azygous
Forum Senior
Topics: 15
Posts: 209
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hi
i just gave my CS yesterday and i m fresh with the things..so planning on writing all i remember....i m bad at spellings to dont make fun of it...
my overall experience was OK...i messed up one case my 1st case....so i dont know whther i m gonna pass or not....
i m going to update this in the evening with details....still sleepy..
general points:
1) this exam does is not a measurment of ur medical skills so dont work much on it....make it sure u complete everything..means everything in 14 minutes...period.
2) i divided the exam in 5 catogeries: opening,CC+HOPI,GE+SE,Summary+councelling, Close.
once you enter CS center:
be cool ..the protocrs r soo nice...relax and chill. talk to the people around and make it easy.
they have coat and steto for you there if you fortgot urs..( actually i forgot both..:no
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Freedom is not worth having if it does not include the freedom to make mistakes...... Mahatma Gandhi
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| drk1980
Forum Guru
Topics: 147
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hey, thanks for sharing. good luck wth ur results.
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| doctor81
Forum Elite
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good luck
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| azygous
Forum Senior
Topics: 15
Posts: 209
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ok
after a good night sleep ..i am back with all that i can help you with..
1) see the the usmle video..it helps u to the feel of the actual exam which cannot be replaced by anything..
2) when u r standing at the door and the announcement is made for u...the first thing u write is the patients name...belive me 8 out of 12 times at the end of the case i forgot abt the name...write as big as u can and when u come in room plz keep the pad upside down...so that the SP may not see what u have written...just my personal advice..then u write the PAMHUGSFOSSOSDA LIQORAAA FCCNDTCHMMSR ..( REMEMBER THE DD
3) the moment u come in after knocking the door..smile...greet the patient..shake hand...i m dr.mmm a physician here to help you....( a advice.... if the SP is not able to talk or in pain...u can directly start with like...mr.SP the nurse told me that you have pain in abd..how may help you with that..or can u tell me more abt it....as in real cases the CC is alwayz told to doc by the nurse..it worked for me in one pt which was very much in pain)..
3)
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Freedom is not worth having if it does not include the freedom to make mistakes...... Mahatma Gandhi
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| azygous
Forum Senior
Topics: 15
Posts: 209
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ok
after a good night sleep ..i am back with all that i can help you with..
1) see the the usmle video..it helps u to the feel of the actual exam which cannot be replaced by anything..
2) when u r standing at the door and the announcement is made for u...the first thing u write is the patients name...belive me 8 out of 12 times at the end of the case i forgot abt the name...write as big as u can and when u come in room plz keep the pad upside down...so that the SP may not see what u have written...just my personal advice..then u write the PAMHUGSFOSSOSDA LIQORAAA FCCNDTCHMMSR ..( REMEMBER THE DD AND
3) the moment u come in after knocking the door..smile...greet the patient..shake hand...i m dr.mmm a physician here to help you....( a advice.... if the SP is not able to talk or in pain...u can directly start with like...mr.SP the nurse told me that you have pain in abd..how may help you with that..or can u tell me more abt it....as in real cases the CC is alwayz told to doc by the nurse..it worked for me in one pt which was very much in pain)..
3)
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Freedom is not worth having if it does not include the freedom to make mistakes...... Mahatma Gandhi
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| azygous
Forum Senior
Topics: 15
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3) one thing i would like to tell is work a little more on the associated complains of the CC..i made a FCCNDTVHSSR for that..it helped a lot
4) there are 10 transitions sentences u have to use and 4 informative one...u cannot miss them in any case...make it like a routine when ur practising these cases..
5) u can talk while washing hands....dont have slience any time in the room unless u ascultating...
6) Ok now the big thing..examination...its so time consuming and u tend to forgot all the things..
7) for general exam..i follwed the PICKLE and added O of opthalmoscope to it...check pedal edema now...and ask fr it also...check pulses...take BP
8) now this is what i did personally for,, systemic exam...
--i started with sp sitting untie the gown with back chest insep/percussion/tactile fremituis/ascultation....check for spinous tenderness and CVA tenderness at the same time..
---SP still sitting..come front take the gown down ..sternal tenderness/ supraclavicular nodes axillary nodes...PMI...all 4 heart sounds and ascultate the lungs..
--tell the SP to lie down....look for JVP..carotid pulse...go for abdomen...IAPP..
