Step II Improve my CS performance...

[solitarydancer]

HI everyone,

I'm an IMG from Europe, and recently failed CS, which is kind of a problem since I'm participating in this year's match...
Anyway, I'm taking it again at the end of november, and I'm wondering what to do to not fail again, obviously.

What I had the least good performances in were :
- Data gathering
- Questioning skills

I got really high performances in Patient note, and Spoken English Proficiency.

Would anyone have suggestion about how to improve my performance ?

Thanks a lot !

 

[jeesapeesa]

HI everyone,

I'm an IMG from Europe, and recently failed CS, which is kind of a problem since I'm participating in this year's match...
Anyway, I'm taking it again at the end of november, and I'm wondering what to do to not fail again, obviously.

What I had the least good performances in were :
- Data gathering
- Questioning skills

I got really high performances in Patient note, and Spoken English Proficiency.

Would anyone have suggestion about how to improve my performance ?

Thanks a lot !

sorry to hear, hopefully with practice you can rock this exam. did you use First Aid for CS? since you specifically said that your poor performances were in the areas of data gathering and questioning skills, it may be due to the lack of focused questioning relating to the chief complaint.

i found that developing a differentials list while reading the patient information on the door was very helpful. it would lead me to a more focused list of questions that i would ask. if the chief complaint would be: shortness of breath, i would develop 4 differentials:
- PE
- Pneumonia
- asthma
- CHF

then i would ask questions for my HPI that can rule in/out these differentials.
- PE
chest pain? diaphoresis? tachycardia? tachypnea? long flight/stasis? injury to leg/chest? history of clots?
- Pneumonia
fevers, chills, nightweats? coughing? sputum production?
- asthma
wheezing? use of bronchodilators? gets better with meds?
- CHF
past MI? orthopnea? edema? frothy sputum? how many flights of stairs?

in addition, i would always finish my HPI with the review of systems (head to toe) headache? blurry vision? appetite? nausea vomiting? chest pain? abdominal pain? diarrhea/constipation? polyuria/dysuria/hematuria?

you can see you can come up with a sh*tload of questions just coming up with a few differentials and ending it with the review of systems. practice with FA and the cases they provide.

 

[SxRx]

sorry to hear, hopefully with practice you can rock this exam. did you use First Aid for CS? since you specifically said that your poor performances were in the areas of data gathering and questioning skills, it may be due to the lack of focused questioning relating to the chief complaint.

i found that developing a differentials list while reading the patient information on the door was very helpful. it would lead me to a more focused list of questions that i would ask. if the chief complaint would be: shortness of breath, i would develop 4 differentials:
- PE
- Pneumonia
- asthma
- CHF

then i would ask questions for my HPI that can rule in/out these differentials.
- PE
chest pain? diaphoresis? tachycardia? tachypnea? long flight/stasis? injury to leg/chest? history of clots?
- Pneumonia
fevers, chills, nightweats? coughing? sputum production?
- asthma
wheezing? use of bronchodilators? gets better with meds?
- CHF
past MI? orthopnea? edema? frothy sputum? how many flights of stairs?

in addition, i would always finish my HPI with the review of systems (head to toe) headache? blurry vision? appetite? nausea vomiting? chest pain? abdominal pain? diarrhea/constipation? polyuria/dysuria/hematuria?

you can see you can come up with a sh*tload of questions just coming up with a few differentials and ending it with the review of systems. practice with FA and the cases they provide.

Good advice.
That's what I've been doing. I write down 4-5 differentials on my piece of paper to guide what type of questions to ask. Then I ask those questions then ask ROS questions. For the ROS questions, I just start at the head, neck (thyroid etc...), chest (SOB), heart (palpitations), abdomen, GU, MSK, skin etc....

 

[jeesapeesa]

Good advice.
That's what I've been doing. I write down 4-5 differentials on my piece of paper to guide what type of questions to ask. Then I ask those questions then ask ROS questions. For the ROS questions, I just start at the head, neck (thyroid etc...), chest (SOB), heart (palpitations), abdomen, GU, MSK, skin etc....

yea, the cases are not too complex and anybody can come up with at least 3 differentials in any case.

some students say they don't want to waste time doing this. but spending a minute or so writing the differentials will be very advantageous when focusing questions. i was one of the last ones to go in the patient's room when the encounter started.

 

[kaypeec]

You can attend one of the step 2 cs reviews. One good one is www.step2cs-cme.com in Atlanta. Check it out