I think I failed Step 2 CS

[JP2740]

-Didnt finish closure on 3 patients
-Forgot some very relevant questions for many cases (too focusedo n what I thought it was)
-Didnt write down some PE stuff I did on some patients
-Starting to think I didnt write down some positive PE findings, or maybe not including them in my defense
-Not sure about all of my diagnoses
-I probably nailed 3 cases, did fine on like 5, and the rest iffy
-My PE's were really abbreviated because I didnt want to lose time. I also didnt do heart and lungs on everyone
-I wasnt specific on some diagnoses, like saying the overall thing instead of the specific type of that diagnosis\
-Probably more that I havent thought about yet because I'm a ****ing scrub

I do pretty good in med school, but I feel like I choked on this exam. I'm ****ing freaking out.

Edit: I passed

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[Frazier]

 

[Brain Bucket]

condolences. did you prep for it?

 

[deleted500612]

I have the same fear. I do fine on written exams under pressure but when it comes to oral exams/presentations I tend to choke when under the gun. From what I've heard it is actually pretty common to not get done a couple of the cases and still pass though so you may have done better than you think.

 

[JP2740]

Yes I got through first aid with another student and went through most of it on my own a second time. Something about the time limit threw me off.

 

[JP2740]

Bump

 

[Brain Bucket]

sucks balls. take a course.

 

[JP2740]

sucks balls. take a course.

I didnt get my score back. I just took it. Im fine w h and ps in real life.

 

[JJMrK]

Stop thinking about it, there's nothing you can do now. You likely passed anyway.

 

[ksharp33]

Felt the same way as you, OP. I feel like I really ****ed it up. I walked out and realized how many dumb mistakes I made.

I am great with patients normally... IDK what happened.

 

[235009]

It's natural to walk out of it thinking you blew it but 9.7 times out of 10 that's not the case. Just forget about it and move on.

 

[JP2740]

bump, anyone with similar experience?

 

[JP2740]

Ya I failed CS. I took it and felt like apprehensive. What was my downfall was the lack in my PE. I really regret that section the most because it caused me to retake it.

What was wrong with your PE?

 

[Brain Bucket]

What was wrong with your PE?

look at post count and avatar.

 

[NickNaylor]

Yes I got through first aid with another student and went through most of it on my own a second time. Something about the time limit threw me off.

Does your school not do any kind of timed SP experience to prepare you?


Sent from my iPhone using Tapatalk

 

[FIREitUP]

that doesn't sound too bad to me...especially if you displayed empathy and "good communication skills"

 

[DermViser]

bump, anyone with similar experience?

I agree. Walking out of Step 2 CS, you tend to micromanage and remember all the things that you SHOULD have done, but not give yourself credit for what you did. Not worth replaying in your head again, and again, and again unnecessarily. My understanding is they have added components to the note that weren't there previously, as well as logistics (not writing) but I believe it still holds true.

Wait for the score report and then take action.

 

[JP2740]

Does your school not do any kind of timed SP experience to prepare you?


Sent from my iPhone using Tapatalk

Yea it was good, but I think on the real thing I wanted to really get everything in. When I ran out of time on 3 it was in the middle of the closure, I was still able to share diagnoses and workup, just not a well rounded closure. I answered challenge questions in all cases, except maybe didn't get to it in one (because of time limit). The time limit just added a pressure that made me not on top of my game completely.

 

[NickNaylor]

Yea it was good, but I think on the real thing I wanted to really get everything in. When I ran out of time on 3 it was in the middle of the closure, I was still able to share diagnoses and workup, just not a well rounded closure. I answered challenge questions in all cases, except maybe didn't get to it in one (because of time limit). The time limit just added a pressure that made me not on top of my game completely.

Yeah, fair enough. I always struggle with these stupid things because of how utterly artificial they inevitably are and the imposed time limits.


Sent from my iPhone using Tapatalk

 

[JP2740]

I agree. Walking out of Step 2 CS, you tend to micromanage and remember all the things that you SHOULD have done, but not give yourself credit for what you did. Not worth replaying in your head again, and again, and again unnecessarily. My understanding is they have added components to the note that weren't there previously, as well as logistics (not writing) but I believe it still holds true.

