USMLE Step 2 CS Fail-ICE

[daifu007]

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Hello,

I received my score for my Step 2 CS two days ago. I failed the ICE component. I had no problem with CIS and SEP. I'm so torn because I have no idea what I could have done wrong (over and over again) to fail the ICE portion and what I can do to rectify my mistakes so this doesn't happen again.
I know the ICE component is comprised of an SP checklist the PE, and PN. Data collection and data interpretation.
I used mnemonics for cc, hpi, ros, shx. Wrote down possible ddx before stepping into the room. I made sure I asked open-ended questions. My physical exam was focused but I always included cardio and respiratory regardless. I started bottom up with my PN in case I ran out of time.
Did I blow the diagnosis? Did I not ask the SP the right questions? Did I do the wrong PE? Was my patient note not up to par?
And most importantly...... what can I do so this doesn't happen again when I retake my exam in November!
I know I'll have to explain this failure for the rest of my life. I know I have limited myself tremendously.

Some other notes: I am an IMG. I did all of my rotations in the US. I'm a native English speaker. I took the exam in LA. I prepared with FA (3wks). I did mock timed encounters to mimic exam day.

 

[ketosisevangelist]

What was the date you took it?


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[daifu007]

What was the date you took it?


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I took the exam in LA on April 19th, 2017. It was an AM exam. My re-take is scheduled for November 1st. PM exam.

 

[ketosisevangelist]

Good luck. LA is awesome. Get in and out burger


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[deleted500612]

Hello,

I received my score for my Step 2 CS two days ago. I failed the ICE component. I had no problem with CIS and SEP. I'm so torn because I have no idea what I could have done wrong (over and over again) to fail the ICE portion and what I can do to rectify my mistakes so this doesn't happen again.
I know the ICE component is comprised of an SP checklist the PE, and PN. Data collection and data interpretation.
I used mnemonics for cc, hpi, ros, shx. Wrote down possible ddx before stepping into the room. I made sure I asked open-ended questions. My physical exam was focused but I always included cardio and respiratory regardless. I started bottom up with my PN in case I ran out of time.
Did I blow the diagnosis? Did I not ask the SP the right questions? Did I do the wrong PE? Was my patient note not up to par?
And most importantly...... what can I do so this doesn't happen again when I retake my exam in November!
I know I'll have to explain this failure for the rest of my life. I know I have limited myself tremendously.

Some other notes: I am an IMG. I did all of my rotations in the US. I'm a native English speaker. I took the exam in LA. I prepared with FA (3wks). I did mock timed encounters to mimic exam day.

Unfortunately it's impossible to say what you missed or how you could improve without seeing your encounters or your notes. Some things to consider might be:

Consistently missing the top DDX or adding inappropriate DDX
Consistently missing the most pertinent investigations or ordering inappropriate investigations
Consistently failing to elicit important aspects of history
Consistently failing to perform the most relevant physical exam maneuvers
Using too much laymen non-medical terminology in the note or failing to structure your notes in a systematic/logical manner.

I emphasize "consistently" because almost everyone, including myself, missed some very important stuff in at least a few stations and its usually fine still and people are given a pass. The exam is pretty gracious in that regard, so if you failed the ICE I would postulate it is probably something that was not only pretty important, but was also consistently missed or done poorly across nearly all stations rather than just a few. Try to brainstorm and see if you can come up with anything that might fit the bill and then try to focus on improving that for your next go.

Just my own personal opinion and people can feel free to disagree, but I think it is a big waste of time to write down differentials before going into the room. Like reading a vignette that says "57M presents to the clinic with recent history of chest pain" for example, your list of differentials is going to be huge and not very well directed. Just wait until you work through the history and then start coming up with differentials in your head as you are able to hone in on the likely cause. Something I found to be a better use of time before entering the patient room is having a template memorized for a patient history and just jotting down the headers for each section of history before going in. This ensures you will never miss anything in the hx and makes it much easier to transcribe your notes into the computer afterward as they are already pre-organized for you. But to each their own and I do realize that other people have done just fine or better using a variety of other methods. Good luck on your retake.