9)...summary...the most imp part...what u told me..what i found out...it might be (DD)..what we are going to do (investigations)..
---councelling..the most imp part of the closing....u have to do ....what precuations the SP has to take based on the CC..
10) closing....ok this is what i did..
a) i m going to tell the nurse to send the investigatiosns quickly
b) the investigations might take 8-12 hours to come..till the time if there is any problems or worsing the CC plz give me a call ..i m goin to keep my contact info with the nurse..
c) and once the investigations comes we will meet again and dicuss abt the problem and management..i would like to again remind you abt i am alwayz here to hep you Mr.SP ..have a great day.!!!! Phew finish..come outside and start writing the PN..
writing PN is easy...so i guess i m not going to write abt it...
i m just worried abt the 1st case i really messed it up...plz pray for me guys...if u need any more things just mail me..
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Freedom is not worth having if it does not include the freedom to make mistakes...... Mahatma Gandhi
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| LisaM
Forum Guru
Topics: 16
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All the best with your results, Azygous. 
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lisa
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| som
Forum Guru
Topics: 59
Posts: 308
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Hi azygous,
what is FCCNDTVHSSR/ can u elaborate it pls?
Thanks a ton for all the tips u shared. my exam is in next month n this is certainly useful info. Good Luck for ur results n U'll be in all our prayers.
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| azygous
Forum Senior
Topics: 15
Posts: 209
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hi
thanz a lot lisaM and som
FCCNDTVHSSR IS JUST a thing that i made up..its not generic..
F-FEVER
C-COUGH
C-COLD
N-NAUSAEA,NUMBNESS
D-DIZZINESS
T-TINGLING
V-VOMITTINGS
H-HEADCAHE
S-SORETHROAT
S-SHORTNESS OF BREATH
R-RIGORS, RASH
THATS ABOUT IT..
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Freedom is not worth having if it does not include the freedom to make mistakes...... Mahatma Gandhi
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| som
Forum Guru
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Posts: 308
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pls check ur pm
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| nisha
lil monkey
Topics: 146
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I think u did a great job and were very meticulous, good luck for your result.
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| seri
Forum Senior
Topics: 4
Posts: 190
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thanks for the post and g/l with the results!
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| azygous
Forum Senior
Topics: 15
Posts: 209
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thanz seri..and keep on praying for me.....
hey som i got ur PM..i guess i m going to write about the transitions in general area..in the hope it will help everyone..
1)Knock 3 times with confidence , a smile , walk in and say, "hello Mr. SP, I am Dr. XYZ and am here to see you today as your physician."
Shake hands with the patient, look around the room and say "Is everything in the room alright for you ?" - SP says yes - Then you say "Let me make you a little more comfortable".....and while saying so, drape the patients legs up to his belly (applies to a sitting or a reclining SP) . Then, "So Mr. Smith, how may I help you today?"
After the patient tells you the chief complaints and stops, first express sympathy - say, "Oh I am sorry to hear that, I shall try my best to help you. Hope you dont mind if I make a few notes as you speak" This makes you free to write or pretend to write as you try to recall what to ask without showing ur nervousness - actually a good time to write ur mnemonics !!
now ask LIQORAAA + FCCNDTVHMSSR
--2) hello Mr.SP now i need to ask you more Q regarding ur health..which will help me nderstand ur health better....NOW ASK FOR START WITH off with data collection, i.e. "PAM HUGS", before you move on to "FOSS", it is good to say, "Mr. SP, the way clinical medicine works, there could be some clues hidden in a few personal questions I need to ask you - is that OK with you ? " and then move on to FO
---4) now tell the SP that anything u going to tell is going to be confidential....ask the sexsual and social SODA.
---
Transitioning to a hand wash:
There have been quite a few concerns about how to handle a change from history mode to a hand wash mode ...A sample transcript :
You = "I shall now need to perform a quick general examination and then look at your heart - is that fine ?" (No need to say Head, Neck, Eyes, Feet, etc and waste seconds ! - you're gonna be graded for doing it , not for u saying it in detail !)
SP = "Sure, doctor"
You = "Arrite ! Before we begin Mr. Smith , excuse me for a moment here to wash my hands" (smile)
I had reserved the time to wash my hands to enquire about occupation and say "thats interesting, my uncle used to do something similar" or something like that.