Wait for the score report and then take action.

Thank you for your response. I think I'm getting better at living with it and trying to just wait for the score report. Whether I pass or fail, I just think it's so unfair to judge med students on this exam that could dictate your career on one particular day. Like you're willing to negate 4 years of work for a test that's pass or fail based on god knows what metrics- and it's a test. I didn't have a single rotation that I didn't honor clinically, yet 1 test day can negate all that.

 

[DermViser]

Thank you for your response. I think I'm getting better at living with it and trying to just wait for the score report. Whether I pass or fail, I just think it's so unfair to judge med students on this exam that could dictate your career on one particular day. Like you're willing to negate 4 years of work for a test that's pass or fail based on god knows what metrics- and it's a test. I didn't have a single rotation that I didn't honor clinically, yet 1 test day can negate all that.

Most programs know that this is a BS test just to grab more money from students. So no, your work will not be all down the drain from this test. If you do fail (and you don't know just yet), then put the pedal to the metal, smash it out of the water the 2nd time, and put it out of our mind for good.

 

[evilbooyaa]

I felt the exact same way when I walked out of CS. I was worried about very similar things (a massive lack of positive PE findings to put in my note, inability to fully close on every case, a couple incorrect diagnoses, forgot to do an eye exam on a headache patient, etc. etc.)

I was told by multiple classmates, "If that's what you're worried about, then you're probably OK".

Got my score report back last week with a pass, with my only problem area being ICE, dipping slightly into the 'average' area. Rest of it was high performance, with english literally being off the charts (sweet, I'm really good at speaking english, hooray!)

Most students freak out after taking this exam (me included). As long as you practiced the note online, I feel relatively confident in the fact that you are likely not in the lowest 5-10th percentile of US MD students.

 

[JP2740]

I passed. Not one part of my score report wasnear borderline and I'm not one of those guys who comes out of an exam freaking out. I'm always confident. Idk if you need to completely **** up to fail or if failing is random. I thought I ****ed up pretty hard

 

[Pons Asinorum]

I passed. Not one part of my score report wasnear borderline and I'm not one of those guys who comes out of an exam freaking out. I'm always confident. Idk if you need to completely **** up to fail or if failing is random. I thought I ****** up pretty hard

It's a weird exam. I really think that if you make sentences with subjects and marginally conjugated verbs, make eye contact and put on your empathy face at some point during the HPI, you will pass. Not exactly sure who it's supposed to filter out to be honest. Failures seem completely random, and rare, exceedingly rare for AMG's. Whatever. Congrats, regardless.

 

[Psai]

nice job bro but it sure took them a long time to tell you

 

[DermViser]

I passed. Not one part of my score report wasnear borderline and I'm not one of those guys who comes out of an exam freaking out. I'm always confident. Idk if you need to completely **** up to fail or if failing is random. I thought I ****** up pretty hard

 

[JP2740]

What? I'm saying I thought I did really bad yet somehow did more than fine. Someone is going to search this topic in the future I figured to give someone some peace of mind

 

[jakeislove]

Congrats!

 

[deleted638696]

I hope people are still using this thread. I just took mine yesterday, and I'm freaking about about the new CIS requirements. I didn't try to get to know the patient as a person (didn't do much small talk except in 1 case), I didn't ask "how is the illness affecting you" (which is a direct question according to the USMLE site), I didn't ask them what they thought about their illness. I didn't ask them how they wanted to manage their problem. Instead, I would say what I thought the problem was, what I would recommend doing, and then ask "how do you feel about that"
I was always warm, friendly, formed a partnership, summarized, was gentle and thorough in the physical exam, and was usually empathetic (I got flustered and thrown off by angry patients). I have a harder time with SPs than real patients so I may have missed some extra opportunities for empathy but I certainly had at least 1 in every encounter. I am really only worried about the specific questions above because they are directly on the USMLE website as objective.
Can anyone comfort me by talking about how they passed the CIS? Did you do those things the USMLE said?