 

[daifu007]

Unfortunately it's impossible to say what you missed or how you could improve without seeing your encounters or your notes. Some things to consider might be:

Consistently missing the top DDX or adding inappropriate DDX
Consistently missing the most pertinent investigations or ordering inappropriate investigations
Consistently failing to elicit important aspects of history
Consistently failing to perform the most relevant physical exam maneuvers
Using too much laymen non-medical terminology in the note or failing to structure your notes in a systematic/logical manner.

I emphasize "consistently" because almost everyone, including myself, missed some very important stuff in at least a few stations and its usually fine still and people are given a pass. The exam is pretty gracious in that regard, so if you failed the ICE I would postulate it is probably something that was not only pretty important, but was also consistently missed or done poorly across nearly all stations rather than just a few. Try to brainstorm and see if you can come up with anything that might fit the bill and then try to focus on improving that for your next go.

Just my own personal opinion and people can feel free to disagree, but I think it is a big waste of time to write down differentials before going into the room. Like reading a vignette that says "57M presents to the clinic with recent history of chest pain" for example, your list of differentials is going to be huge and not very well directed. Just wait until you work through the history and then start coming up with differentials in your head as you are able to hone in on the likely cause. Something I found to be a better use of time before entering the patient room is having a template memorized for a patient history and just jotting down the headers for each section of history before going in. This ensures you will never miss anything in the hx and makes it much easier to transcribe your notes into the computer afterward as they are already pre-organized for you. But to each their own and I do realize that other people have done just fine or better using a variety of other methods. Good luck on your retake.

Hello,

Thank you for your reply. I'll take everything you said into consideration. After analyzing it I think the reason for my failure was likely due to my patient note. I cant say I was absolutely pleased with any of them. I ran out of time with 2 of my notes and I was really rushed to complete all the rest. I never had time to breathe during the PN. I guess in practice its easier because of the EMR.
Since I was pressing for time I figured if I had the main ddx and a good workup a shorter HPI was ok. Probably left out pertinent negatives for HPI and parts of social hx on some of the cases I was rushing on. I guess if I didn't write it down its as if I didn't ask it.
For the PE in retrospect I may have overused abbreviations not on the approved list... idk for example Heart: RRR, nl S1/S2, no M/R/G Lungs: CTA b/l, no W/C/R Abd: (+)BS in all 4 Q's, soft NT/ND, (-)HSM, no masses. Next time I'll write everything out.
I also included "unlikely ddx" but I did so for the sake of being complete. Next time I wont. My workup list was also quite lengthy. I didn't want to miss anything. Also wont do this next time.
I tried my best to avoid layman-terms and just straight saying "normal". I think writing the note was probably the most stressful part of the exam when I think back. I guess I just have to hammer it down for next time.
In the room for data gathering I think I had good mnemonics (LIQORPAAA/ROS/PAM HITS FOSS that sort of thing) so I wouldn't forget to ask anything basic under pressure. Writing down 3 ddx was more so I could tailor extra questions. That being said, you are right... it was not worth my time because I realized sometimes the doorway information was not the real reason the patient was there.
As for the physical exam, I believe I did the necessary exams/maneuvers for the cases. I don't think I just "went through the motions" you know?
I did all the other things like introduction, washing hands, asking for permission, showing empathy, counseling, closing/summarizing the case so on so forth. CIS components I believe?
Maybe what would be beneficial for me would be to practice making my "in room" time shorter by a few mins so I can dedicate more time for my patient note.
Thanks for the pointers!

 

[Martinat]

Hi Daifu,
I also failed my exam in LA in April 2017. I'm an IMG also but with no US experience so far.
Admittedly, My exam wasn't smooth and I was surprised when I found out that I passed CIS high performance and failed ICE. I don't think I was friendly enough, being under a lot of pressure.
The exam was a valuable lesson. I griefed when I learned that I failed, I went numb, my jaw dropped for half an hour, I had to fix it manually, my eyes turned black, my voice didn't come out! I've never griefed before!
If anyone is reading this from the USMLE, please consider not reporting the number of attempts on the CS And lower the pass score bar for the ICE component. We're still learning you know!

