Does ordering too many non-invasive studies hurt CCS score? experience?


5+ Year Member
Aug 26, 2014
I know if you order invasive tests like ERCP on a patient with cholecystitis, that is an invasive test that will make you lose points on the exam.

However, what if I have the same patient with cholecystitis and I order a TSH or a Lipid panel, not necessarily important in this case, but they are superfluous tests. They aren't invasive and in reality, I would not order them, but will I lose points on the exam for ordering these? Are non-invasive tests that aren't exactly necessary OK to order on the test?

I am using, and they score me positively for ordering stuff that needs to be ordered, and will dock me points for invasive tests, but they never comment on whether it is OK to order noninvasive low yield tests?

Other Questions:
1. If a patient has a diagnosis, for example cholecystitis, do I order cholecystectomy first then consult general surgery, or do I consult general surgery and then order the cholecystectomy?
2. Do I put in admit orders like NPO diet, SCDs, SQ heparin, IV Fluids, HOB to 30 degrees after I move the patient to ICU/Ward, or should I put in those orders then move them to the ICU/Ward?
3. How important is it to order followup appointments for medications and such? Almost every case I've done on program mentions to give vaccines, counseling, preventative orders on the 2 minute screen. It has never told me I need to create a followup appointment and order a CBC in 2 weeks to followup starting Clozapine for example.

i appreciate any clarification


2+ Year Member
Feb 5, 2018
1) you want to put in a consult for gen surg first. that way you get the points for correct sequence. then order the cholecystectomy once you get results from gen surg

2) move the pt to the icu/ward then put in the admit order. i dont think (but not 100%) sure you would lose points if you did the reverse but just makes morse sense to transfer and THEN start iv access

3) I think monitoring is fairly important for the exam. i haven't used CCS cases yet, you can counsel during the encounter if you have time. for things like clozapine/CBC i would just put that at the very end in the 2 min screen and set an appt for a later date. definetly do the extra UWorld practice tools for CCS.

i have not taken the exam but this is what i have gathered throughout my studies. i take it in 3.5 weeks.

Your message may be considered spam for the following reasons:

  1. Your new thread title is very short, and likely is unhelpful.
  2. Your reply is very short and likely does not add anything to the thread.
  3. Your reply is very long and likely does not add anything to the thread.
  4. It is very likely that it does not need any further discussion and thus bumping it serves no purpose.
  5. Your message is mostly quotes or spoilers.
  6. Your reply has occurred very quickly after a previous reply and likely does not add anything to the thread.
  7. This thread is locked.
About the Ads