Jugular
Forum Newbie
Topics: 3
Posts: 9
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I PASSED! I PAAAASSSSSEEEEEDDDDD!!!!!
I PAAAAAAAAAAASSSSSSSSSEEEEEEEEDDDDDDDD!
I gave the exam on Nov 7th at Chicago. I gave my Step 1 on Oct 11th and Nov 7th was THE DAY I appeared for Step 2 CS without knowing anything about Step 2 CK! I prepared for it for 2-3 weeks but with a lot of tension and distraction at the back of my mind regarding my pending Step 1 result.
What helped me the most during my preparation is to go through the cases of FA with a friend I met in a forum. One day she would call and the next day I would call and we used to alternate with each other playing the role of being the doctor and the patient, pick up a case from FA and take history, discuss the PE, D/D and the labs, and then, we would open the particular case to check what all have been missed. I used Usmle World and FA. One day before my exam, I practised how to do the physical examination on my husband once.
I thank my Almighty!
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| sar
Forum Guru
Topics: 22
Posts: 639
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Congratulations to you jugular!
CS prep looks so easy when i read your post, but sometimes i feel cs is sooooooooooo difficult when i read other posts.
Any tips you want to give us?
Many many congrats and best wishes,
Sar.
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| Jugular
Forum Newbie
Topics: 3
Posts: 9
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When I compare my wait for Step 2 CS result to the wait of Step 1 result, I feel I worried more for Step 2 CS result wondering what if I fail, whereas for Step 1 I was confident that I'll pass. The difference lies in the fact that I gave my best shot for Step 1 but for step 2 CS I felt my preparation didn't reach the satisfaction mark.
After I gave my Step 1 on Oct 11th, I didn't pick up Step 2 CS book till Oct 19th because I wanted to spend quality time with my 3 year old child for a few days. And then I started preparing, but not whole heartedly because I used to keep browsing the Step 1 forum wondering how much I might score and Step 2 CS forum to look for anyone's exam experience.
What helped me THE MOST was preparing the cases with that phone friend of mine. She was a genius kind of girl - recent garduate and scored 92 and 93 in step 1 & 2. She was God sent. Then on Nov. 2nd I didn't study much because I was worried about the election in US and Nov 3rd I was depressed because John Kerry didn't win (I know... stupid me)! On Nov 4th I got to know that I passed step 1 and then my trips to the mail box started every 1-2 hr checking if my score had arrived. Finally I got my step 1 score on Nov 6th on my way to the airport for CSA.
My best friend was not very encouraging about me giving my CSA before step 2 CK and my phone friend I guess doubted because I had to brush up ALOT(I graduated in 99 with no touch since then)!
Iam fluent in English, I guess that's one of the factors that helped, and in all my cases I remembered to take full history without missing any crucial questions (me and my phone friend used to ask each other the history questions and at the end we would open the case and see how many questions we missed out of the total number of questions - so this practise kind of sealed all the questions in my head and history taking has a lot of points since for each question you get 1 point). Before entering the room, I used to write down on the rough sheet of paper PAM HUGS FOSS and the other pnemonics. And during the interaction with the patient, I used to look at that paper to check if I missed any questions by telling the patient "Let me see if I missed any of the important points" while looking at the paper. Maintain eye contact with the patient with a look of concern. And if the patient gave any info that I would need to mention in the patient's note later like what medications is he/she on, then I would write them down because by seeing so many patients on the same day you get mixed up with their histories. I remembered to knock on the door and address the patient with his/her name during the introduction, wash my hands, TRY to warm up my hands before PE (my hands are always cold), ask permission from the patient ALL THE TIME before doing ANYTHING, after completing PE tie the gown up, show the patient that you care, be friendly and nice. Also, I could complete everything including counseling for all the cases. During the pt's note I used to refer to the rough sheet of paper for info related to the pt.
I won't say that I was perfect. In that short time, you are under alot of stress. For my CNS case, I forgot to do the lungs and heart auscultation although I had time because I was so focused on CNS although I did take a complete history and performed the physical of CNS.
For the hip pain guy, I didn't ask the pt to walk to check for his gait or perform the various movements at the hip joint like flexion, extension,abduction, adduction. Although I did the straight leg raising test, and CNS examination of the lower extremities like pin prick, DTR etc.
For both the cases I could not elicit the DTR although I acted out the performance and carried on as if everything is cool!
These were the 2 cases I was most worried about.
I had a phone case and I loved it since there is no one in the room so you could write down all the info the pt's mother is giving over the phone without giving any excuse and you don't have to do PE or wash your hands etc. It's like u have whole 15 min just to take history. I guess I aced this one since I don't think I missed any questions.
And, always make sure you goto the restroom whenever you are on break since you don't want anything to distract you during the exam.
BE CONFIDENT (dress smartly because it DOES make you feel confident)!
Once you are a doctor, you are ALWAYS A DOCTOR!!! Remember that!
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| sar
Forum Guru
Topics: 22
Posts: 639
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Thank you very much jugular for sharing your experience.
I have disussed cases with my husband, but not all cases. How much time did you spend on councelling and how you did it, can you give its eg to me, for any one case, like alcoholism, or smoking etc?
Thanks a lot again, i have mine next week, thats why i am gathering infos from here and there 
Best of luck,
Sar.
