CS Disaster. Please help!

[raggedred]

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So let me preface this by saying that I did pretty well on steps 1 and 2, and I've done just fine on all of my clinical rotations. I'm not even a foreign medical student (I think you can see where this is heading). So you can imagine my surprise when I got my cs score back the other day and didn't pass.

I'm completely lost right now. My confidence is shot because I don't even know where I went wrong. I scored horribly on everything except english, which after 26 years of practice, I'd hope I would have a handle on. I thought everything went well and that I at least covered all the basic stuff for each encounter. I submitted a score recheck but I'm not counting on it being my saving grace or anything. I've already registered to take it again but at this point I feel like I'm just totally screwed.

First of all, I don't even know what I would do differently the second time around quite frankly. Just as importantly though, I feel like I have absolutely no chance of getting an ortho residency now. The only thing I have working in my favor I guess is that I chose not to automatically have my USMLE transcript released so I suppose that none of the schools I applied to will see this when considering me for an interview.

I feel like this is something that will certainly come up during interviews if I still manage to get some and I just don't know how to handle it. I know I can pass this stupid thing and I feel like I really did the first time, but I guess that's besides the point for now.

If anyone has any advice, I'd really appreciate it. I'm at a total loss here. The last few days really feel like a terrible dream...

 

[Blesbok]

I may be wrong but I don't thnk schools will know that you didn't pass until you start residency assuming you don't release the score and pass before the match.

Also did you study before the last time? Did you read first aid? Did you greet the patients by name, drape them, ask pamhugsfoss, wash your hands, auscultate on the skin, counsel the patients, and ask them if they have any questions?

I just took it and I am kinda scared too but from what others have said these are the first steps to doing well.

 

[ChocolateKiss]

So let me preface this by saying that I did pretty well on steps 1 and 2, and I've done just fine on all of my clinical rotations. I'm not even a foreign medical student (I think you can see where this is heading). So you can imagine my surprise when I got my cs score back the other day and didn't pass.

I'm completely lost right now. My confidence is shot because I don't even know where I went wrong. I scored horribly on everything except english, which after 26 years of practice, I'd hope I would have a handle on. I thought everything went well and that I at least covered all the basic stuff for each encounter. I submitted a score recheck but I'm not counting on it being my saving grace or anything. I've already registered to take it again but at this point I feel like I'm just totally screwed.

First of all, I don't even know what I would do differently the second time around quite frankly. Just as importantly though, I feel like I have absolutely no chance of getting an ortho residency now. The only thing I have working in my favor I guess is that I chose not to automatically have my USMLE transcript released so I suppose that none of the schools I applied to will see this when considering me for an interview.

I feel like this is something that will certainly come up during interviews if I still manage to get some and I just don't know how to handle it. I know I can pass this stupid thing and I feel like I really did the first time, but I guess that's besides the point for now.

If anyone has any advice, I'd really appreciate it. I'm at a total loss here. The last few days really feel like a terrible dream...

I'm sorry, that really REALLY sucks. I would definitely not submit your CS score to residencies that don't ask for it and would not mention it. Hopefully they won't bring it up. Depending on what specialty you're going into, it likely will not even be asked about at most schools.

Regarding prep for take 2, did you read First Aid? It's hard to give advice without knowing how you prepped before. If you didn't read First Aid, you may have just not followed the basic things that the exam wants you to do like introducing yourself properly, counseling on social behavior, washing your hands, etc. Also, did you do badly on the patient interaction part or on the note-writing?

More info will help us advise you better.

 

[raggedred]

I didn't do first aid, but I read through some of the kaplan book with the cases you're most likely to see or whatever. I'm not familiar with the pamhugfoss mnemonic; we use a different one at my school but I'm sure its the same thing. As for all the basics like introducing myself and washing my hands, I absolutely did that stuff. I auscultated on skin, warmed my stethoscope before listening, smiled, made good eye contact. All the basic stuff....

I really don't know where I went wrong but for now I got the first aid book and I guess I'm just gonna have to take it again and hope no one asks about it during interviews....

