Just guaranteed myself a Failed Step 2 CS

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Cadet133

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I am 100% confident I failed step 2 cs. I took the exam last week And after dreading over it Ill finally write about it.

The Negatives:

1. patient: Forgot some PE maneuvers, 1 diagnosis was ok the other one was crap. My response to the challenge question was Pathetic

2. patient: The whole thing was crap. DIdnt know what the hell was going on and put random 2 diagnosis, not sure if the PE had anything to do with anything

3. patient: Forgot some PE maneuvers even the key one, forgot his name when I entered. Had no idea what the diagnosis was put down any 2 and moved on. My response to challenge question was crap

4. patient. Went well except for a key PE maneuver

5. patient. Went very well

6. patient: was horrible. Forgot to do a PE maneuver on the main problem. On the patient note wrote LT (blank) pain instead of RT so I got the opposite side so that was probably the dumbest and stupidest and most costliest thing I've ever done.

7. Went well except when I realized I forgot to ask him about his past medical history so I couldnt document it on the patient note.

8. patient: Went horrible. Couldn't do the PE because he was in extreme pain. Not sure if he was testing me out. Effed up on Challenge question

9.patient: Went ok I guess. Forgot to do a main PE maneuver that warranted it

10. Patient: Horible. Did not know what was wrong with him. FOrgot to document some of my PE on the patient note. Wrote 2 crappy diagnosis

11.patient: Went well

12. patient: Went ok. Didint think I responded well to the SP challenge question



In summary. I've read so many bad experiences but I don't think I've ever read one as bad as mines. Its frustrating because I did really well on step 1 and step 2. As you can see the biggest problem for me was the PE maneuvers and the challenge questions. I was sooooo nervous throughout the entire encounter and sometimes didn't know what to say and was asking randomly at times. I think my prediction is I will have low performance on ICE and maybe borderline on CIS.


The positives:

I walked in greeted them with my name, shook their hand, made eye contact. I washed my hand in all the cases. Asked permission to untie gown. Pulled the bed rest in all patients. I never ran out of time and did a closure on all the patients (even though the diagnosis was wrong on some of them) I counseled on all except for 1 patient who had smoking. I was empathetic in all cases I guess " I understand your concerns I will do my best to find out what is going on and treat you"
 
Me, you, and a few ppl are on the same boat buddy. This test is very subjective and no one really knows what it takes to fail. Come August 12 if you fail, then you will know why as you have listed the reasons. Good luck waiting till then. Im having recurring nightmares about my mistakes so just know that you're not alone!
 
I know exactly how you feel. It's been a horrible few weeks of constant anxiety. I feel the same way about my exam.
 
I also think there's no such thing as a "wrong" ddx. I thinks probably more or less likely ddxs but I think credit is given as long as it's not entirely off and there's supporting evidence, so I wouldn't write it off completely as a failure. Also if it's any consolation I didn't make the same errors as you but I made equally horrible errors on the exam (i.e not asking self evident questions etc...).
 
Yeah, trust me. I spent about 2 months going over all the things I did wrong and I did quite a few of what you've said there. 8 out of my 12 cases weren't from First Aid. I kid you not. I screwed up so many of the diagnoses and felt like most of my challenge questions were answered terribly. It was one long nightmare. I was pretty certain I'd failed, but I didn't. So, have hope. It's going to be horribly nerve wrecking until your results but take heart in the fact that most of us feel like this.
 
You guys did fine. Trust me. As long as your mistakes were not consistent for example. If you had failed to summarize and close for multiple patients then i would be worried. The mentality is these folks who are grading you are not out to get you. They want you to pass they understand the anxiety of the exam and they understand what happens if you dont pass. Being consistently bad through multiple cases, being disrepectful, etc will fail you. Different mistakes 1 here 1 there does not hurt you at all. My experience is as follows. Appi case missed straight leg, missed rosvigs, had a strange case where i had NO idea what the dx was made a few up axiety, fatigue etc....what im trying to say is a mistake here and there on many cases is not a bad thing as long as they were not consistent i missed a few dx, i missed multiple relevant PE exams, and im sure i didnt ask every question and i still passed with a really big margin. My buddy missed 5 or 6 PE on his notes completley left them blank and still passed! As long as you were polite, spoke clearly, explained what you thought the problem was, and discussed a follow up plain....your ok!! GL
 
