Failed CS; need help

[cokecoke]

i just got a score report.
unfortunately i failed. I passed ICE/SEP part but i failed CIS but it's on the high borderline.
i have 1 less x mark to go above borderline on CIS(professionalism), if i had 1 more x mark there (which is above borderline), then i would pass i assume.
is there any way i can ask usmle to regrade my score? if so, do i have any chance to pass?
anyone has done it before?

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[OofMed]

i failed the CIS part also. I couldn't believe it. I took it at the end of my sub-I and all my residents and attendings thought I was great. . AND i absolutely rocked CK. Where did you take it? Did a lot of other people fail? I'm wondering also if they made a mistake.

 

[goldenpath]

How much did you guys study for the exam?

Did you guys wash your hands, act compassionate and drap the patient, summerize the info, or ask if the patients had any questions or concers?

 

[NPR]

How much did you guys study for the exam?

Did you guys wash your hands, act compassionate and drap the patient, summerize the info, or ask if the patients had any questions or concers?

That's more important than anything else

 

[goldenpath]

That's more important than anything else

Granted I dont know if i passed.

I did those things, but there were some things i forgot- didnt do a MMSE on a patient who should have had one, ran out of time on making the psych part on the note (but included some of the stuff in the HPI), forgot to note a signifigant positive sign on the soap, and some others.

I also did not warm up my steathoscope and wasnt able to completely dry my hands after washing them on many of the patients.

Also, I ran out of space on 4-5 of the typed notes. I had the time, just didnt have any space to write all the stuff i needed to (ie left out the family hx or parts of the social hx).

What do you guys think of those errors?

 

[OofMed]

so apparently they grade you much more harshly on the CIS part than the ICE part. I forgot to do an entire H&P on 1 patient (i was so taken by the HPI) but i did great on the ICE part. So don't worry about that. in regards to CIS, I washed my hands for every patient, draped every one, i thought i showed compassion (maybe i didn't and i didn't realize it), and asked if they have questions. i didn't summerize all their info though. Is that where I went wrong? Would that cause me to fail?
I actually went to the NBME office today (I happened to be in philly) and they said regrading it only consists of someone recalculating your scores; they don't actually watch your video

 

[pocketknife52]

i dou

 

[goldenpath]

OofMed:
Does your score report give you anymore info other than just that you failed the CIS? Maybe you didnt ask open ended questions (although i dont know how open ended you can be with "Have you had any nausea? Have you had any weight changes?" ect ect). Did you summerize any give counseling? Are you a AMG?

How did you sleep the night before the test? I personally slept like crap and ended up with only a couple of hours. I think may have made me seem less compassionate or less attentive to the patient, but again, I dont know how I did.

This is such a worthless POS test.

 

[OofMed]

I am an AMG, and I asked open ended questions. I think maybe I didn't do enough counseling, since we really don't have that much practice with it in real life you know? And yea I slept. I really don't understand how some people in my class with horrible interpersonal skills in real life passed and I failed. Before going into the exam, residents that I knew told me that I'd be fine, the test is really just to make sure you speak English and you have sense enough to drape the patient before the exam. If that really is the case, I shouldn't have failed. . maybe they need enough people to fail to justify making AMGs take it. Now I have to fly to LA to be able to take it early enough to get my results before graduation. The philly center has no slots until April. Not to mention the pressure that's on . . I have no idea how to approach it now, and if I fail in March, I don't graduate with my class.

 

[pocketknife52]

oo

 

[goldenpath]

OofMed -

How much counceling did you do?

I think that they need to chage the timing of this test. It is given in the worst possible time. Right when you are making commitments for the next 3-7 years of your life and spending tons of money on interviews, the rug can be yanked right out from underneath you with either of these tests (CK or CS). It is abosultely BS, especially if you are going for a competitive residency.

I hope they think about this when they combine step 1 and 2.

 

[NPR]

How much counceling did you do?

It doesn't matter. I passed and did zero counseling.

What you need to do isn't specific. Rather, you want to provide a general statement of reassurance. For instance,

"After taking a history and performing a thorough physical, I've decided I want to run a couple of lab tests. Once I get the results, I will contact you and arrange for a follow up visit. Hopefully, at that time, we'll be able to provide you with a more concrete answer. Do you have any questions for me at this time?"

Something like that. Always remember to leave time to throw that spiel in there.

Invaluable for picking up points for:
-"counseling"
-arranging follow up
-addressing patient questions/concerns
-summing up
-being professional/comforting if you can do this at a relaxed pace with warmth while smiling

 

[OofMed]

thanks for your sympathy, pocketknife. There's actually a thread from 2005 where someone was in a similar position and was talking about suing the USMLE. . but I guess that never went through.
NPR- my counseling was maybe slightly more specific than yours but less eloquent. For instance, I would say "Well we will run some tests to make sure you're not having a problem with your heart, and take it from there. Any questions?" But good point about mentioning follow-up, I'll do that.
So when a patient says "do I have cancer?" and you really can't rule it out with history alone, what do you say?

 

[Ice dude]

thanks for your sympathy, pocketknife. There's actually a thread from 2005 where someone was in a similar position and was talking about suing the USMLE. . but I guess that never went through.
NPR- my counseling was maybe slightly more specific than yours but less eloquent. For instance, I would say "Well we will run some tests to make sure you're not having a problem with your heart, and take it from there. Any questions?" But good point about mentioning follow-up, I'll do that.
So when a patient says "do I have cancer?" and you really can't rule it out with history alone, what do you say?

u could say this is one possibility, but we need to do furthur work up to arrive on a definite diagnosis.

 

[OofMed]

That's definitely along the lines of what I said. Whatever.

So what's the best place to take it? I scheduled for LA since I thought it would be pretty lol but I heard it's not a good place to take it.