Passed CS!!!!-some helpful tips

[golfpropsychguy]

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This is definitely an exam you need to have a strategy for before going into it. If you think you just need to wash your hands, speak english, and knock on the door your probably going to fail.

A lot of AMG's(not trying to step on any toe's) think they are well prepared for the exam but that really is not the case since they increased the passing score. If the med school you came from, regardless if its american or foreign, had strong teaching in regards to clinical skills than you will have an advantage but if your going into this exam not knowing how to ask questions in regards to lower back pain, frozen shoulder, headaches, hearing loss(I chose these because we all know CHF, Diabetes, COPD) than you need to brush up.

The most important part of the exam and probably the part that most people fail is the information gathering section(asking questions, physical exam, and writing a note). Of these three the most important is the questions you will ask.

When I took the exam my physical exam and note writing were horrible!!!! But what I made sure to do prior to the exam was to memorize the specific questions you need to ask based on the chief complaint. I basically took FA and memorized the questions they asked per practice case. You will not see anything different then what is in FA!!!!

Of course you should know how to perform a physical exam(usmleworld has great videos).

FA and Uworld are also great for learning how to write a note. Just follow that format and memorize how to write all the normal findings(PERLA,EOM intact etc...)

lastly- writing the note- I started the exam by typing it and it was a disaster so I wrote every note after that which was the best thing I did. I was worried about my handwriting, which is horrible, but the moment I switched to writing I was more confident because I knew I could write faster than type. Bottom line-if your going to type make sure your not just a fast typer but that you can type NOTES with abbreviations fast!-there's a huge difference.

Take home-Know the questions you need to ask each patient based on there chief complaint and you will pass.😀
hopes this helps.

 

[arthrodisiac]

lastly- writing the note- I started the exam by typing it and it was a disaster so I wrote every note after that which was the best thing I did. I was worried about my handwriting, which is horrible, but the moment I switched to writing I was more confident because I knew I could write faster than type. Bottom line-if your going to type make sure your not just a fast typer but that you can type NOTES with abbreviations fast!-there's a huge difference.

i'll just play devil's advocate here and say that if your handwriting is crap like mine, then dont even think about handwriting. I can type very fast and I never ran out of time on the note. My notes were very complete. If you come from a school where you are writing lots of notes on rotations, 10 minutes is more than enough time to document these basic exams. These arent homeless people with hiv, hepc, pcp, chf, etc, etc.

 

[medblazer21]

This is definitely an exam you need to have a strategy for before going into it. If you think you just need to wash your hands, speak english, and knock on the door your probably going to fail.

A lot of AMG's(not trying to step on any toe's) think they are well prepared for the exam but that really is not the case since they increased the passing score. If the med school you came from, regardless if its american or foreign, had strong teaching in regards to clinical skills than you will have an advantage but if your going into this exam not knowing how to ask questions in regards to lower back pain, frozen shoulder, headaches, hearing loss(I chose these because we all know CHF, Diabetes, COPD) than you need to brush up.

The most important part of the exam and probably the part that most people fail is the information gathering section(asking questions, physical exam, and writing a note). Of these three the most important is the questions you will ask.

When I took the exam my physical exam and note writing were horrible!!!! But what I made sure to do prior to the exam was to memorize the specific questions you need to ask based on the chief complaint. I basically took FA and memorized the questions they asked per practice case. You will not see anything different then what is in FA!!!!

Of course you should know how to perform a physical exam(usmleworld has great videos).

FA and Uworld are also great for learning how to write a note. Just follow that format and memorize how to write all the normal findings(PERLA,EOM intact etc...)

lastly- writing the note- I started the exam by typing it and it was a disaster so I wrote every note after that which was the best thing I did. I was worried about my handwriting, which is horrible, but the moment I switched to writing I was more confident because I knew I could write faster than type. Bottom line-if your going to type make sure your not just a fast typer but that you can type NOTES with abbreviations fast!-there's a huge difference.

Take home-Know the questions you need to ask each patient based on there chief complaint and you will pass.😀
hopes this helps.

Thanks for the post. Looking back now I think this is where I really ****ed up. I asked most of hte LIQOR stuff but I didnt ask a lot of questions that were SPECIFIC to that complaint, for example any bladder incontinence with back pain. My paltry ROS is probably why I failed.

 

[bobmarley77]

just got my PASS minutes ago....what a relief...

1)ask the questions using the acronyms...I never use acronyms but it's so MUCH easier...just do it. Also, I like to summarize/repeat what they say and say, "is there anything else that happened?"
2)make sure you note down pertinent positives and negatives and put this in your HPI
3)just do a focused physical....all they want in the note is the pertinent physical findings. Also, it is important to explain to the patient what you are doing.
4)I typed my note even though I type slow....by doing this, I was able to read my note and edit it easily
5)make sure you have enough diff diagnoses...if you're weak on this, make index cards for each FIRST AID case and practice generating diff diagnoses INSTANTLY

 

[daru1]

just got my PASS minutes ago....what a relief...

1)ask the questions using the acronyms...I never use acronyms but it's so MUCH easier...just do it. Also, I like to summarize/repeat what they say and say, "is there anything else that happened?"
2)make sure you note down pertinent positives and negatives and put this in your HPI
3)just do a focused physical....all they want in the note is the pertinent physical findings. Also, it is important to explain to the patient what you are doing.
4)I typed my note even though I type slow....by doing this, I was able to read my note and edit it easily
5)make sure you have enough diff diagnoses...if you're weak on this, make index cards for each FIRST AID case and practice generating diff diagnoses INSTANTLY

To this and the original poster: I think if everyone taking the test this year had read and heeded your advice, there would be a 100% pass rate from AMGs (I know the NBME wouldn't let this happen because this is the greatest money grab they've ever come up with, but you get the point). I don't use acronyms either but I thought, 'well it's been working for those that have taken the test before me, I might as well try it.' Doing this and memorizing a couple of questions (not all questions -- you'll run out of time) for each differential is the reason I passed. To get enough differentials isn't that hard, I believe you can be pretty broad, but the information you get in the interview is much more critical than coming up with 5 probable causes.

I will just repeat:
1. Follow some sort of acronym style, even if you don't do it in practice.
2. Ask questions about the specific chief complaint after/during the acronym usage.
3. Practice typing the notes with the abbreviations. I was the last out of the room in 11/12 stations (the phone call goes by fast). I made up the time with my abbreviations.
4. Don't go in thinking your **** doesn't stink. Just try to act like an old-school home-visit type doc with compassion.

 

[carrie198]

Check out the computer note writing format before taking the exam. I think you can practice on the USMLE website. I had no idea how it worked, so I was afraid to type my notes during the exam. However, by the 8th note or so, my hand was completely cramped up and my handwriting was crap.

First Aid is a great representation of the exam. I didn't memorize FA, but read it on the plane on the way to the exam and in my hotel the night before. FA is especially helpful when coming up w/ DiffDx and dealing with difficult questions (you'll get one for every patient).

There are lots of points for little things, so read this section of FA. For example, use patient's name, make eye contact, wash hands, ask permission to do exam, cover parts of pt you aren't examining, and ask if pt has questions. These are key. Overall, not too bad. It was a long, tiring day, but it is well-run and will be over before you know it.

Good luck!