CS Exam Thoughts

[persia]

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I Just took the CS exam in LA this week and I had some thoughts that I figured I would share for anyone who hasn't yet taken the exam. Maybe others can add their own thoughts as well.

First, I did study pretty hard for the exam and used USMLEWorld's website for practice exams and other study aids. I know it sounds like overkill, but it really was incredibly helpful to have 40+ practice cases, as well as 40 patient check off list cases. First Aid was good, but the UW site was awesome. 👍

I made sure I could also type the notes on the NBME site, using their practice template. That made me feel very confident that I could do it within their time limits. I practiced typing alot of cases.

The actual day is very long! by the last two cases I was fried and could hardly remember (or care) about the patient's complaint. There are breaks in the day but still, you get very tired. A double espresso with breakfast was a big help for the day. I know people make fun of this exam, but it is still a big deal and a long day. I was glad I overstudied and I also learned alot in the process. Now the long wait for the results!

 

[arthrodisiac]

thanks for the advice persia. i have to take it in a couple weeks, been kind of lazy, but ill give usmleworld a spin..worked well for ck.

 

[DebDynamite]

Well, I studied about as much, IMO, as any AMG "should" study.

I took the test 11/08 in ATL. What I did to prepare: I borrowed FA from a classmate, and I read the first 100 pages. This part of FA reminds you/warns you about all of the things you need/ought to do in order to pass the exam. The mini cases are all I needed to review in order to broaden my ddx list and refresh my memory. I also went to the NBME web site and looked over what they had to say about the exam, (and scanned the sample computer layout to see what the note screen would look like). So, in total I guess I read about 5-8 hours before the test itself. I really think that you don't even have to do that much- it's just that I'm going into psych and I wanted to go over ddx lists since I've been in psych for the last 5 months.

I thought the test was virtually identical to most SP encounters I had in med school- except that the SP's are more straightforward with you. Ie- @ my med school you had to pry out the emotional agenda/issues, these SP's are actors who act out any affect that you might need to ask about. If the pt looks anxious- you just ask, "you seem anxious- is there anything wrong?". I just didn't think it was that bad- because they tell you the answers they are supposed to tell you. I also had just enough time for it all. It was as if the NBME has studied the art of a hurried patient encounter and expects you to pull it off. I wasn't really tired @ the end b/c of the test itself- but because I had to drive down to the airport ( I live in ATL) and get up early. If I had to fly to my site and sleep in a strange bed I would have been pretty beat. As it was, I was just tired because I took my last board exam before graduation and there was an overwhelming feeling of relief at the end.

If you are an AMG with a pulse and without an attitude, I really think any more than the above is overkill.

 

[DebDynamite]

As an addendum to my previous post I would like to add this:

Although I really do think in my heart of hearts I passed CS, that I did well and should pass, I realize fully that I might flunk it. I just have this eerie feeling after having finished it that the 4% of AMG's who don't pass really really really get screwed.

My point is, don't study too hard. Sure FA is good-BUT we should all be able to pass the test WITHOUT FA. If there is some secret order of operations for when to wash your hands, etc, I could have flunked it! Lame.

 

[overthebars]

SP's much more straight forward than my school's fakers. For whatever reason I was much more self-conscious about forgetting to percuss the lung fields, listen to the carotids, and palpate the PMI in many of my patients. Forgot an allergy question here and there. Had one patient with an interesting PMH nugget that she just blurted out as I was about to leave the room that added a test to my workup. If I could do it again (and I may have to) "Is there anything else you would like to talk about?" seems to work wonders with these SPs.

Started my PEx at the warning announcement, usually barely finished it. Sometimes I didn't.

Since the test is so heavily weighted to patient interaction I basically started "counseling" them as soon as I had an the faintest idea what was going on "..based on what your telling me I think we should get you a chest Xray, but let me examine you first to make sure that is all we need...".

Writing a note without a treatment section is wierd. I believe your note would have to make no sense to fail that. I type slowly and my handwriting is ilegible so that was the most stresfull part.

 

[persia]

I ended up writing the note because typing under stress, and the weirdness of the bar advancing across the screen (and running out of space!) was too much for me. When in doubt, keep it simple. The written note was pretty easy and I felt more confident that I included everything. I started by writing the diagnoses, further workups and then wrote PE and finally the cc/hpi stuff.

I agree about 'did I do all the manouvers?' (sp?) I just did the basic stuff like CV/Pulm/abd and then some other extras like neuros, pulses and jvd's and some percussions, etc. if it seemed necessary. It was hard to think of everything to do and then actually do it as well as counsel, etc. Mostly, I just tried to be a nice person and get a complete history and ask, "is there anything else you wanted to talk about today?" before I left.

Whew! I am glad it is over.

 

[mdphd2b]

I agree about 'did I do all the manouvers?' (sp?) I just did the basic stuff like CV/Pulm/abd and then some other extras like neuros, pulses and jvd's and some percussions, etc. if it seemed necessary. It was hard to think of everything to do and then actually do it as well as counsel, etc. Mostly, I just tried to be a nice person and get a complete history and ask, "is there anything else you wanted to talk about today?" before I left.

Hi persia,

I took the CS last Fri in Philly. I also feel my histories were very complete, and I'm always great w/empathy and interpersonal communication skills on these things, but I know I missed doing "everything" on a few cases, esp with the Neuro exam. On a syncope SP, I didn't have time to do full Neuro/CV exams. Also I remember one SP who was a smoker and I totally forgot to counsel her on it at the end 😡 I should have addressed it immediately during the history part, instead of holding all counseling until the end! Oh well...