FAT_GOITER
Forum Senior
Topics: 18
Posts: 110
|
Can somebody please answer my question?
Is it allowed to wear a stop watch during the exam?
Appreciate it
Fat Goiter
|
| 2bmd
Forum Senior
Topics: 8
Posts: 100
|
I dont think you can have a stop watch. They do say that digital watches are NOT allowed, but during my exam, there were several students with them, and no procters said anything. The proctors themselves, however do have stop watches.
Personally, if you have a stop watch (or are trying to keep THAT close an eye on your time during your exam), you'll just freak out more b/c you'll be focusing on TIME more than asking the necessary questions, the PE, and the closing. The CS "flows"...you cant afford to get hung up on how much time you have left. You get in there, start talking, and if youve practiced enough, it all flows very smoothly. Except the first room, cause youre soo nervous (at least I was).
The longest part, for myself, was getting the history. During my first encounter, I heard the 5 minute warning and I was still asking questions. I jumped to the PE. From then on, I just asked basic hx questions (LIQORAAAPAMHUGFOSS), asked a Q or 2 if there was a pos, and went on. I made sure I was already doing the PE by the time the 5 minute warning came. Also, I used the PE time to gather my thoughts, and if I had more questions, I asked once I finished the PE. Honestly, it really is just like an average patient interaction.
Sorry this is so long winded. Hope it helps. Good Luck. :icon_thumb:
|
| FAT_GOITER
Forum Senior
Topics: 18
Posts: 110
|
Thanks a lot 2BMD for your reply, it really helps.
Two more questions if you could answer.
1: I have heard that asking relevant questions are what they look for far more then standard LIQ..........FOSS. Is that correct?
2: Did you encounter bunch of postitive physical findings? Do they test on CNS and other pos. findings too?
I personally cannot even finish by now LIQ......FOSS even within 9-10 minutes. I have no idea how I would accomodate everything.
THANKS A LOT 2BMD.....
|
| 2bmd
Forum Senior
Topics: 8
Posts: 100
|
Hi Fat Goiter
Yes its true, you do want to ask as many relevant questions as possible, however your history also has to be as complete as possible. Having taken the exam and asking myself what the point was...if I were an examineR I would want to know if the examineEs are able to think of the body as a whole....for example, if your patient has a cough, you arent JUST focusing on the lungs, as Im sure you know there are many reasons for a cough not related to the lungs. So your history has to make sure youve asked the questions to rule out other possible reasons.
I stuck with the LIQ... just because I found that it kept me organized. Once I read the doorway information, I wrote a few differentials I could think of just based on that info, and the patient interview was just a matter of ruling in, or ruling out that condition. So direct your questioning towards just that. If you think your patient gallstones, you dont need to ask EVERY question about that. You just need to ask enough to have it as a differential...then move on.
Regarding your other question....actually no, I rarely had positive findings...even when I EXPECTED to find them. Just goes to show that the history is where you are going to find what you need....the PE is just matter of going through the motions, making sure you know how to interact with the patient (dont hurt them, tell them when your about to do something, etc).
Lemme know if you have any more questions. Take care. 
|
| FAT_GOITER
Forum Senior
Topics: 18
Posts: 110
|
Thanks for your reply 2BMD.
If you are giving me an opportunity to ask more questions then I would definitely take an advantage of it :-)
1: I have heard that SP's overwhelm us with tons of info even in a reply of one question. Is that true? If true, how you dealt with it?
2: How many questions they fire during the closing session specially when you know you have a minute or so left and are trying to wrap up? Meaning do they give us an advantage or still try to create difficulties?
Would you like to give any additional secret tip or advice? Your answers are really helping me. I am appearing in the exam next week and you know I already have spend lots of money on Residency applications plus no telling about the CSA expenses. I just CANNOT "AFFORD" TO FAIL.....:-(
Thanks a bunch and wish you a very good luck with your results and residency.
|
| 2bmd
Forum Senior
Topics: 8
Posts: 100
|
Not a problem at all FG...
Well, they dont really fire away. You know that they arent supposed to give info unless prompted, but quite a few times, I found that they would 'give away' info before I would ask it...which only helped. Rather you didnt have to HUNT as much for the info. Sometimes it would throw me off, cause in my mind I have my questions for organized based on what info I am given ('if this, then ask that'). If I am given more info than I can handle at the time, I just go back over it with the patient. For example, if I asked where exactly is your pain, and they start off telling me its over here, and doing this makes it better or when I eat this something happens.... I just stuck with my organization, and when I came to when I would have normal asked the question, I just reaffirm with the patient what they already gave me (ok so you mentioned this happens when you eat)...that way, even though they have given me more info than I need, I have still organized it. And dont think of it in a bad way if they do give you more info than asked....it may actually trigger more questions for you to ask that you may not have been thinking of. But again, it didnt really happen often, what DID happen that was more nerve wrecking, was the exact opposite....they dont tell you ANYTHING.... #-o
Your closing question or situation will be either or, and only one. You may have a patient thats in a rush and needs to leave now, or someone that just wants to know what youre thinking after the PE. Nothing to worry about as long as you address it.
My advice....dont be afraid to ask the obvious. I am still kicking myself for not asking about something that was blantant. I mean it may have been relavent to the case, or it may not have been....I will never know since I never asked. I'll give you an example of a situation during my pediatric rotation. The mother of a child admitted had strabimus. I had seen her serval times and noticed it, but as a part of social etiques, you dont think to ask about things like "whats wrong with your eyes, or how did you lose your arm, etc." My attending did, and the mother had said that she was actually blind in that eye, had surgery as a child, and her mother has the same condition as well. The child was admitted for asthma (unrelated), but still gave some form of potential risks for the child. Going back to the CS...ask the obvious, it may help you diagnose, it may not. During my patient encounter, I just thought it would be rude if I asked 'why do you have this', especially since it didnt really SEEM related to what the patient presented with.
Most importantly, stay calm, and CONFIDENT. Even if you dont know what to do or ask...ACT like you do, if you stay calm, it will come to you and ask it then. Its really not that bad...the worst part was I was in the PM session (11 cases) and it was exhausting.
Anymore questions...ask away!
|
| FAT_GOITER
Forum Senior
Topics: 18
Posts: 110
|
THANK YOU VERY MUCH 2BMD for your time & help. I understand what you are saying. I hope I do well in the exam. I will post my experience once finished.
|
|
| |
| | | | | | | |