 

[JP2740]

I didn't ask any of the questions you listed. I didn't even know about them. I think you're ok.

 

[deleted638696]

I didn't ask any of the questions you listed. I didn't even know about them. I think you're ok.

Thank you so so much. I can't believe I didn't even make small talk. There are so many posts on SDN of people who sound like they were polite and somehow failed CIS and it really psyched me out. I have a knot in my stomach and I just wish I could make it go away. 2 months is a long time.
You're so nice to reply, now I have some hope. This is the best I've felt since I've left the test, although I'm still very worried of course. It seems like such an arbitrary system

 

[JP2740]

Thank you so so much. I can't believe I didn't even make small talk. There are so many posts on SDN of people who sound like they were polite and somehow failed CIS and it really psyched me out. I have a knot in my stomach and I just wish I could make it go away. 2 months is a long time.
You're so nice to reply, now I have some hope. This is the best I've felt since I've left the test, although I'm still very worried of course. It seems like such an arbitrary system

Are you AMG or IMG?

It seems like more people are failing based on what they write in the notes nowadays. Suffice it to say, I missed A LOT, A LOT and wasn't borderline in anything. So basically even if you feel like you missed a ton, you are in my shoes. So really you won't know if you failed until you get your score, so it's not worth worrying about. Chances are you passed, not that you failed.

 

[deleted638696]

AMG. Thanks for passing on some reassurance. Didn't expect to feel bad once the test was over.

 

[surfermd1]

JP2740, I'm and AMG and I'm really worried I might have failed my CS, particularly the ICE portion. Did you miss any major systems for the PE? For example, I missed a neuro exam, in a case where it was prob the most impt exam to do. I also didn't do motor strength in a fatigued patient. I generally did CV, pulm and abdomen. Lastly, I felt that 5/12 of my differentials were so-so. I probably had the actual diagnosis in there, but my other 2 were less likely, but I tried to support them. My notes in general were pretty thorough and fairly organized.

 

[anbuitachi]

test is very subjective guys. it depends on how your examiner feels

 

[235009]

JP2740, I'm and AMG and I'm really worried I might have failed my CS, particularly the ICE portion. Did you miss any major systems for the PE? For example, I missed a neuro exam, in a case where it was prob the most impt exam to do. I also didn't do motor strength in a fatigued patient. I generally did CV, pulm and abdomen. Lastly, I felt that 5/12 of my differentials were so-so. I probably had the actual diagnosis in there, but my other 2 were less likely, but I tried to support them. My notes in general were pretty thorough and fairly organized.

sounds like you did very well actually

 

[Uhl88]

Its been 2 weeks since i took the test... and I am freaking out about all the mistakes i made. I realize this is a normal response to the test but I just can't sleep or eat right now. Having small panic attacks. Perhaps its because I took it the second time and so much is at stake for passing this exam.. but I can't even think..

I think I am significantly PTSDed from my first failure, esp since I had no doubt that I passed my first try..



So without giving away any cases, here are the mistakes that I remember:



- didn't wash hand for one case (got off rhythm)

- didn't do one MMSE and neuro exam that may have been required

- flustered and may have rushed one case, answered the difficult question but added more detail to the difficult question

- didn't know the exact ddx for 2 cases, had 2-3 ddx for all cases except 2 where i only had 1, one of the 2 cases was really vague, had very little idea what was going on

- missed atleast one hx question if not multiple for each case to r/o a ddx

- feel like missed one PE maneuver per case

- missed couple diagnostic tests per case, including rectal/pelvic exam for 1, on average had about 4-5 tests, few i had up to 7... but I still missed some critical diagnostic test which I slapped my head for when I left the exam

- since I was writing the note all shorthand to maintain eye contact, it was pretty messy and I had to decipher it while writing the PN. I remembered few ROS questions that I might have asked during the encounter, but wasn't sure but the note was mostly done from my blue sheet

- some I forgot to ask 1-2 components of the onset duration, frequency, progression since I was committed to asking open ended questions.

