Feeling like I failed CS

[elektroshok]

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I know there are other threads, but has anyone who felt AWFUL after taking CS this year with the new scoring system come to find they passed?

I go to a US school, we've had three OSCEs and have done fine with those, but for some reason was more stressed out about this. I'm sure I missed an exam question or two as well as some physical stuff on a chunk of the patients.

I always shook hands, introduced myself, set the agenda, summarized after the HPI portion before getting the rest of the history and proceeding to the physical. Patients were already draped in each room. I summarized in closing for each patient what were a couple things I thought could be going on, some of the tests we should run and asked if they had any other questions or concerns that hadn't been answered.

I'm just freaking out since I've been reading online about people failing when they didn't think they would have at all. I mean how bad do you have to do to really fail this test - because I'm not sure I passed....

 

[espas]

I know there are other threads, but has anyone who felt AWFUL after taking CS this year with the new scoring system come to find they passed?

I go to a US school, we've had three OSCEs and have done fine with those, but for some reason was more stressed out about this. I'm sure I missed an exam question or two as well as some physical stuff on a chunk of the patients.

I always shook hands, introduced myself, set the agenda, summarized after the HPI portion before getting the rest of the history and proceeding to the physical. Patients were already draped in each room. I summarized in closing for each patient what were a couple things I thought could be going on, some of the tests we should run and asked if they had any other questions or concerns that hadn't been answered.

I'm just freaking out since I've been reading online about people failing when they didn't think they would have at all. I mean how bad do you have to do to really fail this test - because I'm not sure I passed....

I had a similar experience. I took CS a few days ago and feel absolutely horrible. I also go to a US school and felt like I blanked on a lot of the SPs and did not do a lot of the PE maneuvers that are required/missed the differential.

There were at least 3-4 SPs where I did not do important PE maneuvers (especially the full neuro exam due to time). I also had 2 patients where I was clueless on the differential and a 3-4 patients where I only had time to have 2 diagnoses on my differential. The new guidelines only have an ICE component PE checklist for the SPs and then the history is judged by the note. And my notes were good except for the DDx on 1/3 of the SPs.

All other things I did relatively well. I counseled when appropriate, was courteous and empathetic, and took good histories (part of the reason my time was limited).

Given the new scoring guidelines, will I have a hard time passing the ICE component of this exam? elektroshok, have you heard anything that would reassure us? I am under the impression that if I fail, I won't find out til the end of August, making applying to the match/getting interviews impossible.

 

[EaglesAllDay]

Trust me you are not the only one....I took my exam last month in Philly....and im scared as sh**....my results should be out next week, all i can remember is the stuff i messed up on....cant even study for CK properly cause this is looming over my head....im a US IMG so the new curve they put on it has me worried even more....I think my CIS and SEP (obviously) will be fine but ICE is worrying me like crazy....mainly cause i made so many mistakes imo....messed up the diagnosis in 3 cases, forgot to ask some very relevant questions in 2/3 cases (realized it later on like wtf how the hell could i forget to ask that), did some PE maneuvers that I couldnt write down on the PN cause of time running out in a couple of cases, forgot to write some important workup in a few cases, forgot to do some relevant PE maneuvers in a few cases, and was unable to write couple important history findings on the PN cause i ran out of time.

Did all the usual things well (knocked on the door, wore gloves, smiled and shook hands, repeated patients name 5/6 times, told them everything i was going to do on PE and asked if it was okay to perform a PE, took out the leg rests, asked a lady with cough if she needed a tissue, asked permission to tie/untie gowns, said please and thank you many times, counseled where appropriate, summarized history in most cases and asked if they would like to add anything, congratulated them for living a healthy lifestyle if they did, asked if they had any questions or concerns at least twice every encounter, explained in laymans terms the tests i wanted to do, always gave a proper closure (at least 2 minutes for it)

Anybody with an experience like mine? How did the results go?? What do you think are my chances???

Ugh, hate this feeling...hopefully the main thing is building that rapport with the SPs and I felt i did that....8 more days till i know my fate

 

[espas]

Trust me you are not the only one....I took my exam last month in Philly....and im scared as sh**....my results should be out next week, all i can remember is the stuff i messed up on....cant even study for CK properly cause this is looming over my head....im a US IMG so the new curve they put on it has me worried even more....I think my CIS and SEP (obviously) will be fine but ICE is worrying me like crazy....mainly cause i made so many mistakes imo....messed up the diagnosis in 3 cases, forgot to ask some very relevant questions in 2/3 cases (realized it later on like wtf how the hell could i forget to ask that), did some PE maneuvers that I couldnt write down on the PN cause of time running out in a couple of cases, forgot to write some important workup in a few cases, forgot to do some relevant PE maneuvers in a few cases, and was unable to write couple important history findings on the PN cause i ran out of time.

