Step 2 CS Panic Mode

[1057233]

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Hi ladies and gents,

First post on here , needed some guidance on step 2 cs, I just took it today and came out feeling decent but now thinking through some of my tough cases i remember many things that I forgot to document in my note and 1-2 differential diagnosis that I may have missed the primary cause. I did almost all the physical exams needed but i feel my documentation of everything may not have been completely written out. I know the SP doesnt grade you history anymore so im worried that if I didnt have it in my history I may lose alot of points.

I know the internet is littered with panic posts about CS but id really like some insight from anyone who is willing to dish it out!

Thanks guys

 

[mvenus929]

Worrying about it now isn't going to change your score. Take a deep breath, and hang on for the wait. It's a long one.

 

[ahmedjq]

Well, I probably forgot to shake hands quite a few times. The fact of the matter is, we just have to forget about the test until early December when scores come out.

 

[1057233]

Yea it's just so difficult. Did you guys have any trouble with diagnosis ? It seems I missed at least 2 of the exact diagnosis and therefore missed some labs along with it , I also miss typing out some history and physical things , ugh sleepless night and anxiety

 

[frostyfries]

I thought the test was more about coming up with a reasonable differential and listing some appropriate diagnostic tests rather than "getting the one diagnosis". For some patients I thought there were a couple plausible diagnoses. You may be overthinking it. Or I did it wrong and should be panicking too.

 

[MCAT08]

Well, I probably forgot to shake hands quite a few times. The fact of the matter is, we just have to forget about the test until early December when scores come out.

is that really how long its going to take to get scores back?!! 😱

 

[mvenus929]

is that really how long its going to take to get scores back?!! 😱

For people who took it after the beginning of September, you'll be waiting until November or December for scores.

 

[MCAT08]

Ahh man seems like i just missed the cut off and the more i think about it the more i feel like i failed.. just realized i also forgot to shake hands on EVERY patient like there is no such thing as greeting the patient with a hand shake

this wait is gonna kill me, the thought of failing CS of all board exams is excruciating

 

[Stellar Clouds]

I have some advice for you. You are fine. Click the X in the tip right corner of the current open window. Do not open this site again until after your score comes back. Go to your fridge. Pop open a cold beer. Enjoy 4th year.

 

[ashwilliams123]

The wait time on this test to get scores back is absolutely ridiculous.

 

[step1saga]

Even though I took this test last year, I think It has changed a little but believe me or not I thought I failed too. I was sure of it. I did not finish my physical exam on any of the cases. A lot of blunders too. No one really knows how it is graded honestly.

 

[Mog16]

I failed it in march. I just took it again yesterday and feel like I failed again. I don't know how much of that is just the dread of possibly failing or actually feeling bad about how I did. I feel like my heart is going to explode and I can't breathe. I don't know what will happen to me if I fail it again. Even with a 245 on step 1 no one is going to want someone who can't pass cs.

 

[Kaputt]

Hi ladies and gents,

First post on here , needed some guidance on step 2 cs, I just took it today and came out feeling decent but now thinking through some of my tough cases i remember many things that I forgot to document in my note and 1-2 differential diagnosis that I may have missed the primary cause. I did almost all the physical exams needed but i feel my documentation of everything may not have been completely written out. I know the SP doesnt grade you history anymore so im worried that if I didnt have it in my history I may lose alot of points.

I know the internet is littered with panic posts about CS but id really like some insight from anyone who is willing to dish it out!

Thanks guys

I took CS this summer and all the same stuff happened to me. 2-3 cases I was very unsure of the diagnosis and thus my exams suffered. For each case, I'd remember at least 2-3 exam maneuvers or questions I wished I asked (like in the pediatrics phone case, I forgot to ask about vaccination history and developmental history). Then, I would remember during the next case that I forgot to document something I did for the last case. Only a couple of cases did I even end up putting physical exam findings to support my diagnoses...mostly it was just a couple elements from the history. I ran out of time on one case. My physical exams routinely left much to be desired; it was sloppy, sloppy stuff. It was a comedy of errors, basically. The only things I did right every time was washing my hands, being polite, and shaking hands.

And I passed. By a healthy margin. I know you're going to feel like crap until you know for sure that you passed, but just try your hardest not to think about it because it's all in the past now. Just focus on moving forward and close SDN.

 

[Frogger87k]

Yes, Yes I know another just took CS freaking out post, but I feel like I did not counsel anyone during my exam, I told a few patients if they had no risk factors (drugs, sex, alcohol) that their "lifestyle habits were good ", but that was the extent of what I said. I also even forgot to counsel some patients with actual positive risk factors (drugs, alcohol, smoking) etc. In addition to all this I forgot to ask about sexual hx in two cases, one where it may have been important. I guess my freaked out question is if not counseling patients is an automatic big hit.

I am really worried about the CIS subcomponent specifically the (Information Sharing Skills Section) given that counseling is a big part of that particular aspect. I did always have decent closures with the SP's (offering specific diagnosis and tests I would do)and I'm pretty sure I emphasized to most patients that I would contact them once I got the results of the tests I mentioned back. I also tried to avoid medical jargon for the most part got caught once by one SP but otherwise stated quickly the meaning of any medical term I used in every other case.

Does anyone know if the CIS subparts are graded together like an average or do you have to pass each individual subpart to pass the CIS component as a whole? Cause I feel like otherwise I was empathetic, offered multiple opportunities for patient to state their questions and concerns, summarized patient's HPI after taking it, wore gloves always, asked permission to do nearly every physical exam maneuver, made appropriate transition statements, empathized that the patient was in control of his/her medical care and that they were part of the medical team.

I know, I know I should just wait for the results, (which is in 2 months ugh) but I wanted to get SDN's opinion on if I have enough leeway from what other people have seen. Or should I melodramatically prepare for the retake later this year. Thanks again fellow SDNers any input would be appreciated.

Oh and I just realized that I may only have shook hands half the time now too (oh the anxiety)!

 

[hoopie]

Yes, Yes I know another just took CS freaking out post, but I feel like I did not counsel anyone during my exam, I told a few patients if they had no risk factors (drugs, sex, alcohol) that their "lifestyle habits were good ", but that was the extent of what I said. I also even forgot to counsel some patients with actual positive risk factors (drugs, alcohol, smoking) etc. In addition to all this I forgot to ask about sexual hx in two cases, one where it may have been important. I guess my freaked out question is if not counseling patients is an automatic big hit.

I'm curious to hear others thoughts on this because I'm in the same boat. I feel like this was my biggest issue on the CIS part of the exam so I'm hoping this won't hurt me too much.

 

[step2csscared]

Hey guys, I just took my cs a few weeks ago and really scared about how it went. Especially the ICE part, if someone could shed some light:

1) can't remember it
2) should've put the the 2nd ddx as first and vice versa but they were both good. 3rd ddx was way off, had one supporting point, don't know why I even put it
3) first 2 ddx pretty wrong. 3rd ddx was way off (had supporting points but only 1-2)
4) went well
5) went well
6) went ok
7) encounter went ok, ddx were also ok (i didn't have more than 2 supporting points for each ddx)
8) really wasn't sure what patient had, weak ddx and 1-2 points supporting them
9) went well, but forgot 1-2 important questions about chief complaint
10) went well, but forgot 1-2 important questions about chief complaint as well
11) went well
12) went well


Aside from that I would usually finish with 1-2 minutes to spare after closure, counseling and the basics (washing hands, proper draping, knocking, physical exam etc). I'm mostly worried about the ICE but then again who knows about the other sections, I just feel I messed up a bunch of diagnosis that I should've gotten.

Thanks for any advice