- didn't ask some relevant social history questions such as exercise, diet, lifestyle, living conditions, safety, although i don't think I had any abuse cases

- might have not counseled on few pt, esp smoking

- forgot to do gait for some who may have required it

- missed out some counseling on the end with regard to lifestyle (exercise and diet), may have forgotten few counseling for smoking patients

- finished pt note but ran out of character space so had to delete some ROS to fill in other things

- missed documenting few PE I did

- only asked pertinent ROS, but probably missed some questions here as well...

- didn't ask how the illness was affecting the pt's life and what the pt thought the illness was for any case

- forgot Ob/Gyn q for one case although i don't think it was relevant to the CC

- didn't use medical terminology in the PN when it could have been used (e.g emesis instead of vomiting)



What i did right:

- was generally empathetic, whenever doing the abdominal exam, I always asked the pt if he/she felt comfortable lying on the exam table, pulled out the extension, and when helped the pt sit back up.

- draped the pt appropriately, exposing only the minimal skin of exposure, untied and tied the gown back appropriately and folded the gown to expose the back and the chest with minimal exposure for ascultation

- washed hands for all cases except 1, always knocked and introduced/ smiled/ shaked hands/ always asked 3-4 open ended questions and maintained eye contact while pt talked, used transition statements when switching from HPI to ROS to rest of the hx such as "well Mr/Mrs, I want to now ask you few questions about your general health, would that be okay?", also told the pt "Mr/Mrs so and so, I wanted to let you know that everything we talk is going to remain confidential, but i wanted to ask you few questions about your sexual practices" before asking about sexual hx

- counseled pt when I could, asked CAGE for all drinkers (may have been unnecessary) but I said it in the way of "so, Mrs/Mr so and so, here are few questions we ask all pt who drink.. do you mind if I ask those questions?"

- smiled when leaving the room if the pt encounter was good, always left saying "Thank you for letting me serve you today, I hope you feel better soon"

- did LIQRAAA ODFP for all pain pts

- asked for more details every time I finished closed ended-questions, summarized after finishing history, always told the pt what physical exam I was going to do

- I told the pt what I was doing while I was doing the physical exam, auscultated heart and lungs for all patient including the PMI for female pt by asking the pt to lift her left breast

- palpated thyroid when appropriate, did abdominal exam (inspection, auscultation, palpation, percussion) when appropriate with additional manuevers,

- did additional MSK maneuvers along with ROM, sensation, pulses, strength, DTRs for 2 MSK cases I think

- always finished closure with what I thought the concerning ddx were for the CC, the diagnostic tests I was going to order, and left the room with about a min (average) to spare

- always finished pmhx, pshx, shx, fhx, meds, allergies along with the HPI

- answered challenging questions appropriately

- explained all things in layman terms even after using the medical terms

- pretty certain i got main diagnosis and few ddx for 10/12 but not certain for the other 2..

 

[Kaustikos]

So,
Maybe it's me but I got my grade back and it's like CS is like my OSCE and has more to do with the HPI and ROS than anything. I did mine and didn't get one physical exam finding. I still had a solid differential. Aced (yes you only pass but my "standing" relative to the mean meant I destroyed it) it. It's literally about how you act as a physician and ask the right questions.
Also how you conclude it. Never given a diffinative answer and say you'll confer with colleague, labs, etc. Know what think is right. These people don't expect a diagnosis. You shouldn't have one.

 

[tiedyeddog]

Its been 2 weeks since i took the test... and I am freaking out about all the mistakes i made. I realize this is a normal response to the test but I just can't sleep or eat right now. Having small panic attacks. Perhaps its because I took it the second time and so much is at stake for passing this exam.. but I can't even think..

I think I am significantly PTSDed from my first failure, esp since I had no doubt that I passed my first try..