 

[Jayhawkdoc91]

1. Hey all, just wanted to see what you guys thought of the mistakes I made during the exam.
   
   In one encounter, pt told said he had an allergy to something but in my haste on the note, wrote that he had none...
   
   In another patient I wrote that lungs were clear bilaterally in haste and bc of carelessness but when I was listening to lungs, the exam was hindered by a particular sign/symptom. Otherwise I documented the exam accurately. How much would they ding me for this?
   
   So frustrating to think about all the little mistakes...
   

 

[Martinat]

Hi Jayhawkdoc,
With only couple mistakes, you'll probably pass. It takes one to go into panic mode during the exam to fail. So relax, you're good!

 

[novafan3000]

Would anyone anyone comment on their thoughts for neuro exams if "CN II-XII grossly intact" is sufficient for ICE?

 

[Jayhawkdoc91]

Hi Jayhawkdoc,
With only couple mistakes, you'll probably pass. It takes one to go into panic mode during the exam to fail. So relax, you're good!

Thanks for the encouraging words man!

 

[Martinat]

Novafan,
Come to think of it, I'm not sure if CNII-XII intact is enough or whether you have to specify CNII Visual acuity 20/20, nl visual fields, CNIII,IV,VI EOMI CNV nl sensory and motor, CN VII Smile, close eyes, CN VIII equal hearing, CNXI shrug shoulders, CNXII protruding tongue centered.

 

[Jayhawkdoc91]

Hi Jayhawkdoc,
With only couple mistakes, you'll probably pass. It takes one to go into panic mode during the exam to fail. So relax, you're good!

Stood on the left side for some of the physical exams, do you think that'll knock me down a lot?

 

[Jayhawkdoc91]

Hi Jayhawkdoc,
With only couple mistakes, you'll probably pass. It takes one to go into panic mode during the exam to fail. So relax, you're good!

I performed the actual maneuvers fine though I believe.

 

[Martinat]

Good luck you all!

 

[Martinat]

Fun part is, USMLE leave it to our imagination to figure out what went wrong in the exam!

 

[daifu007]

1. Hey all, just wanted to see what you guys thought of the mistakes I made during the exam.
   
   In one encounter, pt told said he had an allergy to something but in my haste on the note, wrote that he had none...
   
   In another patient I wrote that lungs were clear bilaterally in haste and bc of carelessness but when I was listening to lungs, the exam was hindered by a particular sign/symptom. Otherwise I documented the exam accurately. How much would they ding me for this?
   
   So frustrating to think about all the little mistakes...

Hi Jayhawkdoc91,

Take a breather... relax. Wait 3 months.
There's not much you can do about the mistakes you may or may not have made now. How much will they mark you down for mistake XYZ? I don't have the answer for that. I wish I did.
I hope you are just sweating a little bit and your results will be ok in the end.
Its alright to freak out and over analyze small mistakes. We all do the same after a big exam.
Let us know how it goes once you get your results.

Best of Luck

 

[daifu007]

Hi Daifu,
I also failed my exam in LA in April 2017. I'm an IMG also but with no US experience so far.
Admittedly, My exam wasn't smooth and I was surprised when I found out that I passed CIS high performance and failed ICE. I don't think I was friendly enough, being under a lot of pressure.
The exam was a valuable lesson. I griefed when I learned that I failed, I went numb, my jaw dropped for half an hour, I had to fix it manually, my eyes turned black, my voice didn't come out! I've never griefed before!
If anyone is reading this from the USMLE, please consider not reporting the number of attempts on the CS And lower the pass score bar for the ICE component. We're still learning you know!

Hello Martinat,

I was also very shocked at my results. Its disheartening.
But the fact remains that I did fail... So what can I do to ensure I do not fail my second attempt?
I did a bit of analyzing and I think in my case it boiled down to my Note.

