Step2CS Blunder or is it going to be alright?

[fmgmedstudent]

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Hi,

Please let me begin by thanking you for answering these two questions. I am worried sick and I would like some input. So here is what happened.

I had 12 pt encounters. I was unable to finish the first one (ran out of time as I finished the physical exam). I did not counsel, close or give tests to this first patient but I was super nice to them. The remaining 11 cases went well - i did everything including counselling where it was needed. Here are my two questions:

1) How much effect do you think not closing one case would have?

2) I kind of made a mistake with one patient- he kept saying, " I am wasting your time doctor" and I kind of spoke without thinking and said this - "Yes, if you are wasting my time it is because of your health, I would much rather have you get healthy. So feel free to waste as much time as you would like." I don't think the patient took it well (he made an instant face) or he could be acting. When I tried to counsel him he also said he did not wish to talk about his smoking and alcohol habits. Other than saying this I was nice to him throughout the encounter. This patient encouter has been eating at me. I was extremely careful in my remaining 11 cases to be very empathetic and compassionate. Do you think this could haunt me? Please advice, i am losing sleep over it.

 

[Depakote]

Hi,

Please let me begin by thanking you for answering these two questions. I am worried sick and I would like some input. So here is what happened.

I had 12 pt encounters. I was unable to finish the first one (ran out of time as I finished the physical exam). I did not counsel, close or give tests to this first patient but I was super nice to them. The remaining 11 cases went well - i did everything including counselling where it was needed. Here are my two questions:

1) How much effect do you think not closing one case would have?

2) I kind of made a mistake with one patient- he kept saying, " I am wasting your time doctor" and I kind of spoke without thinking and said this - "Yes, if you are wasting my time it is because of your health, I would much rather have you get healthy. So feel free to waste as much time as you would like." I don't think the patient took it well (he made an instant face) or he could be acting. When I tried to counsel him he also said he did not wish to talk about his smoking and alcohol habits. Other than saying this I was nice to him throughout the encounter. This patient encouter has been eating at me. I was extremely careful in my remaining 11 cases to be very empathetic and compassionate. Do you think this could haunt me? Please advice, i am losing sleep over it.

#1) I didn't close at least one of my cases and still passed.
#2) Not quite sure what to make of that... If I had to guess they might dock you a point or two, my understanding of how the test is graded is that it's really a checkbox you "did or didn't" for certain criteria. In this case, you might not get the points for compassion and counseling, but I don't think they're going to insta-fail you for the test if you did well for the other 11 stations.

Either way, it's over and you can't control the outcome now... try not to stress over it.

 

[lord_jeebus]

I wouldn't worry.

I'd guess #2 was a case where you were supposed to pick on depression and suicidal ideation. I missed an obvious domestic abuse case on my Step 2CS and passed, if that's any consolation.

 

[joecole]

you're good to go - dont worry!

 

[JgMantilla]

I am in a pretty similar situation... I managed to counsel all patients and close all 12 encounters, but I forgot to ask some/several questions and finished most cases with about 5 extra minutes, so I feel I was too quick... (that worries me)... I think I made some decent notes/Diagnoses. What do you guys think?