So without giving away any cases, here are the mistakes that I remember:



- didn't wash hand for one case (got off rhythm)

- didn't do one MMSE and neuro exam that may have been required

- flustered and may have rushed one case, answered the difficult question but added more detail to the difficult question

- didn't know the exact ddx for 2 cases, had 2-3 ddx for all cases except 2 where i only had 1, one of the 2 cases was really vague, had very little idea what was going on

- missed atleast one hx question if not multiple for each case to r/o a ddx

- feel like missed one PE maneuver per case

- missed couple diagnostic tests per case, including rectal/pelvic exam for 1, on average had about 4-5 tests, few i had up to 7... but I still missed some critical diagnostic test which I slapped my head for when I left the exam

- since I was writing the note all shorthand to maintain eye contact, it was pretty messy and I had to decipher it while writing the PN. I remembered few ROS questions that I might have asked during the encounter, but wasn't sure but the note was mostly done from my blue sheet

- some I forgot to ask 1-2 components of the onset duration, frequency, progression since I was committed to asking open ended questions.

- didn't ask some relevant social history questions such as exercise, diet, lifestyle, living conditions, safety, although i don't think I had any abuse cases

- might have not counseled on few pt, esp smoking

- forgot to do gait for some who may have required it

- missed out some counseling on the end with regard to lifestyle (exercise and diet), may have forgotten few counseling for smoking patients

- finished pt note but ran out of character space so had to delete some ROS to fill in other things

- missed documenting few PE I did

- only asked pertinent ROS, but probably missed some questions here as well...

- didn't ask how the illness was affecting the pt's life and what the pt thought the illness was for any case

- forgot Ob/Gyn q for one case although i don't think it was relevant to the CC

- didn't use medical terminology in the PN when it could have been used (e.g emesis instead of vomiting)



What i did right:

- was generally empathetic, whenever doing the abdominal exam, I always asked the pt if he/she felt comfortable lying on the exam table, pulled out the extension, and when helped the pt sit back up.

- draped the pt appropriately, exposing only the minimal skin of exposure, untied and tied the gown back appropriately and folded the gown to expose the back and the chest with minimal exposure for ascultation

- washed hands for all cases except 1, always knocked and introduced/ smiled/ shaked hands/ always asked 3-4 open ended questions and maintained eye contact while pt talked, used transition statements when switching from HPI to ROS to rest of the hx such as "well Mr/Mrs, I want to now ask you few questions about your general health, would that be okay?", also told the pt "Mr/Mrs so and so, I wanted to let you know that everything we talk is going to remain confidential, but i wanted to ask you few questions about your sexual practices" before asking about sexual hx

- counseled pt when I could, asked CAGE for all drinkers (may have been unnecessary) but I said it in the way of "so, Mrs/Mr so and so, here are few questions we ask all pt who drink.. do you mind if I ask those questions?"

- smiled when leaving the room if the pt encounter was good, always left saying "Thank you for letting me serve you today, I hope you feel better soon"

- did LIQRAAA ODFP for all pain pts

- asked for more details every time I finished closed ended-questions, summarized after finishing history, always told the pt what physical exam I was going to do

- I told the pt what I was doing while I was doing the physical exam, auscultated heart and lungs for all patient including the PMI for female pt by asking the pt to lift her left breast

- palpated thyroid when appropriate, did abdominal exam (inspection, auscultation, palpation, percussion) when appropriate with additional manuevers,

- did additional MSK maneuvers along with ROM, sensation, pulses, strength, DTRs for 2 MSK cases I think

- always finished closure with what I thought the concerning ddx were for the CC, the diagnostic tests I was going to order, and left the room with about a min (average) to spare

- always finished pmhx, pshx, shx, fhx, meds, allergies along with the HPI

- answered challenging questions appropriately

- explained all things in layman terms even after using the medical terms

- pretty certain i got main diagnosis and few ddx for 10/12 but not certain for the other 2..

I hate to brush your feelings aside here, you've obviously been dwelling on your performance during the exam, but you should just forget about it and chill. It is a crap exam that you probably passed with flying colors.

 

[JP2740]

Its been 2 weeks since i took the test... and I am freaking out about all the mistakes i made. I realize this is a normal response to the test but I just can't sleep or eat right now. Having small panic attacks. Perhaps its because I took it the second time and so much is at stake for passing this exam.. but I can't even think..

