FA seems to suggest a pretty extensive workup list for the various chief complaints. I know in real life you wouldnt necessarily order all of these at the same time. For the purposes of the test, should we list all of these or will w get points detracted for too long of a list?
How extensive should our workup be for CS?
- Thread starter nope80
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Took CS in May, and I personally tried to not leave any spaces blank in the DDX section. If my memory serves me correctly, there were 5 boxes for a differential and 5 boxes of potential tests you would order. I kind of paired the diagnosis with the test I ordered.
Using that method I scored well above the average in all three categories. And just a side note, if you are an American med student who speaks English as a first language, you should NOT worry too much about this test. Just read through FA once, then maybe through the cases one more time. Your home med school OSCE was likely more difficult than Step 2 CS.
They don't really score negative points on the CS. The scoring is from a checklist where it's either there or it isn't. Realistically, the DDx and workup is the least of your worries on the note (The history and PE are much more valuable). But don't leave anything blank if you can think of something to fill it with.
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I basically just came up with a differential for whatever they gave me and then ordered whatever tests were important for ruling-in and ruling out the conditions involved. I didn't get too fancy.
If I was trying to show you used Y test to confirm a diagnosis I was pretty sure I had with my H&P plus test X above, I put that lower on the list.
I agree with the sentiments above... they're primarily testing whether you are able to extract the information needed and then present it in a logical format. Focus on that. Your differential and workup are important, but they're not the primary reason they are testing you.
If I was trying to show you used Y test to confirm a diagnosis I was pretty sure I had with my H&P plus test X above, I put that lower on the list.
I agree with the sentiments above... they're primarily testing whether you are able to extract the information needed and then present it in a logical format. Focus on that. Your differential and workup are important, but they're not the primary reason they are testing you.
I guess I just don't understand based on what is written in First Aid. Okay, so they give a classic description of migraine headaches. But then in the differential they go into tension, cluster headache, trigeminal neuralgia, etc things that really are clearly not correct given their super specific clinical passage. However, putting that aside, in the workup they have: CBC, ESR, CT-head, MRI-brain, LP. Are they serious? You would never do all of those things esp at once?! Any suggestions?? I'm starting to freak out..
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The standardized patient's complaints aren't quite so specific. Our school actually did a mock CS exam for us which is apparently remarkably close to the real thing. The SPs had complaints that definitely steered you in a certain direction, but they weren't obviously one things versus another. And as other people have said, unless you leave your DDx and plan blank, you won't fail by not getting every possible thing on the check list. One tip that works pretty well for me is creating a broad differential before you go into the room. CC is "headache," differential is big. Mentally take things off your list as you go, but if you can't take brain cancer off of your ddx based on H&P then head CT or MRI should be on your plan. Just think broad, you'll be fine. The pass rate is remarkably high 👍.