You should also reflect on what you think you can change. I think at the end of the day we are all stressed, so make sure you are first off comfortable interviewing patients.
You felt you were not nice...well that's part of CIS. You mentioned you passed CIS. So that's not the problem. If the exam wasn't smooth what was the issue? Other than Nerves... What can you fix?

ICE is Data collection and Data interpretation. Questions you asked in the patient encounter, the physical exam and your documentation (the note). Which part was your weakness?
I agree that they should give more feedback on the results if you fail. But I dont blame the exam scoring system. It is what it is. For now look back, reflect, improve.

Best of luck to you in your future attempt!

 

[Martinat]

Thank you Daifu,
You read my post very carefully and you pointed out all the main issues. Were you this attentive in the exam? It seems like You're the exact opposite of me. I'm very inattentive while you're very detail oriented! You ran out of time on two of your notes, while I had plenty of extra time!
Best of luck to you as well!

 

[daifu007]

Thank you Daifu,
You read my post very carefully and you pointed out all the main issues. Were you this attentive in the exam? It seems like You're the exact opposite of me. I'm very inattentive while you're very detail oriented! You ran out of time on two of your notes, while I had plenty of extra time!
Best of luck to you as well!

Martinat,
My intention was not to be impolite or crude when responding to you. I apologize if I came off as such. I read your post and I shouldn't assume to know what happened. I'm sorry. I don't know you, but I empathize with you because maybe we are both in the same position. For me this has been pretty brutal. In the end I hope we are successful and learn from our mistakes...whatever they may be.
Even if we travel different paths I think we have the same end goal.
Good luck on your retake

 

[Martinat]

Daifu,
No, I find you a very nice person. It's true after my attempt, I find myself reflecting way too much on my life and on everyone's else lives. Thank you for your kind words.

 

[Usmlesteps1]

Hello,

I received my score for my Step 2 CS two days ago. I failed the ICE component. I had no problem with CIS and SEP. I'm so torn because I have no idea what I could have done wrong (over and over again) to fail the ICE portion and what I can do to rectify my mistakes so this doesn't happen again.
I know the ICE component is comprised of an SP checklist the PE, and PN. Data collection and data interpretation.
I used mnemonics for cc, hpi, ros, shx. Wrote down possible ddx before stepping into the room. I made sure I asked open-ended questions. My physical exam was focused but I always included cardio and respiratory regardless. I started bottom up with my PN in case I ran out of time.
Did I blow the diagnosis? Did I not ask the SP the right questions? Did I do the wrong PE? Was my patient note not up to par?
And most importantly...... what can I do so this doesn't happen again when I retake my exam in November!
I know I'll have to explain this failure for the rest of my life. I know I have limited myself tremendously.

Some other notes: I am an IMG. I did all of my rotations in the US. I'm a native English speaker. I took the exam in LA. I prepared with FA (3wks). I did mock timed encounters to mimic exam day.

I need your help , I am IMG , first of all I was sleeping just view hours the day before exam and my Exam was Afternoon time to 10 pm
Anyway , since my test I felt brain block , I just can remember 10 cases , I forget 2 , I don't know if I did well or bad in exam but All I remember is that:
Mistakes:
1-SP do some head movement in one counter many times ,I didn't ask him why .
2- I forget MMS exam in patient with head trauma ( I did all other neurological examination)
3- five cases I felt my first differential D is ok but I wrote other DD that I feel not accurate .
4- The work up in 3 cases with special exam (like pelvic , rectal ) I wrote it as 3rd diagnostic work up instead of first .
5- I forget to ask pt who is 17 yo about immunization status .
6- some cases I didn't ask the SP other associated symptoms .but I clearly know the diagnosis. I was supposed to review that symptoms.
6- I found 2 SP sitting on chair , I asked while I am standing So difficulty eye contact , also I didn't cover them on the examination.
7- after I did the closure , I remember some Symptoms in 3 cases then I asked the SP.
8 -I was totally exhausted in last 3 cases that affect my confident and speech .
9- I think the SP recognize my fatigue because I was yawning
10-I felt my language has a lot of frequent stoping for thinking , then I talk.

