I took CS a week ago... and it went... disastrously to say the least.
It all started at the beginning of the day. I practiced typing patient notes for about 2 weeks to prepare for this test, using a bullet format given on their Interactive Patient Note. Well it turns out this is a sham... on the real test, if you use bullets the remainder of the line is counted as a character for each remaining character on that line. While having to type in prose isn't the biggest issue in the world, when you've been practicing a certain way for a few weeks and have to entirely change your strategy on test day... needless to say, it's an issue that can definitely hurt you.
After that it's all downhill:
1. I ran our of time while telling the patient their diagnosis on 2 cases. I ran out of time while trying to tell the patient some closing remarks on another 3-4. Luckily for the most part I counseled during the HPI, so I was running out of time while trying to say some lame statement like "yall come back now ya heard?" Not literally, but if you've taken the test you know what I mean.
2. I was not able to complete very good physical exams on nearly anyone. Pain case, got ROM and gait, but was unable to get straight leg, or motor strength... heart case and I forgot to take femoral pulses, no JVD (getting the patient to lay back with "5 MINUTES HURRY THE HELL UP" sound of doom playing in the back ground is a daunting task.) And a myriad of other tests which I forgot to/ didn't have time to perform.
3. Documentation, documentation, documentation. I performed SOOOOOO many tests that I didn't document in my note either due to fear, pressure, stress, anxiety or whatever adjective for pissing my pants exists. This is where I am deriving my most fear. On a case where it was absolutely critical, I did not document heart of lung tests that I performed because I was sooooo proud of myself that I remembered to perform a fundoscopic exam👎... major major error. I think there were several other instances where I didn't document the critical test related to the exam.
4. A guy smoked 1PPD x 40 years... did I think this was important enough to document? Well yes, but guess what... I ran out of space because I couldn't write in bullet form and time ran out so I couldn't go back and figure out what to delete quickly enough to fit it in.
5. Pertinent negatives? Who needs 'em? Apparently not me, because I didn't list any in the DDx portion.
Well that pretty much sums up what I can remember. I have lost a lot of sanity over these idiotic mistakes I made. It's saddens me to think my career which I've dedicated hundreds of thousands of dollars and countless thousands of hours of hard work, may now be over... 🙁
It all started at the beginning of the day. I practiced typing patient notes for about 2 weeks to prepare for this test, using a bullet format given on their Interactive Patient Note. Well it turns out this is a sham... on the real test, if you use bullets the remainder of the line is counted as a character for each remaining character on that line. While having to type in prose isn't the biggest issue in the world, when you've been practicing a certain way for a few weeks and have to entirely change your strategy on test day... needless to say, it's an issue that can definitely hurt you.
After that it's all downhill:
1. I ran our of time while telling the patient their diagnosis on 2 cases. I ran out of time while trying to tell the patient some closing remarks on another 3-4. Luckily for the most part I counseled during the HPI, so I was running out of time while trying to say some lame statement like "yall come back now ya heard?" Not literally, but if you've taken the test you know what I mean.
2. I was not able to complete very good physical exams on nearly anyone. Pain case, got ROM and gait, but was unable to get straight leg, or motor strength... heart case and I forgot to take femoral pulses, no JVD (getting the patient to lay back with "5 MINUTES HURRY THE HELL UP" sound of doom playing in the back ground is a daunting task.) And a myriad of other tests which I forgot to/ didn't have time to perform.
3. Documentation, documentation, documentation. I performed SOOOOOO many tests that I didn't document in my note either due to fear, pressure, stress, anxiety or whatever adjective for pissing my pants exists. This is where I am deriving my most fear. On a case where it was absolutely critical, I did not document heart of lung tests that I performed because I was sooooo proud of myself that I remembered to perform a fundoscopic exam👎... major major error. I think there were several other instances where I didn't document the critical test related to the exam.
4. A guy smoked 1PPD x 40 years... did I think this was important enough to document? Well yes, but guess what... I ran out of space because I couldn't write in bullet form and time ran out so I couldn't go back and figure out what to delete quickly enough to fit it in.
5. Pertinent negatives? Who needs 'em? Apparently not me, because I didn't list any in the DDx portion.
Well that pretty much sums up what I can remember. I have lost a lot of sanity over these idiotic mistakes I made. It's saddens me to think my career which I've dedicated hundreds of thousands of dollars and countless thousands of hours of hard work, may now be over... 🙁
Our school makes us take CS by November so that our scores are available for residencies before we rank, so I think that they'll at least be looking for it prior to ranking time.