Mossjoh said:
Anyone? Anyone? I know more of you have taken CS
Just took it yesterday in Houston.
Pretty long test for us.... 12 stations. We went through 5 stations, took a 30 minute lunch break (a sandwich bar, which looked like it cost a whole $25 to fund), went through 4 stations, took a 15 minute rest break, then finished off the last 3 stations. Following the exam you fill out an evaluation/survey sorta like Step1 and CK. Oh, before you begin there's about an hour or so of orientation where you get your badges, clipboards, etc. , and then they show you a video and powerpoint presentation about what to do and what not to do. From the start of orientation to finishing the survey it took 7.5 hours (8am - 3:30pm). Be prepared to be referred to as "Dr." and expect to be surrounded by a lot of people in white coats longer than your's.
It's not really that bad. Everyone there was nervous, many being more so than I was which made me a feel a lot better. People looked bad before, during, and after the test. Figures, since the NBME refuses to let us know how the grading truly works; in other words, everyone feels bad about the exam, and no one really knows how they're going to do. The good news is that the odds are in your favor with a greater than 85% pass rate. Most likely you'll do fine and pass, even if you feel like crap about it.
Patients were very nice, most were very good at being SPs, a few seemed kinda new at it (don't freak out about that; it's actually kinda funny and nonintimidating). I'm guessing 2 of the stations (since we had 12 total) aren't scored, but no one knows which ones.
The biggest problem with the test is that you feel rushed the whole time. I made it though the history and physical only on my very first station, when the "this encounter is over" announcement was made. So much for counseling the patient and telling him what I thought. Fifteen minutes JUST ISN'T ENOUGH to do a really good job. You just have to go in there, ask as many relevant questions as possible, examine the relevant systems, give the patient one or two possible diagnoses and their initial workups, ask if they have any questions, and boogie outta there. After the debacle on my first station, I managed to make it out of the following 11 stations with about 10-30 seconds to spare. No one there on my day seemed to have any trouble finishing the patient note. The only thing about the PN is that you don't have a whole lotta space to write/type in. You have to be frugal with information
Don't forget that each individual encounter is ALL ABOUT THE SP. Everything you do, from the moment you knock on the door, to the moment you leave the room, should be done with the patient in mind. Smile, make eye contact, shake hands, be friendly, don't judge, be honest with them, talk before touching, and try to always ask them if what you're about to do is ok or not, especially when explaining the workup to them at the end ("I think it'd be best to draw some blood and get an xray, does that sound ok?"). The way I looked at it was: Try to make the SP feel like they are totally in control of the encounter and that the decisions are completely theirs and not mine, with what I say serving strictly as recommendations
not orders.
Overall, not bad, just really expensive and time-consuming. I didn't even feel like drinking afterward. I went to bed early and drove home early next morning. I just wanted the hell out of Houston.
Goodluck mossjoh
