softy
Forum Newbie
Topics: 2
Posts: 5
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Hi friends,
im so glad today,the oasis trick told me that i passed it.
I wish u all, good luck in all your endeavours.
Believe in ur God n yourself
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| sar
Forum Guru
Topics: 22
Posts: 639
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Congratulations Softy!
I am very happy to hear many good news today on this forum. It gives courage to future examinees! give some tips for succcess??
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| softy
Forum Newbie
Topics: 2
Posts: 5
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hi sar,
believe me,it is not as difficult as it seem to
i prepared for about 20-25 days for csa
i did usmle world throughly, do also read the challenging questions,they are very similar to what is asked by the SP.the videos in it r also good.
i did not go thru the OSCE book.i do not know about the new edit. do not panic if u have a case which u have not prepared.just go n talk politely n confidently to them.
empathize with him.if it is a case of acute abdomen,first sayI CAN UNDERSTAND what u r going thru right now,im here to help u,can i ask u a few questions so that i can understand ur problem better!
a few more essential tips
knock the door,greet the pt first by his last name, then introduce urself
drape the pt,ask before doing anything,WASH UR HANDS WITH SOAP ,
EMPATHIZE,PULL THE LEG REST FOR HIM,DO NOT SAY U HAVE CANCER OR AIDS,DO NOT GIVE FALSE REASSURANCES,IN THE END ASK IF HE HAS ANY CONCERNS,THEN WRITE DOWN THE NOTE IN A READABLE WRITING,manage ur time well.i did not have any prob with time.
i told u earlier it is simple .ALL THE BEST .
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| sar
Forum Guru
Topics: 22
Posts: 639
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Thank you soooooooo much softy!
I am very fortunate to have you guys on this forum to help and advice me. Till today everyone has answered me what ever i asked him or her, and i asked so many questions, so many times. 
You have really given imp tips in a very concise way. Thanks again.
I wish i would do good too like you all successful exam takers!
Best wishes,
Sar.
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| sar
Forum Guru
Topics: 22
Posts: 639
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Softy can you tell me how would i explain to SP if i would be suspecting that he has cancer or AIDS???
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| maqsur
Forum Junior
Topics: 5
Posts: 78
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Forgive me for answering, sar, but I wanted to take a stab at your question. I would let the patient know that based on his/her symptoms, I would like to run further testing. I would let the SP know that there could be benign or more serious conditions responsible for his/her symptoms, but that I want to see the results of other tests before making any definitive diagnosis. I would even use the words, "Let's do these things first, and we'll go from there. Any questions or concerns?"
Hasan
___________________
Hasan
MS-4, St. George's University
Aspiring Peds Resident
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| sar
Forum Guru
Topics: 22
Posts: 639
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thanks maqsur, but wont you tell him about the Ist 2 or 3 possibilities, and in that wont you name AIDS, or Cancer if they are on top of your list??
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| maqsur
Forum Junior
Topics: 5
Posts: 78
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Well, based on my experience, with the exception of like 1 or 2 cases, the rest of the cases weren't cut and dry from the physical exam and history. So accordingly, I would not give the patients a specific diagnosis. I would tell them I would like to order some labs/imaging, and that we would go from there. One step at a time. Phrases like that, vague yet reassuring. I think that's the main thing, you wanna reassure the patient, without giving wrong information. If I thought there was a possibility of something serious, like there was with one patient, I told him that it could be something serious like cancer, or it may be a simple ulcer. Even in that case, I still said to the man, not to worry over it because those are just possibilities, and we need to run tests to be sure what is going on, so let's go from there. As I said before, after this I would ask each patient again if they had questions or concerns.
___________________
Hasan
MS-4, St. George's University
Aspiring Peds Resident
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| sar
Forum Guru
Topics: 22
Posts: 639
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Thanks again maqsur, so in conclusion what i got from your answer is that I should tell him about further workup but not the dx. eg SP with difficulty in swallowing and wt loss etc. I would tell him" i am not sure at this point but i will run some tests, like we will take an x ray film after giving you a liquid to swallow, and another test in which we will see inside your oesophagus(i think it is a laymans word) with a camera attached to a flexible tube. It may be a cancer, and it may be some other disease.
Is it correct?
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| uspinoydoc
Forum Junior
Topics: 1
Posts: 91
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Hope you don't mind if i add some input..
In some of my cases, maybe even half, I didn't even tell the patient the exact diagnosis I was considering. I just said "based on the information i've gathered and my examination, I have an idea what we're dealing with, but we need to run some tests first such as A,B,C...do you know what those are?" (if the patient doesn't know, explain in simple ways) "After we get the results, I want you to come see me again so we can discuss them then we'll go from there." (if patient challenges you with questions like DO YOU THINK THIS IS CANCER/AM I GOING TO DIE? /DO I NEED SURGERY?) "Until we have the results, I can't really answer that question. I CAN tell you though, whatever it is, we'll do our best to take care of it, ok?" "So please schedule your tests and I'll see you again, do you have any other questions?"
I'm not suggesting you never tell the patient what you're considering of course. But I think if you're considering CA, AIDS or anything else really serious, it's better not to say it. Just remember to be compassionate and show empathy, even if you have to "act" a little. I think though, or at least hope that most of us have these qualities inside of us already.
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| maqsur
Forum Junior
Topics: 5
Posts: 78
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Yes, I agree with above. As to when in the conversation to say the cancer word or whatever, do before you tell the patient what tests you will run. Explain that "based on his/her symptoms and your physical exam, it could be several things, serious and not-so-serious. Therefore, we shouldn't jump to any conclusions, and we should run x-and-y tests so that we can arrive at a more definitive diagnosis. So, don't worry from now about what's going on, since we do not know yet. Keep a positive attitude, let's do these tests, and we will go from there and help you get better. Any questions or concerns?"
That's my take.
___________________
Hasan
MS-4, St. George's University
Aspiring Peds Resident
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