anyone still have access to Kauffman vids? Wanted to see if it’s worth buying?

OMM videos were spot on.

I watched a few but not all of them. However, I did go through all his soap notes and looked at the A&P the night before so I had plenty of dx’s in my head for a given encounter. It was extremely beneficial