I think I am significantly PTSDed from my first failure, esp since I had no doubt that I passed my first try..



So without giving away any cases, here are the mistakes that I remember:



- didn't wash hand for one case (got off rhythm)

- didn't do one MMSE and neuro exam that may have been required

- flustered and may have rushed one case, answered the difficult question but added more detail to the difficult question

- didn't know the exact ddx for 2 cases, had 2-3 ddx for all cases except 2 where i only had 1, one of the 2 cases was really vague, had very little idea what was going on

- missed atleast one hx question if not multiple for each case to r/o a ddx

- feel like missed one PE maneuver per case

- missed couple diagnostic tests per case, including rectal/pelvic exam for 1, on average had about 4-5 tests, few i had up to 7... but I still missed some critical diagnostic test which I slapped my head for when I left the exam

- since I was writing the note all shorthand to maintain eye contact, it was pretty messy and I had to decipher it while writing the PN. I remembered few ROS questions that I might have asked during the encounter, but wasn't sure but the note was mostly done from my blue sheet

- some I forgot to ask 1-2 components of the onset duration, frequency, progression since I was committed to asking open ended questions.

- didn't ask some relevant social history questions such as exercise, diet, lifestyle, living conditions, safety, although i don't think I had any abuse cases

- might have not counseled on few pt, esp smoking

- forgot to do gait for some who may have required it

- missed out some counseling on the end with regard to lifestyle (exercise and diet), may have forgotten few counseling for smoking patients

- finished pt note but ran out of character space so had to delete some ROS to fill in other things

- missed documenting few PE I did

- only asked pertinent ROS, but probably missed some questions here as well...

- didn't ask how the illness was affecting the pt's life and what the pt thought the illness was for any case

- forgot Ob/Gyn q for one case although i don't think it was relevant to the CC

- didn't use medical terminology in the PN when it could have been used (e.g emesis instead of vomiting)



What i did right:

- was generally empathetic, whenever doing the abdominal exam, I always asked the pt if he/she felt comfortable lying on the exam table, pulled out the extension, and when helped the pt sit back up.

- draped the pt appropriately, exposing only the minimal skin of exposure, untied and tied the gown back appropriately and folded the gown to expose the back and the chest with minimal exposure for ascultation

- washed hands for all cases except 1, always knocked and introduced/ smiled/ shaked hands/ always asked 3-4 open ended questions and maintained eye contact while pt talked, used transition statements when switching from HPI to ROS to rest of the hx such as "well Mr/Mrs, I want to now ask you few questions about your general health, would that be okay?", also told the pt "Mr/Mrs so and so, I wanted to let you know that everything we talk is going to remain confidential, but i wanted to ask you few questions about your sexual practices" before asking about sexual hx

- counseled pt when I could, asked CAGE for all drinkers (may have been unnecessary) but I said it in the way of "so, Mrs/Mr so and so, here are few questions we ask all pt who drink.. do you mind if I ask those questions?"

- smiled when leaving the room if the pt encounter was good, always left saying "Thank you for letting me serve you today, I hope you feel better soon"

- did LIQRAAA ODFP for all pain pts

- asked for more details every time I finished closed ended-questions, summarized after finishing history, always told the pt what physical exam I was going to do

- I told the pt what I was doing while I was doing the physical exam, auscultated heart and lungs for all patient including the PMI for female pt by asking the pt to lift her left breast

- palpated thyroid when appropriate, did abdominal exam (inspection, auscultation, palpation, percussion) when appropriate with additional manuevers,

- did additional MSK maneuvers along with ROM, sensation, pulses, strength, DTRs for 2 MSK cases I think

- always finished closure with what I thought the concerning ddx were for the CC, the diagnostic tests I was going to order, and left the room with about a min (average) to spare

- always finished pmhx, pshx, shx, fhx, meds, allergies along with the HPI

- answered challenging questions appropriately

- explained all things in layman terms even after using the medical terms

- pretty certain i got main diagnosis and few ddx for 10/12 but not certain for the other 2..