The good things:
1- Knock the door in all encounter.
2- introduces self and clarify role .
3- ask the SP if he feel comfortable .
4- ask the SP how w'd like to be addressed .
- keep good eye contact .
- very good empathy
- try my best in answering the challenging Q.
5- I did good HPI , ROS , PAM HITS FOSS in all cases( Female I did for all of them LMP RTV CS PAP)
All heavy drinker ,I asked them CAGE.
6- I did summarization , transition, paraphrase ,Open Q in all cases.
6- I wash my hand before all examination
I did good physical exam for all Cases gentle , Ask consent , exposure , then thanks the SP .
7- I did closure for all cases , then ask did you understand me , are you agree on my plan, do you have any Question , do you have any concern .
8- I did counseling in all cases.
9- I thank the pt then leave the room.
10- I wrote the notes very well .
What is the percent that I will pass, please !!

 

[Martinat]

Dear USMLE step 1, If my opinion matters, I think your performance was good enough! Especially that you had a good eye contact and empathy. A failed result can be shocking, but maybe it's for our own good so we know our deficits and work on them!

 

[Usmlesteps1]

I failed the exam

I need your help , I am IMG , first of all I was sleeping just view hours the day before exam and my Exam was Afternoon time to 10 pm
Anyway , since my test I felt brain block , I just can remember 10 cases , I forget 2 , I don't know if I did well or bad in exam but All I remember is that:
Mistakes:
1-SP do some head movement in one counter many times ,I didn't ask him why .
2- I forget MMS exam in patient with head trauma ( I did all other neurological examination)
3- five cases I felt my first differential D is ok but I wrote other DD that I feel not accurate .
4- The work up in 3 cases with special exam (like pelvic , rectal ) I wrote it as 3rd diagnostic work up instead of first .
5- I forget to ask pt who is 17 yo about immunization status .
6- some cases I didn't ask the SP other associated symptoms .but I clearly know the diagnosis. I was supposed to review that symptoms.
6- I found 2 SP sitting on chair , I asked while I am standing So difficulty eye contact , also I didn't cover them on the examination.
7- after I did the closure , I remember some Symptoms in 3 cases then I asked the SP.
8 -I was totally exhausted in last 3 cases that affect my confident and speech .
9- I think the SP recognize my fatigue because I was yawning
10-I felt my language has a lot of frequent stoping for thinking , then I talk.

The good things:
1- Knock the door in all encounter.
2- introduces self and clarify role .
3- ask the SP if he feel comfortable .
4- ask the SP how w'd like to be addressed .
- keep good eye contact .
- very good empathy
- try my best in answering the challenging Q.
5- I did good HPI , ROS , PAM HITS FOSS in all cases( Female I did for all of them LMP RTV CS PAP)
All heavy drinker ,I asked them CAGE.
6- I did summarization , transition, paraphrase ,Open Q in all cases.
6- I wash my hand before all examination
I did good physical exam for all Cases gentle , Ask consent , exposure , then thanks the SP .
7- I did closure for all cases , then ask did you understand me , are you agree on my plan, do you have any Question , do you have any concern .
8- I did counseling in all cases.
9- I thank the pt then leave the room.
10- I wrote the notes very well .
What is the percent that I will pass, please !![/QUOTE

 

[W19]

Which center

 

[Usmlesteps1]

Which center

Chicago

 

[W19]

I was told that is one of the easiest center (whatever that means)... I guess you probably had a really bad day.

 

[Usmlesteps1]

I was told that is one of the easiest center (whatever that means)... I guess you probably had a really bad day.

It is bad day

 

[lifegoalz]

I also failed it. I only failed ICE part. I don't even know what I did wrong. We are students on tight budget now we have to pay huge amount again. Now I am extra burden on my family. I feel so worthless, useless, and a big failure in life. I don't know where to turn for help. I have decided to study for CK and come back to CS next year.