Did all the usual things well (knocked on the door, wore gloves, smiled and shook hands, repeated patients name 5/6 times, told them everything i was going to do on PE and asked if it was okay to perform a PE, took out the leg rests, asked a lady with cough if she needed a tissue, asked permission to tie/untie gowns, said please and thank you many times, counseled where appropriate, summarized history in most cases and asked if they would like to add anything, congratulated them for living a healthy lifestyle if they did, asked if they had any questions or concerns at least twice every encounter, explained in laymans terms the tests i wanted to do, always gave a proper closure (at least 2 minutes for it)

Anybody with an experience like mine? How did the results go?? What do you think are my chances???

Ugh, hate this feeling...hopefully the main thing is building that rapport with the SPs and I felt i did that....8 more days till i know my fate

EaglesAllDay . . . I think you and I had really similar experiences. Could you keep me updated on your situation so I can gauge what to do? Hopefully, we are making a bigger deal out of our mistakes than they actually were. They can't fail everyone who misses a few PE maneuvers and a few DDx can they? 🙁

 

[EaglesAllDay]

EaglesAllDay . . . I think you and I had really similar experiences. Could you keep me updated on your situation so I can gauge what to do? Hopefully, we are making a bigger deal out of our mistakes than they actually were. They can't fail everyone who misses a few PE maneuvers and a few DDx can they? 🙁

Yeah I certainly hope thats the case....most people i talk to only can think of the mistakes they made after this exam....nobody is ever 100 % confident they passed (or so i hear)

Will update this thread next week.....hope we all make it

 

[stitchie]

I had a similar experience. I took CS a few days ago and feel absolutely horrible. I also go to a US school and felt like I blanked on a lot of the SPs and did not do a lot of the PE maneuvers that are required/missed the differential.

There were at least 3-4 SPs where I did not do important PE maneuvers (especially the full neuro exam due to time). I also had 2 patients where I was clueless on the differential and a 3-4 patients where I only had time to have 2 diagnoses on my differential. The new guidelines only have an ICE component PE checklist for the SPs and then the history is judged by the note. And my notes were good except for the DDx on 1/3 of the SPs.

All other things I did relatively well. I counseled when appropriate, was courteous and empathetic, and took good histories (part of the reason my time was limited).

Given the new scoring guidelines, will I have a hard time passing the ICE component of this exam? elektroshok, have you heard anything that would reassure us? I am under the impression that if I fail, I won't find out til the end of August, making applying to the match/getting interviews impossible.

I feel exactly as you described, and performed very similarly on the exam I would say, in terms of missing some differentials and having a few encounters with very lacking PEs. I also missed important points in the history of a few of my patients. I want to kick myself because I didn't really do much to prepare for this exam--I was so sure I would sail right through it, it didn't seem worthwhile to bother. I have good clinical skills in real life, and did just fine on the practice OSCEs my school offered, so I never thought I'd walk out of the exam feeling like I had sucked big time.

I just wanted to say good luck to you and others in similar boats. It does make me feel better to see stories like this, in a way. Perhaps what I'm perceiving as a very poor performance on my part is actually how I lot of people end up doing when under pressure on exam day. I know I could have done much, much better--but when I try to take an objective look back on the exam, I realistically know that time constraints plus the general stress of being evaluated by someone you're trying to pretend is a real patient make it impossible to do a "perfect" job. Hopefully a not-terrible job is good enough for passing. I think I can convince myself I was not-terrible on at least 11/12 encounters.

Keep everyone posted as results come in--I know I and other future examinees will appreciate seeing how things turn out!

 

[elektroshok]

any updates from anyone in this thread?

 

[Houmd]

FWIW I didn't even do a PE on my last two patients, ran out of time on several, did a poor PE on most. Some DDx sucked and I passed comfortably.

This is a test about getting checks in boxes. If you did all the gimme's (spoke english, introduced yourself, counselled, summarized a hx etc) then you're fine.

 

[espas247]

FWIW I didn't even do a PE on my last two patients, ran out of time on several, did a poor PE on most. Some DDx sucked and I passed comfortably.

This is a test about getting checks in boxes. If you did all the gimme's (spoke english, introduced yourself, counselled, summarized a hx etc) then you're fine.

Is this true? If it is, it makes me feel a whole lot better because my PE were poor but I still did them. How was your scoring on the ICE section?

 

[elektroshok]

Does anyone know if there are two random cases that aren't scored or if they drop your two worst ones or what? I know they say that 10/12 are graded...