 

[Blesbok]

I didn't do first aid, but I read through some of the kaplan book with the cases you're most likely to see or whatever. I'm not familiar with the pamhugfoss mnemonic; we use a different one at my school but I'm sure its the same thing. As for all the basics like introducing myself and washing my hands, I absolutely did that stuff. I auscultated on skin, warmed my stethoscope before listening, smiled, made good eye contact. All the basic stuff....

I really don't know where I went wrong but for now I got the first aid book and I guess I'm just gonna have to take it again and hope no one asks about it during interviews....

What was the mnemonic you used? Did it cover the entire history and social aspects? What was the format of your notes?

 

[ShyRem]

Be careful and do your research here on the programs you are applying to. There are an increasing number of programs that require a pass on step 2 (both parts) before ranking you for the match.

And FYI, I was asked if I took my step 2 at my interviews so far (I had and passed). Programs that require step 2 to rank may be more likely to ask if you've taken it yet.

 

[Dr McSteamy]

just take it again, and take a more thorough history.

it won't kill you

 

[Doctor Bagel]

I'd definitely recommend checking out First Aid. IMO, the CS is kind of a weird (and stupid) exam that doesn't really correlate well with true clinical experiences or even OSCEs. The good news is that you didn't automatically release it, so it most likely won't even come up. Most programs still do not require you to pass Step 2 before ranking, some do but not most. I can't tell you for sure what will happen, but I can say we've had a few people at my school who've matched in pretty good stuff (neurosurg, urology, etc.) who failed CS.

 

[peace zealot]

Have you got some date for retaking CS before Feb 2010?

 

[raggedred]

Thanks for the advice everyone. I started reading the first aid and while its kinda obvious stuff, its also a good review. I could have sworn I did all the major things it says to do, but maybe my memory just sucks.

I've signed up for a February test date right now and I'm just keeping my fingers crossed that something opens up before then so I can get my score back before match...

 

[peace zealot]

Good luck for your exam.

 

[kaboodle]

I was in the same boat, unfortunaltly, so I know what it's like to feel like your sinking and don't know what to do. What was hard for me to realize was to put my pride aside...hmm that rhymed...and look for help. So I asked all of my friends and read on here to "study 1st aid and you'll be fine if you do that". I thought, OK, that doesn't make me feel good at all because I did that before and still failed. So what I did was, and please do this....as painful as it may be......remember put your pride aside:

1. Memorize the 1st aid minicases in the front. It will allow you to know what are your differentials for each and every diagnosis and will also tell you what questions to ask so the SP will give you the points.

2. Then, go through and memorize--or feel comfortable, with all the cases in the back of the book. That will help you put all your "questioning" together.

3. Then repeat step 1 and 2 with Kaplan complex cases book. I bought that book and looked through it for about 5 minutes before going through 1st aid and I said to myself, "what shi**ty book, why did I buy that!! It turns out to be the best thing I did. I put my pride aside and read the entire book from front to back. Believe it or not, the 1st half of the book was the best because it explained how to ask questions, and how to perform the PE to get your points. People often say, the PE is the least important part of the exam. That is a big no no. If you don't do the PE, you don't get the points on your data gathering, note, info sharing, and others. It is hugely important to do the PE, because ICE is very difficult to pass so do the PE!!

4. After you have memorized the 1st aid minicases, 1st aid practice cases and the front half of complex cases book by Kaplan, you'll be set.

5. I chose to go to a Kaplan 5 day course after doing steps 1-4 and it was VERY helpful. It confirmed that I was doing things right, but it also taught me how to do things correctly that I thought I was already doing right, but wasn't.

6. I would recommend the Kaplan course since you have until Feb. Yeah it's expensive, but so is sitting out the year because you failed CS again. Put your pride aside and make it happen. Oh yeah, one more thing. I passed my CS after doing that!!!😀

 

[Frugal Traveler]

Kaboodle... thanks for your advice. I have not taken Step 2CS yet, but I am going to study for it because it is a costly exam.

To the OP --> everyone knows how it feels when something like this happens... you take a big gulp and all your pride is gone.

Keep on going and listen to the advice in this thread. Also would recommend talking to a dean or adviser at your school (especially if you have someone that does OSCEs at your school... ask the person that runs those to show you some tips or tricks).