 

[Martinat]

Lifegoalz,
This is exactly how I feel too! Right now 3/10 IMGs and 1/10 AMGs fail the exam. I feel like We're being treated unfairly by the USMLE. yes we didn't perform well on the exam but failing 30% & 10% is excessive. Failing 2% would be more realistic. Studying medicine should be more rewarding, even if oversees. Do I really have to point this out?!
Make it scorable exam and no one will get to the exam unprepared. Yes it's a good exam but have some mercy on us USMLE! We're humans too!
Yes Lifegoalz, bitter pill to swallow! I feel you!

 

[Ismet]

I failed the exam

Which part? CIS, ICE, or SEP?

 

[lifegoalz]

What are you guys doing differently for ICE section of the exam? How much time are you investing this time around? Any suggestion? Any course? Should we sign up to take it at different center?

 

[affa89-cs]

What are you guys doing differently for ICE section of the exam? How much time are you investing this time around? Any suggestion??

hey did you give your exam again?? how did it go this time? i failed ice too, found out in january. i gave my exam again in march ,i hope i pass this time. seriously scared and having these nightmares of what i did wrong..

 

[Martinat]

Hi affa89-cs I took for the exam for the second time and failed again. They raised the cut off. I actually stared studying for the CS again right after the second attempt, I knew it was a failure. I got lower score on ICE than first attempt. We need to work on our history taking skills. Don't let others put you down.

 

[W19]

Hi affa89-cs I took for the exam for the second time and failed again. They raised the cut off. I actually stared studying for the CS again right after the second attempt, I knew it was a failure. I got lower score on ICE than first attempt. We need to work on our history taking skills. Don't let others put you down.

Are you a US student?

The ICE component is not only the history taking, you also need to get the correct diagnoses for the most part and write a coherent note.

 

[Martinat]

Thank you W19, I'm an IMG, yes I understand it's the history, PE, and proper DDx & documentation.
I took a Kaplan course before my first attempt and they predicted that I would fail the ICE component, They didn't really go the extra mile to ensure that I don't fail the ICE component in the real exam though. Awesome standardized patients at Kaplan, I have to say.

 

[W19]

Thank you W19, I'm an IMG, yes I understand it's the history, PE, and proper DDx & documentation.
I took a Kaplan course before my first attempt and they predicted that I would fail the ICE component, They didn't really go the extra mile to ensure that I don't fail the ICE component in the real exam though. Awesome standardized patients at Kaplan, I have to say.

Why did you take it then if they predicted you were going to fail? Anyway, take it Houston if you have not taken it there... This time make sure you are actually ready.

 

[Martinat]

Thanks W19, I took my chances! Houston center is fully booked forever and beyond. Even Houston will probably start failing more students in the future to make the exam more standardized and fare. The LA center is good, our documentation sucks.

 

[lifegoalz]

hey did you give your exam again?? how did it go this time? i failed ice too, found out in january. i gave my exam again in march ,i hope i pass this time. seriously scared and having these nightmares of what i did wrong.. [/QUOTE

.[/QUOTE]


I'm sorry you are also going through this. I know it's a devastating experience, but don't worry you will get through it. Only focus on the positive things and try avoiding negative thoughts as much as possible. We are already in stressful field and extra stress will not be good for our mind. We face hard times to become better and stronger so it's ok if it happened to us. We will come out of it stronger and better. I haven't taken it yet. My plan is to focus on ICE section mostly, l'll PM you about it.

 

[affa89-cs]

Hi affa89-cs I took for the exam for the second time and failed again. They raised the cut off. I actually stared studying for the CS again right after the second attempt, I knew it was a failure. I got lower score on ICE than first attempt. We need to work on our history taking skills. Don't let others put you down.

omG i am so sorry to hear about it.. i am really stressed out. i tried to focus on history taking and even learnt from 2 experienced people i hope i pass this time.. your experience is giving me chills seriously.. its really u predictable . i wish you best of luck .. try to use notes to memories all ddx and ask all relevant questions. tell me your email is ill.fwd you well written notes to follow for ddx and questions to ask for each symptom. they helpd me the second time.. expecting my result in 2 weeks. fingers crossed. thanks for the reply..