 

[Houmd]

Is this true? If it is, it makes me feel a whole lot better because my PE were poor but I still did them. How was your scoring on the ICE section?

LOL I'm not even kidding. but in my defense I did take very extensive histories and counselled every patient. I passed comfortably though even on ICE

 

[Houmd]

Does anyone know if there are two random cases that aren't scored or if they drop your two worst ones or what? I know they say that 10/12 are graded...

Up to 2 of them may be experimental and not graded. You may or may not have one or two that are experimental but you'll never know

 

[swamprat]

OP I thought I bombed this exam, missed main diagnosis on several patients, missed PE moves, was iffy on whether I was empathetic enough etc. after a long wait I comfortably passed. Try not to worry although easier said than done.

 

[elektroshok]

FWIW I didn't even do a PE on my last two patients, ran out of time on several, did a poor PE on most. Some DDx sucked and I passed comfortably.

This is a test about getting checks in boxes. If you did all the gimme's (spoke english, introduced yourself, counselled, summarized a hx etc) then you're fine.

OP I thought I bombed this exam, missed main diagnosis on several patients, missed PE moves, was iffy on whether I was empathetic enough etc. after a long wait I comfortably passed. Try not to worry although easier said than done.

Hopefully I passed. Can't stop thinking about the stuff I didn't do, arggg

 

[espas247]

OP I thought I bombed this exam, missed main diagnosis on several patients, missed PE moves, was iffy on whether I was empathetic enough etc. after a long wait I comfortably passed. Try not to worry although easier said than done.

Would you mind being more explicit by what you mean when you "missed PE moves?" I think there were a few patients that deserved a neuro exam that I did not have time to do. However, EVERY patient got a CVS/Pulm/Abd exam (bare bones, not a detailed exam) from me and a few other maneuvers related to their complaint. I think my histories were solid and empathetic "enough". What you think? Similar to you?

 

[min27]

Deleted

 

[EaglesAllDay]

Trust me you are not the only one....I took my exam last month in Philly....and im scared as sh**....my results should be out next week, all i can remember is the stuff i messed up on....cant even study for CK properly cause this is looming over my head....im a US IMG so the new curve they put on it has me worried even more....I think my CIS and SEP (obviously) will be fine but ICE is worrying me like crazy....mainly cause i made so many mistakes imo....messed up the diagnosis in 3 cases, forgot to ask some very relevant questions in 2/3 cases (realized it later on like wtf how the hell could i forget to ask that), did some PE maneuvers that I couldnt write down on the PN cause of time running out in a couple of cases, forgot to write some important workup in a few cases, forgot to do some relevant PE maneuvers in a few cases, and was unable to write couple important history findings on the PN cause i ran out of time.

Did all the usual things well (knocked on the door, wore gloves, smiled and shook hands, repeated patients name 5/6 times, told them everything i was going to do on PE and asked if it was okay to perform a PE, took out the leg rests, asked a lady with cough if she needed a tissue, asked permission to tie/untie gowns, said please and thank you many times, counseled where appropriate, summarized history in most cases and asked if they would like to add anything, congratulated them for living a healthy lifestyle if they did, asked if they had any questions or concerns at least twice every encounter, explained in laymans terms the tests i wanted to do, always gave a proper closure (at least 2 minutes for it)

Anybody with an experience like mine? How did the results go?? What do you think are my chances???

Ugh, hate this feeling...hopefully the main thing is building that rapport with the SPs and I felt i did that....8 more days till i know my fate

Passed right on the dot on CIS and ICE ....asterik in SEP

wow the nightmare is finally over, thought for sure i was gonna go down

KEEP HOPE ALIVE ALWAYS!!!

Just to add i took it in the dreaded Philly...i don't think place matters at all

 

[stitchie]

thanks for the update!

 

[ipizzy]

I just took CS and I'm also not feeling too great about it...I keep remembering more and more things I didn't do but reeeeeeally should have done (especially important questions for data gathering and physical exam stuff). Like all I learned during med school went out the window; felt like I really f'ed up at least one case in terms of ICE points, plus I would say forgot to do relevant questions/PE maneuvers on most if not all of them. I tried being empathetic but based on the looks I was getting from some of the SPs, they weren't necessarily buying it

I did manage to keep it together enough to do the basics (eye contact/using pt's name/shaking hands/gloving/draping/asking permission to do PE maneuvers/counseled on most occasions when it was called for) but the new grading criteria have me worried (especially for ICE) :-\ I swear I know how to gather data!!

Thank you to all those who have posted their stories/results in this thread, I feel a little better haha. I can't believe how long it takes for results to come out 🙁