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| Jugular
Forum Newbie
Topics: 3
Posts: 9
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To be honest, to the smokers, I forgot to tell them not to smoke and to those who doesn't use condom, I forgot to ask them to have safe sex! But, I remembered to ask a TB pt to wear a mask and stay in the room till I get back with him asap with the lab results and explained that I have a suspicion that you have tb, I might be wrong but I'll appreciate it if you kindly cooperate and wear the mask till I confirm the diagnosis with the lab results since it's contagious. Towards the end, I would tell them that Iam gonna run a few tests and get in touch with them as soon as I get the result. I have a suspicion that he/she might have this or that, but, I can't say definitely till I get the lab results. After I get the results, then I can reach the conclusion about the diagnosis and proceed from then on regarding the treatment and management. Say things like we are going to work out your health problem together. If they needed any kind of psychotherapy or counsel with a dietitian or social service regarding financial matter or baby sitting, offer such arrangements. And then, it was nice to meet you and see you as soon as I get the lab results.
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| sar
Forum Guru
Topics: 22
Posts: 639
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Thanks again jugular,
Do they have a mask? and did he wear it during history taking and exam??? Why did you say a TB pt to stay in room? can lab results be back in such a short duration??
Did you take notes of PE too, or just for history?
Enjoy your exam free days + result, with your child and husband!
Have a good day!
=;
Sar.
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| Jugular
Forum Newbie
Topics: 3
Posts: 9
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I don't know if they have any masks or not, but, any clinical setting or hospital setting will definitely have a few masks around. I just said it because it can be spread through respiratory droplets. And regarding the lab result, I meant skin PPD, I didn't mention the test name to the patient because then the SP will cut my score saying that I used medical terms instead of using layman language! I asked him to stay in the room so that an assistant can come do the skin ppd and why not a CXR?! CSA is all about acting and pretending. 
Anyway, I still have Step 2 CK to give. I know that you are done with CK and scored great. Congrats for that. I'll contact you and ask a few questions regarding CK after you are done with CS. Can I have your email address?
Best of luck for your CS. I know that you'll ace it!
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| sar
Forum Guru
Topics: 22
Posts: 639
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Sure jugular, you can conact me any time on this forum or thru pm on this forum or thru my email. I will send it to you. Once i am done with CS i will be here for you
I thought you are done with all steps, any way you will do great in step 2 CK too! Its hard to study with a kid, you did a great job!
I was asking you that would they provide us the mask, besides other things that they will provide like something to check sensation etc? Thats what i wanted to know.
Yes you are right, i didnt think about PPD, good job!
CS needs lots of thinking and common sense, that i think i dont have
Ok then thanks again,
I will be in touch with you,
Sar.
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| Jugular
Forum Newbie
Topics: 3
Posts: 9
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Just remember to take your exam permit, your white coat and stethoscope. The rest they have in the patient's room. The SP's room looks just like how the patients' rooms look like when you goto any doctor in US. I used the cotton bud for dull sensation and the bare end of it for sharp sensation. They have the reflex hammer and all the other things you might need in there. Remember to switch off the light to examine the eyes with an ophthalmoscope for CNS PE. And, I didn't jot down anything regarding PE, just a FEW specific things in history.
Don't worry so much. Try to relax! It will go fine. Before you know it, it will be over because time flies very fast once the exam starts! Best of luck again.
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| sar
Forum Guru
Topics: 22
Posts: 639
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Thanks again jugular!
I will let you know when i will done with my exam.
Have a good ck prep!
Sar.
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| Jugular
Forum Newbie
Topics: 3
Posts: 9
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| afds
Forum Elite
Topics: 62
Posts: 193
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congrats jugular!
u did a great job
can u please tell m from where did u study for CS?
thanks
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| Veer-Zaara
Forum Elite
Topics: 16
Posts: 268
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Jugular........what were all your resources you had used for CS?
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| Anairisvaldes
Forum Newbie
Topics: 1
Posts: 4
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Hi, Congratulations for your good result.
You wrote that you used Usmle World and FA. Where do I find it?
I'll appreciat your answer.
Ana
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| ravi_online
Forum Senior
Topics: 10
Posts: 92
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thanks a lot jugular for sharing your exam experience with us. can you please tell us complete meaning of pnemonic PAM HUGS FOSS & other one you would like to share with us. How is weather during the month of nov. & dec. As i am an IMG, will take my step2 cs in chicago.
best of luck to you.
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| dev
Forum Guru
Topics: 70
Posts: 1,794
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hey did u get ur ck resu;t ravi?
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| shehzad
Forum Newbie
Topics: 1
Posts: 17
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Jugular, thanks for giving us all that info.
Good luck.
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| NJones
Forum Newbie
Topics: 0
Posts: 18
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Hey Jugular,
Congratulations! I'm currently preparing to take the step2CS. And I also reading the first aid, usmleworld course and NMS book. I'm trying to practice all the cases but I have some doubts:
Could you tell me if I should discuss all the work up and my diferential diagnosis with the patient or I should discuss about it a general way without specifying each entity of my DD. I'm really concerned because English is not my native language and I notices that during the practice cases, sometimes I used technical words intead of the commom words.
I will apreciate your suggestions and comments about it.
Thanks,
NJones
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