You guys did fine. Trust me. As long as your mistakes were not consistent for example. If you had failed to summarize and close for multiple patients then i would be worried. The mentality is these folks who are grading you are not out to get you. They want you to pass they understand the anxiety of the exam and they understand what happens if you dont pass. Being consistently bad through multiple cases, being disrepectful, etc will fail you. Different mistakes 1 here 1 there does not hurt you at all. My experience is as follows. Appi case missed straight leg, missed rosvigs, had a strange case where i had NO idea what the dx was made a few up axiety, fatigue etc....what im trying to say is a mistake here and there on many cases is not a bad thing as long as they were not consistent i missed a few dx, i missed multiple relevant PE exams, and im sure i didnt ask every question and i still passed with a really big margin. My buddy missed 5 or 6 PE on his notes completley left them blank and still passed! As long as you were polite, spoke clearly, explained what you thought the problem was, and discussed a follow up plain....your ok!! GL
Thanks guys.
 
Yikes I might have summarize for 3 patients only. But I closed for every one. So who knows
 
You guys did fine. Trust me. As long as your mistakes were not consistent for example. If you had failed to summarize and close for multiple patients then i would be worried. The mentality is these folks who are grading you are not out to get you. They want you to pass they understand the anxiety of the exam and they understand what happens if you dont pass. Being consistently bad through multiple cases, being disrepectful, etc will fail you. Different mistakes 1 here 1 there does not hurt you at all. My experience is as follows. Appi case missed straight leg, missed rosvigs, had a strange case where i had NO idea what the dx was made a few up axiety, fatigue etc....what im trying to say is a mistake here and there on many cases is not a bad thing as long as they were not consistent i missed a few dx, i missed multiple relevant PE exams, and im sure i didnt ask every question and i still passed with a really big margin. My buddy missed 5 or 6 PE on his notes completley left them blank and still passed! As long as you were polite, spoke clearly, explained what you thought the problem was, and discussed a follow up plain....your ok!! GL

Yeah. I'm in agreement with bigpacman101 that not closing/summarizing can lose you a lot of points. But I disagree that they want you to pass. I don't think they care about the actual students. And this is coming from someone who passed first attempt (me). But my perspective is just n=1. Oh and btw it's extraordinarily unlikely that anyone taking this exam would leave 5-6 P/E sections completely blank, despite what he or she said.
 
Yeah. I'm in agreement with bigpacman101 that not closing/summarizing can lose you a lot of points.
Crap I only summarized for like 2-3 patients but I explained to them the disgnosis and work up Etc. I always finished with 1 min left
 
I think there needs to be a clarification of what some people mean by "summarize." If you mean reciting all of the patients story and complaints back to them to clarify that you understood correctly, I did that on zero patients and I passed. I "summarized" by offering a number of possible diagnoses and telling them which symptoms they had that supported each. Then I told them what the work up would include and counseled them on behaviors if needed. I think that is adequate for summarizing/closing.
 
Crap I only summarized for like 2-3 patients but I explained to them the disgnosis and work up Etc. I always finished with 1 min left
I think there needs to be a clarification of what some people mean by "summarize." If you mean reciting all of the patients story and complaints back to them to clarify that you understood correctly, I did that on zero patients and I passed. I "summarized" by offering a number of possible diagnoses and telling them which symptoms they had that supported each. Then I told them what the work up would include and counseled them on behaviors if needed. I think that is adequate for summarizing/closing.

I think summarizing the CC/HPI and giving brief DDx/Ix is sufficient for the ICE points. But everything else is good for boosting CIS. That's my sentiment at least.
 
I think summarizing the CC/HPI and giving brief DDx/Ix is sufficient for the ICE points. But everything else is good for boosting CIS. That's my sentiment at least.

I thought ICE consists of just physical exam + patient note? And CIS consists of summarizing + closure?
 
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