sashaMD123

2+ Year Member
Sep 1, 2016
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Medical Student
hello guys,
(yes, I just joined this forum to meet similar freaked out peers like me). I had my step 2 CS in august and I am literally freaking out after the exam.
I am an international med student, have not taken my step 1 and step 2 CK and here are a couple of things I did wrong.
1-In my first station, I made my female patient very uncomfortable by asking sexual hx(which i thought was pertinent) and when I asked OB/GYN, she questioned my rationale for asking it and I flustered and I auscultated her over the breast which was a huge screwup (although her breast were small) ! and given the fact that it was my first station, I forgot to counsel her on relevant aspects.In all, I forgot counselling on 2-3 cases, but other times i did it on pertinent aspects
2- I mishandled one of the challenging questions hugely.
3-There was a difficulty in comprehending 1 patient in the question which was really important for diagnosis and I think the patient was a bit angry about me repeating my question
5-I forgot to document some of the examinations I had done on the patient, including 1 supporting finding and thyroid exams
6-My top differentials on most cases were strong but the 2nd diff on 2-3 cases were plain brain farts.
7-I never asked any patients if they understood me, I just asked if they have any question for me.One of the patient actually said I was speaking fast.
8-Some of the patients had no challenging questions for me.
9-My patient notes were fine I guess, except for few times when I forgot to document few things.

I am majorly concerned about my empathy part (CIS), I think 2-4 patients might not be happy with me .i TRIED SHOWING EMPATHY EVERYTIME, I did all standard things. I hope I hope I hope I pass.

Anyone who has similar history or is undergoing similar agony please hit me up. Could really use some comforting words.

UPDATE: I PASSED!!!!! (IF I can pass, anyone Can) Lets keep the hope Alive :)
 
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SilverCat

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Aug 17, 2012
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Welcome to the freakout, friend. I also took the exam Aug 10th in Philly, and am having PTSD flashbacks to this exam.

If it makes you feel any better, look at the thread for the people who just got their results for CS--most passed. To me, your mistakes don't seem too serious.
 
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sashaMD123

sashaMD123

2+ Year Member
Sep 1, 2016
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Medical Student
Welcome to the freakout, friend. I also took the exam Aug 10th in Philly, and am having PTSD flashbacks to this exam.

If it makes you feel any better, look at the thread for the people who just got their results for CS--most passed. To me, your mistakes don't seem too serious.
I hope I hope we both pass, even if borderline. I shall be the world's happiest person then. This wait is the killer!
 

Ismet

PGY-almost done!
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1- perhaps she meant to appear uncomfortable - it's not a comfortable subject to talk about, but you can preface it with a few words that helps to normalize the questions and show that you think her answers to your questions may help you figure out what's going on with her. Also, if there's breast tissue where you have to listen to the heart, you're gonna have to put your stetho there. Just be respectful, ask her to lift her breast to listen to tricuspid and mitral, etc. Unless you were auscultating in the completely wrong area.
2- Meh
3- Meh
5- Meh
6- You probably did better than you think you did.
7- Don't worry about it.
8- Don't worry about it
9- Don't worry about it

If these things are all that went wrong, then it went really well. We all mess up on CS.
 
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doogiehowser19

5+ Year Member
Oct 4, 2011
9
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Hi guys,

I am AMG from a reputable medical school. I just took mine last week and have been feeling awful. This is how it went for me:
1 - Straightforward case. Forgot to do 1 very simple maneuver.
2 - Similar to #1. Forgot to do same maneuver as #1.
3 - Did not ask about sexual history when it would have been pertinent
4 - Had no idea what was going on so closure was somewhat messy.
5 - Accidentally told him "during your (nameless disease) episode", when I actually meant to just repeat the symptomatology. I quickly said "please disregard that, that's not what I meant. I meant x symptom." And moved on. Closed and went back to do 1 exam maneuver.
6 - Patient told me an exam maneuver was painful so I told him "please don't do that if it hurts, I will try to listen as best as I can". Closed but then asked a couple HPI type questions.
7 - Decent encounter overall. But forgot FH.
8 - Agitated seeming patient, but I thought I addressed her needs. I might have goofed up the challenge question.
9 - Decent encounter overall.
10 - Very stoic sort of patient, kept coughing. Realized afterwards that maybe I should have given water.
11 - Awesome encounter.
12 - Decent encounter overall. Again, went back to ask a couple questions after closure.

My closures were mostly about the tests I would be ordering. I never gave a full ddx, just sort of explained in simple terms "oh this could be a problem in the x so I would like to obtain imaging and blood tests". Always asked if they had questions. Tried to be comforting when possible. Sometimes, I closed and then went back to do an exam maneuver or ask a couple of HPI questions that I remembered. Not sure if this is acceptable.

For all, I felt that I ran out of space in HPI. Didn't even put pertinent negatives a lot of the time because there was no room! I always did some type of PE, but could not always fully document. Forgot diagnostic workup completely in 1 case. I put about 3 pieces of evidence under each dx, not sure if that was enough.

Preparation was First Aid 2CS. I did the cases twice with a friend. Practiced on their note software. Passed school OSCEs. Although in my recent rotations I wasn't seeing patients, so this might have worked against me. I felt that my flow wasn't what it was a few months ago, despite practicing for about a week.

Thoughts on this? I'm feeling pretty bad right now.

Praying that I pass. Otherwise this might jeopardize match for me if I have to retake it as I don't think I will have score back in time for rank lists. This is going to be an awful, long wait.
 

thelittleone

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Sep 27, 2011
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Honestly, yours sounded better than how mine went. My first case, I ran out of time; didn't even get to summarize. One of my ending cases, was halfway through exam before I realized I forgot to put on gloves...said sorry, put on gloves. And on all of them, as I was typing note, pertinent things would pop into my head that I should've asked, but didn't. Oh well, what's past is past, just got to wait for the score now. :(
 

doogiehowser19

5+ Year Member
Oct 4, 2011
9
7
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Medical Student
I am also extremely freaked out. Hoping we all pass this awful exam. I certainly felt like nerves got the best of me on test day.
 
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sashaMD123

sashaMD123

2+ Year Member
Sep 1, 2016
12
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Status
Medical Student
I hope we all had a positive result???? :-D :-D