 

[zbiels]

Hello Martinat,

I was also very shocked at my results. Its disheartening.
But the fact remains that I did fail... So what can I do to ensure I do not fail my second attempt?
I did a bit of analyzing and I think in my case it boiled down to my Note.

You should also reflect on what you think you can change. I think at the end of the day we are all stressed, so make sure you are first off comfortable interviewing patients.
You felt you were not nice...well that's part of CIS. You mentioned you passed CIS. So that's not the problem. If the exam wasn't smooth what was the issue? Other than Nerves... What can you fix?

ICE is Data collection and Data interpretation. Questions you asked in the patient encounter, the physical exam and your documentation (the note). Which part was your weakness?
I agree that they should give more feedback on the results if you fail. But I dont blame the exam scoring system. It is what it is. For now look back, reflect, improve.

Best of luck to you in your future attempt!

Hi there, I just recently failed the ICE portion, and I think it must have been my note. Any advice? I do not know what to do.

 

[Mallampati 4]

Step 2 CS is the biggest BS in the history of medical education. Additionally, the sad, ugly truth is that recently it has also become a tool to filter out IMGs. I mean what are they really trying to measure by this stupid acting based simulation? Knowledge? Skills? Are we trying to become actors, clowns, or physicians? Since when a doctor needs to take the sound of whistling through a mouth for wheezing in the lungs? How and who really grades this crap? And based on what systemic measurement they calculate the final grades? Corrupted BS

 

[Doc2b82]

I feel like the most difficult thing to accept about CS is that the standard patients are given a list of questions/words/expressions that they are told to expect from us....and so if you say "hello" instead of "hi" you could get less points....obviously not literally hi/hello...but you know what I mean.

 

[Superduper23]

For anyone who is reading this please please pay attention! I went through the trouble of creating an SDN account for the sole purpose of this 1 post. I never ever write posts because they are a waste of time imo, but this one I just couldn't let go.
SDN is one of the worst platforms for feedback or opinions or reviews or anything to do with board exams passing/failing specifically. I am not saying SDN isn't good for academic talk about physio, biochem, basic sciences or clinical medicine but I am strictly talking about board exams USMELI's passing/failing. This forum had me stressing out over the last 3 months! whilst waiting for my Step CS score to come back, all the BS stuff I read just spiked my anxiety to another level!
The reasons people claim they failed with the minor mistakes they made and reciprocally the people who come on here to give advice to those supposed failures, who get off on the fact that others are failing and try to give advice for there next retake is absurd.
People only come on here and say they failed when they have absolutely nothing better to do, lets not forget only 3-5% people fail this test so you are seeing about half of them 1.5-3% of people coming on here(SDN) and wining and complaining because about 100% of people who pass aside from the ones who take pleasure in others misery don't come onto SDN and post about it!
I firmly believe that there are lots of trolls on here who waste there time scaring other by saying they failed for X,Y,Z reasons when they really haven't either failed or they did fail but know exactly why and they come on here pretending like they did nothing wrong!

Ill make it short I just received my score report for CS after 3 months, I passed all 3 sections with flying colors! CIS, SEP 100% right shifted to the max and ICE completely right shifted well above average.
I initially thought I had done poorly then came on SDN and thought for sure I had failed without a doubt contrary to what all my friends told me I got consumed into SDN forums. I didn't do anything perfect or even close to it, I had many mistakes in my game. I was sick during the test with food poison, I hadn't slept and I only did 4 days of dedicated studying for CS. Today I am sure that SDN is BS and unfortunately so many people come onto this platform and scare the crap outta people like me by the fake stories they write .
I did very well on step 1 and CK well above average and I was still craping my pants about CS because of this forum! so do what you will but if you take it from me NEVER EVER come here for advice on if you failed a board or not. Talk to your friends people in the same boat but don't come here! Use this only as an academic platform to help you with a problem you cant solve.
I know this is long but I felt strongly about it and if your the one reading this and your someone like me I hope you listen to me, your going to be OK I promise just leave this site and relax soon you will see that it will turn out fine!
Much love ya'll peace out! GL to all the med students out there and real people on SDN Im sure they do exist just not as many as I feel should do !