Sounds like you did better than me bro. Don't sweat it although I heard not washing your hands is very very bad

 

[Uhl88]

So,
Maybe it's me but I got my grade back and it's like CS is like my OSCE and has more to do with the HPI and ROS than anything. I did mine and didn't get one physical exam finding. I still had a solid differential. Aced (yes you only pass but my "standing" relative to the mean meant I destroyed it) it. It's literally about how you act as a physician and ask the right questions.
Also how you conclude it. Never given a diffinative answer and say you'll confer with colleague, labs, etc. Know what think is right. These people don't expect a diagnosis. You shouldn't have one.

congratulations. yeah i heard that the score distribution is such so that HPI is worth 40, PE is 10, differentials are 40 and diagnostic exams 10 percent. Each are rated in a scale from 1-4. I am worried about my patient note since I ended up putting non-medical jargon in there such as redness instead of erythma, pale instead of pallor, swelling instead of edema, numbness weakness, burning pain with urination instead of dysuria, feeling hotter/fcolder than usual instead of cold intolerance heat intolerance, lumps or bumps instead of lymphadenopathy, flank pain instead of CVA tenderness, SOB instead of dysapnea, etc. I did have medical terms for certain symptoms such as PND, orthoapnea, heart palpitaitons, etc, but I was rushed for time in most cases so I kinda just put whatever came into my mind. I later realized that USMLE penalized not using accurate medical terminology on the notes, but I am not sure if it is just the differntials or the entire HPI. I know for the differentials I put medical terminology for all cases, but I am just not sure about the HPI portion. On their sample note, they say "pulled muscle" is not a medical term hence it will result in a lower score. And also with regards to ROS, I only asked few pertinent positives, didn't ask unncessary ROS since I thought the point of the game was to keep everything focused.

 

[JP2740]

congratulations. yeah i heard that the score distribution is such so that HPI is worth 40, PE is 10, differentials are 40 and diagnostic exams 10 percent. Each are rated in a scale from 1-4. I am worried about my patient note since I ended up putting non-medical jargon in there such as redness instead of erythma, pale instead of pallor, swelling instead of edema, numbness weakness, burning pain with urination instead of dysuria, feeling hotter/fcolder than usual instead of cold intolerance heat intolerance, lumps or bumps instead of lymphadenopathy, flank pain instead of CVA tenderness, SOB instead of dysapnea, etc. I did have medical terms for certain symptoms such as PND, orthoapnea, heart palpitaitons, etc, but I was rushed for time in most cases so I kinda just put whatever came into my mind. I later realized that USMLE penalized not using accurate medical terminology on the notes, but I am not sure if it is just the differntials or the entire HPI. I know for the differentials I put medical terminology for all cases, but I am just not sure about the HPI portion. On their sample note, they say "pulled muscle" is not a medical term hence it will result in a lower score. And also with regards to ROS, I only asked few pertinent positives, didn't ask unncessary ROS since I thought the point of the game was to keep everything focused.

Let me just tell you: You have to **** up pretty hardcore to fail this exam OR the grading is arbitrary.

 

[tiedyeddog]

Let me just tell you: You have to **** up pretty hardcore to fail this exam OR the grading is arbitrary.

I almost feel like failure is random... I know three people who have failed CS. All of them decently smart, personable, and very fluent in english. I am sure they didn't mess up anything more than I did yet they failed?

 

[Uhl88]

I do wonder, did anybody else also notice a fairly high failure rate in their school this year? Again, our school had 10 percent failure rate, which is certainly higher than laster year (3 percent)..

 

[Kaustikos]

I do wonder, did anybody else also notice a fairly high failure rate in their school this year? Again, our school had 10 percent failure rate, which is certainly higher than laster year (3 percent)..