All in all... good luck

 

[m250]

I may be wrong but I don't thnk schools will know that you didn't pass until you start residency assuming you don't release the score and pass before the match.

Also did you study before the last time? Did you read first aid? Did you greet the patients by name, drape them, ask pamhugsfoss, wash your hands, auscultate on the skin, counsel the patients, and ask them if they have any questions?

I just took it and I am kinda scared too but from what others have said these are the first steps to doing well.

What does the PAMHUGSFOSS mnemonic stand for?

 

[Blesbok]

What does the PAMHUGSFOSS mnemonic stand for?

I used PAMSCHUGFOSSODATIME actually
PMH
Allergies
Meds
Surg Hx
Constitutional Sx
Hospitalizations
Urinary problems
GI problems
Family Hx
Ob/Gyn Hx/Symptoms
Sexual History
Smoking
Occupation
Diet
Alcohol
Travel Hx
Illicit Drugs
Married/Kids
Exercise

 

[m250]

I used PAMSCHUGFOSSODATIME actually
PMH
Allergies
Meds
Surg Hx
Constitutional Sx
Hospitalizations
Urinary problems
GI problems
Family Hx
Ob/Gyn Hx/Symptoms
Sexual History
Smoking
Occupation
Diet
Alcohol
Travel Hx
Illicit Drugs
Married/Kids
Exercise

Did that cover everything we are supposed to ask for CS in order to get all/most of the points? I know it covers quite a bit, but I thought there was a mnemonic (which I believe I knew at some point during the last 2-3 years) that included questions to ask regarding specific details about their CC, such as symptoms, duration, aggrevating factors, alleviating factors, etc? Basically, a quick way to run through the important points about their CC. Anyone happen to know what it is or have one?

Your mnemonic is good to help remember things like travel, exercise, diet, occupation, and some of the more ancillary questions that I tend to forget when in a hurry. I take CS in a few weeks and am trying to collect a few easy, comprehensive mnemonics to help make sure I dont miss key points if I get pinched on time.

 

[Blesbok]

Did that cover everything we are supposed to ask for CS in order to get all/most of the points? I know it covers quite a bit, but I thought there was a mnemonic (which I believe I knew at some point during the last 2-3 years) that included questions to ask regarding specific details about their CC, such as symptoms, duration, aggrevating factors, alleviating factors, etc? Basically, a quick way to run through the important points about their CC. Anyone happen to know what it is or have one?

Your mnemonic is good to help remember things like travel, exercise, diet, occupation, and some of the more ancillary questions that I tend to forget when in a hurry. I take CS in a few weeks and am trying to collect a few easy, comprehensive mnemonics to help make sure I dont miss key points if I get pinched on time.

I also used LIQORPAAA
Location
Intensity (1-10)
Onset
Radiation
Progression
Alleviating
Aggravating
Associated Symptoms

 

[m250]

I also used LIQORPAAA
Location
Intensity (1-10)
Onset
Radiation
Progression
Alleviating
Aggravating
Associated Symptoms

I like it, that's similar to what I was trying to remember. Thanks!

 

[OMMFan]

Be careful and do your research here on the programs you are applying to. There are an increasing number of programs that require a pass on step 2 (both parts) before ranking you for the match.

Is there any way, other than asking each program directly, to find out which programs require the CS/PE before ranking applicants?

I had to postpone mine and the first available date was January 6. I may have my scores in time, but I can't count on it. So perhaps it would make sense for me to eliminate the programs that won't rank me without a definite Pass on the PE.

Thanks for bringing this to my attention!

 

[TMP-SMX]

Opqrstaa

 

[paperdoll25]

CODIERS SMASH FM with FED TACOS under the 1st S(Social Hx) in SMASH
Chronology
Onset
Duration
Intensity
Exacerbating Factors
Remitting Factors
Sx Assoc
Social Hx->Food, Exercise, Drugs, Tobacco, Alcohol, Caffeine,Occupation, Sex
Medication
Allergies
Surgical Hx
Hospitalizations
Family med Hx
Med Hx for the pt