- Joined
- Jun 7, 2016
- Messages
- 12
- Reaction score
- 4
Guys, I'm not kidding. This isn't a situation where I forgot Fam Hx in a few cases. I made some next level, embarrassing, ridiculous mistakes that will haunt me for the next 3 months. I'm an IMG who got 240+ on Step 1, English is my native language, and I want to go into Psych. Haven't taken CK yet (maybe a mistake?). Anyways, took the exam in Philly a few days ago and have been steadily losing my mind since then.
IF Y'ALL ARE FEELING BAD ABOUT DOING BADLY, TAKE A LOOK AT HOW BADLY I ****ED UP, AND YOU'LL PROBABLY FEEL A LOT BETTER ABOUT YOURSELF.
I would appreciate an HONEST opinion of what you think. The nerves hit me and I probably had approx. 2 panic attacks per patient lol. Naturally as soon as I left the room, I knew exactly what was incorrect. I won't write anything that violates NBME rules.
1. Palpated PMI while patient was laying down in one case (like an idiot)
2. All abdominal exam patient had legs STRAIGHT instead of flexed (also like an idiot)
3. Performed a whisper test incorrectly (like a huge idiot)
4. Forgot Weber, Rinne, and cranial nerves for a case that warranted it (ughhh)
5. Did really half-assed lung/heart exams (unbelievably idiotic x1000)
6. Ran out of time on one case and completely didn't close (ended after PE)
7. Forgot to check oropharynx in a case that probably warranted it
8. Answered 2-3 difficult questions really awkwardly
9. Forgot to wash hands once (all other times I used gloves instead)
10. Checked oropharynx with fundoscope ... can I even do that?? (there wasn't a pen light)??
11. Completely missed an easy case, I didn't even have the correct diagnosis in Ddx. Just completely botched. Couldn't elicit DTRs so recorded the patient as having hyporeflexia.... FML.
12. Didn't counsel 2x smokers
13. Forgot fam history in 2-3 cases.
14. Forgot to ask age of menarche in female patient, although might not have been THAT important.
15. Some of the Ddxs were iffy I felt...
16. One patient was kind of rude and it flustered me so I did the entire HPI/physical exam/closure OUT OF ORDER (PE interspersed between HPI and closure).
17. Miss-spelt Zantac as Xantac... haaaaaaaa
18. Didn't know American brand name Afimex or something... I thought they'd only be using generic names.
19. Didn't counsel on one incidence of noncompliance
20. Forgot to write patient's general appearance/state in ALL PE areas of PN. sdkfhsldkjfhslkjdfhlskdjhflsdkjhf
21. OMG the list probably goes on.
What I did do:
I was super polite and energetic. I asked the patients how their disease was affecting their lives, I CAGE'd everyone who drinks, I closed on every case except one (although a few closures were awkward/stupid), I shook hands, made eye contact, asked everyone if it's okay that I write while we speak, told everyone "I'm sorry to hear that" about chief complaint, congratulated any successes, pulled out the leg thing for abdominal exams, asked if patients needed help, explained rectal and pelvic exams, NEVER left a patient note blank (filled everything), always asked if any questions/concerns/is everything clear, and I was gentle with the physical exam.
IF Y'ALL ARE FEELING BAD ABOUT DOING BADLY, TAKE A LOOK AT HOW BADLY I ****ED UP, AND YOU'LL PROBABLY FEEL A LOT BETTER ABOUT YOURSELF.
I would appreciate an HONEST opinion of what you think. The nerves hit me and I probably had approx. 2 panic attacks per patient lol. Naturally as soon as I left the room, I knew exactly what was incorrect. I won't write anything that violates NBME rules.
1. Palpated PMI while patient was laying down in one case (like an idiot)
2. All abdominal exam patient had legs STRAIGHT instead of flexed (also like an idiot)
3. Performed a whisper test incorrectly (like a huge idiot)
4. Forgot Weber, Rinne, and cranial nerves for a case that warranted it (ughhh)
5. Did really half-assed lung/heart exams (unbelievably idiotic x1000)
6. Ran out of time on one case and completely didn't close (ended after PE)
7. Forgot to check oropharynx in a case that probably warranted it
8. Answered 2-3 difficult questions really awkwardly
9. Forgot to wash hands once (all other times I used gloves instead)
10. Checked oropharynx with fundoscope ... can I even do that?? (there wasn't a pen light)??
11. Completely missed an easy case, I didn't even have the correct diagnosis in Ddx. Just completely botched. Couldn't elicit DTRs so recorded the patient as having hyporeflexia.... FML.
12. Didn't counsel 2x smokers
13. Forgot fam history in 2-3 cases.
14. Forgot to ask age of menarche in female patient, although might not have been THAT important.
15. Some of the Ddxs were iffy I felt...
16. One patient was kind of rude and it flustered me so I did the entire HPI/physical exam/closure OUT OF ORDER (PE interspersed between HPI and closure).
17. Miss-spelt Zantac as Xantac... haaaaaaaa
18. Didn't know American brand name Afimex or something... I thought they'd only be using generic names.
19. Didn't counsel on one incidence of noncompliance
20. Forgot to write patient's general appearance/state in ALL PE areas of PN. sdkfhsldkjfhslkjdfhlskdjhflsdkjhf
21. OMG the list probably goes on.
What I did do:
I was super polite and energetic. I asked the patients how their disease was affecting their lives, I CAGE'd everyone who drinks, I closed on every case except one (although a few closures were awkward/stupid), I shook hands, made eye contact, asked everyone if it's okay that I write while we speak, told everyone "I'm sorry to hear that" about chief complaint, congratulated any successes, pulled out the leg thing for abdominal exams, asked if patients needed help, explained rectal and pelvic exams, NEVER left a patient note blank (filled everything), always asked if any questions/concerns/is everything clear, and I was gentle with the physical exam.
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