Fail and match. Wait till the numbers get published: schools are in trouble.

congratulations. yeah i heard that the score distribution is such so that HPI is worth 40, PE is 10, differentials are 40 and diagnostic exams 10 percent. Each are rated in a scale from 1-4. I am worried about my patient note since I ended up putting non-medical jargon in there such as redness instead of erythma, pale instead of pallor, swelling instead of edema, numbness weakness, burning pain with urination instead of dysuria, feeling hotter/fcolder than usual instead of cold intolerance heat intolerance, lumps or bumps instead of lymphadenopathy, flank pain instead of CVA tenderness, SOB instead of dysapnea, etc. I did have medical terms for certain symptoms such as PND, orthoapnea, heart palpitaitons, etc, but I was rushed for time in most cases so I kinda just put whatever came into my mind. I later realized that USMLE penalized not using accurate medical terminology on the notes, but I am not sure if it is just the differntials or the entire HPI. I know for the differentials I put medical terminology for all cases, but I am just not sure about the HPI portion. On their sample note, they say "pulled muscle" is not a medical term hence it will result in a lower score. And also with regards to ROS, I only asked few pertinent positives, didn't ask unncessary ROS since I thought the point of the game was to keep everything focused.

I used Chronology of present illness wherein I just put everything down in a timeframe. Read up on it: ICU uses it all the time here and people here love it because it's so easy to read. It's more "surgery" in that it's to the point but it's the best when time isn't on your side.
It IS about hpi. They want to know how good you are at getting facts from the patient and less so physical exam findings. I don't know if its just me, but I knew my top three differentials without a physical exam for alot of them.
It was nerve wrecking at first because I didn't get clue cards or my physical exam findings weren't giving me cards. I just said **** it. I focused on communication and getting out in a good manner.
Regarding the note: I literally put words in and skipped to my differential. Then I went back and made it more "comprehensible".
Seriously think that using surgery jargon/note writing is what they want out of this exam.

 

[tiedyeddog]

Yeah i feel the same. Our school had 10 percent failure rate this year.. Ludacris.. They said on the nbme website that they are making renovations this year. Escalating the passing threshold so an estimated 8 percent from 4 percent AMG would fail. Now this is just an estimate.. But really the percentage i heard from other schools and ours (n=3) are like 10 percent or greater.. That means essentially 1500 AMG have failed this year and about half to less are in my shoes, remediating or have recently taken this test. Given NBME earn 35 million + per year on the first attempts and about 3 million on second timers, I think its kinda ridiculous. Also having failed once, I have so much at stake. To realize 4 years hard work + match to be evaporated in front of your eyes because u did not act kind enough to 12 judges is not easy.

I think my school had about an 8 percent fail rate? I know not everyone who failed had a good track record nor did they study before hand but some of them did.

 

[Kaustikos]

I think my school had about an 8 percent fail rate? I know not everyone who failed had a good track record nor did they study before hand but some of them did.

It's why my school mandated people take CS early. Not because of mistrust but so their career isn't screwed by one exam that they couldn't reschedule before residency

 

[tiedyeddog]

It's why my school mandated people take CS early. Not because of mistrust but so their career isn't screwed by one exam that they couldn't reschedule before residency

Mine too actually, they just pushed up the last day to take it by a month and a half because a couple people had to withdraw from the match because they couldn't take it in time before matriculation to residency. I think it is absolutely insane an exam we have to travel to, get a hotel for, then pay 2.5 k for takes more than two months to grade. Especially when you consider the crap results they give you. I have no idea how to interpret how I did other than I passed. The whole thing is a scam.

 

[MrGrrrMonster]

Thats nice that some schools mandate a deadline to take it. My school does not, and as such I didn't take mine until January of this year and was definitely somewhat concerned about whether or not my grade would be back in time for rank lists. I know many programs do not care too much one way or the other, but I think its best to have it in early.

 

[Apoplexy__]

I passed. Not one part of my score report wasnear borderline and I'm not one of those guys who comes out of an exam freaking out. I'm always confident. Idk if you need to completely **** up to fail or if failing is random. I thought I ****ed up pretty hard

THANK YOU for updating this thread with your outcome. The worst possible thing to read on this thread is a highly relatable post of someone fearing they failed, with either a cliffhanger (usually) or worse, a confirmed failure.

I take mine in 7 days. Ugh.