 

[MyAtypicalJourneyToMD]

Hello,

Thank you for your reply. I'll take everything you said into consideration. After analyzing it I think the reason for my failure was likely due to my patient note. I cant say I was absolutely pleased with any of them. I ran out of time with 2 of my notes and I was really rushed to complete all the rest. I never had time to breathe during the PN. I guess in practice its easier because of the EMR.
Since I was pressing for time I figured if I had the main ddx and a good workup a shorter HPI was ok. Probably left out pertinent negatives for HPI and parts of social hx on some of the cases I was rushing on. I guess if I didn't write it down its as if I didn't ask it.
For the PE in retrospect I may have overused abbreviations not on the approved list... idk for example Heart: RRR, nl S1/S2, no M/R/G Lungs: CTA b/l, no W/C/R Abd: (+)BS in all 4 Q's, soft NT/ND, (-)HSM, no masses. Next time I'll write everything out.
I also included "unlikely ddx" but I did so for the sake of being complete. Next time I wont. My workup list was also quite lengthy. I didn't want to miss anything. Also wont do this next time.
I tried my best to avoid layman-terms and just straight saying "normal". I think writing the note was probably the most stressful part of the exam when I think back. I guess I just have to hammer it down for next time.
In the room for data gathering I think I had good mnemonics (LIQORPAAA/ROS/PAM HITS FOSS that sort of thing) so I wouldn't forget to ask anything basic under pressure. Writing down 3 ddx was more so I could tailor extra questions. That being said, you are right... it was not worth my time because I realized sometimes the doorway information was not the real reason the patient was there.
As for the physical exam, I believe I did the necessary exams/maneuvers for the cases. I don't think I just "went through the motions" you know?
I did all the other things like introduction, washing hands, asking for permission, showing empathy, counseling, closing/summarizing the case so on so forth. CIS components I believe?
Maybe what would be beneficial for me would be to practice making my "in room" time shorter by a few mins so I can dedicate more time for my patient note.
Thanks for the pointers!

I just failed the ICE component of CS too and from the looks of it... I did everything you did! My PE notes looked just like that (RRR, nl s1/s2, no m/g/r... etc). I used the same mnemonics. I had timing issues on 1 or 2 patient notes and near-issues on the rest.

I know this post is from 2017, but PLEASE if you see this... what did you change about your notes to improve your ICE on your 2nd attempt?

Thank you so much.

 

[FutureMDiA]

I just failed the ICE component of CS too and from the looks of it... I did everything you did! My PE notes looked just like that (RRR, nl s1/s2, no m/g/r... etc). I used the same mnemonics. I had timing issues on 1 or 2 patient notes and near-issues on the rest.

I know this post is from 2017, but PLEASE if you see this... what did you change about your notes to improve your ICE on your 2nd attempt?

Thank you so much.

I failed ice too

 

[Martinat]

[B]Superduper23[/B], its absolutely uncalled for to call anyone a troll; which makes me think why would someone like you pass the exam but not me. Documentation gets better with practice. you clearly lack sympathy and I still wish you the best in life. For IMGs who need real advice as to how to pass the exam, I learned the hard way that you have to pass a mock exam before taking the test.
I failed 3 times and i call it game over. I'm getting by doing other jobs now and life goes on, life always has other plans! There's nothing wrong with venting a little bit. Yes its a good exam but i'm not sure its the right tool to filter applicants. They changed the step 1 exam to a pass/fail exam now, which in my opinion is a big mistake. Now students will run to take the step 1 and flunk that test too. I would've never failed the step 2cs had it been a scorable exam. A pass/fail exam give you a false sense of security. I don't know why anyone would get stressed out by this thread. If you know that you can pass this exam then you'll pass it. Some managed to pass even after a failed attempt like affa 89 cs. I will probably go for a fourth attempt if i feel comfortable financially to spend another 1500$ on this exam and another 1500$ on a mock exam.