Dean wants me to reschedule for STEP II

[plainolerichie]

---

Members don't see this ad.

I got an email from the dean of student affairs at my school saying she wants me to reschedule my Step II CS (which is for this Monday) to a later date and work on additional "remediation." We take this "practice" / mandatory-to-pass clinical skills exam called a cpx early in the summer after third year, I took mine about a week and a half ago. In advising sessions, the dean says basically everyone passes except 2-3 a year. So, I didn't really take it seriously, just reviewed some basic physical exam stuff for a couple of hours the night before. Well, it was a bit tougher at times, especially parts of 2/8 stations, but overall, I felt OKAY about it. I asked the instructor in charge of that test if I could go over it with her since I was taking CS in about two weeks from the test date so we did. We went over three stations that I felt worse about and she had some advice.

Anyways, now my dean sent me an email saying she felt that I should reschedule and work on it more before I take the Step-II CS! The problem is, it's so hard to reschedule, especially since I have sub-I's all fall in ortho (going into ortho, btw) and all the dates in LA are full for the rest of summer. That and we have had about 10 SP history and physical exam tests in my school throughout the first three years and I HAVE PASSED ALL OF THEM!!! We have had 5 in year III, and I did below average in my school on all except 1 in internal medicine, but I did about average in most and passed all of them. At my school (USC) we work extensively on history and physical skill and practice H and P skills during years I and II, and take exams for it through all three years.

But she wants me to reschedule now based on the CPX we just took! I personally feel that I'll have the weekend to look up more of the ER/outpatient common medical problems I forgot about and focused exams and history for them, read the First Aid CS. I personally feel I'll be fine. I was completely chill about it until she sent me that email...

Some about me, I'm born and raised in the US in TN, I am not a foreign medical grad and English is my first language. Even though I'm from the south, I speak English correctly 🙂. I go to USC (Cali, not South Carolina). I am admittedly quiet and softspoken and have received notes on evals because of not sounding confident enough, but still.

Do you think the Step-II CS is something to worry about necessitating rescheduling? Don't 95+% of US grads pass it, especially ones with practice H&P skill throughout medical school? She had mentioned 1 student might fail from our school every year.

 

[Keg]

Rich,

So, it sounds like the dean is genuinely concerned for you. Perhaps you could meet with them (or someone) to figure out where you were lacking on the CPX evals? That way, you can figure out if it's something that you can change (certain questions not asked/phrased incorrectly, physical exam technique) or if it's something that's intrinsic to you (soft-spoken-ness) that can't be changed with more practice.

I know it'd a bitch to reschedule the thing, but think of how much fun it would be to have to reschedule - and pay the $1300 or so over again if you are in the unlucky 2-3% of American medical graduates who don't pass the first time. I'm pretty much planning on doing what you're doing to prep (reading CS over 2-4 days and not stressing too much about it). So I'd start where I said above and see if your perceived deficiencies are in areas that you can change. If so, think long and hard about taking it Monday. If there are things that you can't change, suck it up and hope that the patient will accept you for who you are.

And with regards to scheduling changes being problematic, does Keck require that you take it by a certain date? Could you have a lay over for a day or two in Chicago or Houston on the way back to Tennessee for Christmas, or Thanksgiving, or Spring Break?

In any case, I'd bet you'd do fine no matter what you decide. Like you say, a larger percent of condoms fail than AMGs fail CS.

 

[plainolerichie]

Crap, I keep forgetting that "Richie from USC" is not very discrete!

 

[Ashers]

Crap, I keep forgetting that "Richie from USC" is not very discrete!

Not really. You guys have a lot of people trying to do ortho there? My sister's in your class, and she's doing ortho. And she's always complaining about OSCEs.

Anyway... I had a similar issue at my school with our practice thing. I had a bit more time to study afterwards, but if you study FA for CS and read it make sure you know it well you should be fine.

Despite what people at my school thought that I'd fail even after the whole remediation process, I passed. I just made sure to know FA for CS. I even read the sections for the foreign grads to see if there were any extra tips.

Be thorough, and ask lots of questions. I gathered asking questions got the most points because I left out whole parts of an exam I'd do on a normal person, and I still did fine.

 

[plainolerichie]

Random question... When auscultating the heart on a patient who you believe to have a non-cardiac issue, should you be able to auscultate the heart with them sitting or laying flat and still get points, as opposed to 45 degrees when all you're doing is auscultation. I ask just to save time by having one less position change. It's been annoying me while going through First-Aid what the "right" or "credit scoring" way to do it would be when if someone comes in for any random thing and they say you should auscultate heart and lungs...

 

[ucsfstudents]

I would recommend talking to the dean and getting his/her input on what you need to work on. It seems like you'll need to really practice for the exam since you've scored below average. It is true that FA for Step 2 CS is all you need. After talking to the dean, getting advice from faculty and students who have taken the exam, and putting in a LOT of practice using FA for step 2 CS, you should be fine.
Good luck!!

 

[Keg]

Random question... When auscultating the heart on a patient who you believe to have a non-cardiac issue, should you be able to auscultate the heart with them sitting or laying flat and still get points, as opposed to 45 degrees when all you're doing is auscultation. I ask just to save time by having one less position change. It's been annoying me while going through First-Aid what the "right" or "credit scoring" way to do it would be when if someone comes in for any random thing and they say you should auscultate heart and lungs...

I listened to the first three fields with them sitting up/forward, and then had them roll onto their left side into a pseudo left lateral decubitus to listen to the mitral area. We'll see how that worked on or before August 21.