Transitioning to a Physical exam:
Before you begin physical examination say "I will now need to perform a quick general examination and then we shall have a look at your chest [or abdomen - wutever the chief complaint is]" and do keep talking during each thing your examine - like "lets start with your eyes, could you look up for me" while examining pallor. By the way , a good mnemonic of quickly completing general examination is "PICKLE" - Pallor, icterus, Cyanosis, Clubbing, Koilonychia, Lymphadenopathy and Edema Feet" along with Jugular veins, carotid bruit if a CVS case.
At the end of the entire general + systemic examination, summarise :
"Based on what you told me and your physical exam, there are certain diagnostic possibilities like 1._____, 2. ________ or 3. _______ and others. But to be more certain, let us order a few tests - like blood tests, chest x-ray , an EKG , and then discuss further management. "
The last minutes...
While concluding, keep this 4-stage pattern in mind to cover everything and to be courteous:
a. First, Counsel !!! For example - for a case of diabetes, it is good to say a few words on foot care ! if the patient smokes or drinks alcohol - say "are you aware of the harmful effects of smoking / alcohol ? Have you ever considered quitting - if you wish to , we have a good support team that is willing to help you quit the habit" thats it - dont get personal about it .
b. Then say " Have you understood everything we have discussed today ?"
c. Then "Are there any special concerns you have ?"
d. Finally " Thankyou very much Mr. SP . I shall leave my contact information with my nurse - feel free to contact me anytime if you have any questions"
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Freedom is not worth having if it does not include the freedom to make mistakes...... Mahatma Gandhi
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| som
Forum Guru
Topics: 59
Posts: 308
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thanks azygous !! that's very generous of you
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| reliable_26
Forum Junior
Topics: 14
Posts: 43
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Thanks azygous..
U real did a cool job....
have u got ur result?
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| srf
Forum Guru
Topics: 73
Posts: 405
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there is no scoring for cs ,if that would have been the case you are sure to get above 90.
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| dokyjun
Forum Newbie
Topics: 4
Posts: 10
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hi, i am taking my exam in LA in 2 days, i had a couple of questions
1. do we take a flash light, reflex hammer, etc. 2. do we shake hands when we walk in?
i would appreciate if you fill me in
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| azygous
Forum Senior
Topics: 15
Posts: 209
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hi dokyjun..
sorry for replying late..i was busy taking a break..
1) no no they have everything there.
2) shake hands with all of them except the ones in pain lying in the bed...
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Freedom is not worth having if it does not include the freedom to make mistakes...... Mahatma Gandhi
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| azygous
Forum Senior
Topics: 15
Posts: 209
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i m replying to one of my PM..as it will help a lot of other people.....
""""""Hi,
I am also an IMG and I will be takin mine CS in atlanta...here I must ttell you that I am final year medical student and i am really scared of CS
although your post has really helped me and made me pray for your success but can you please tell me something more like about the PLACE...I read that its on 5th floor...
and any other tricks?
I am doing UW and thinking to start workin on it on 10th june while my exam is on 27th July...is that okay""""""""""""""& #34;""
hi...hey thanz fr praying for me..let me tell u first..be confident and cocky..it might sound rude but it helps in exam like this..
i stayed in best western and paid 54$ inculding tax ( call them n ask for CSA exam discount) they have wireless internet but from dayz inn hotel...if u want i can give u there number..
go to the exam center in the evening....its walkable..
bring food with u in the hotel for ur dinner as there is only mac donalds across the street and u dont want to waste time there....
iron ur clothes in the evening and practice ur cases with tie on( u may laugh on this but it might be a bit diffcult with trousers and tie)
sleep as ealy as u can...get up around 6...practice
1) general case
2) pedis case
3) pyshicatry case
4) absue case
5) telephone case..
take some sweet and start walking to the center ( i ate gulab jamun)
yes the center is on the 5th floor....once ur out of lift take left and u r in the exam place....
talk to everyone u meet ...i had a girl from cincinnati next to me..we were talking abt the seinfeild episode in which kramer and his brother are SP's and were laughing abt it...its very relaxing..
but remember one thing dont talk abt the cases to anyone anywhere...period..
plz dont eat onions in the lunch..and bring some those breath dissolving things with u..plz plz bring those..
plz bring hankercheif...u get so sweaty...u need it before u knock on the door..
i just did the kaplan book and u have plenty of time buddy..10th june to 27th july...wow..i wish i could have that time
if u or anyone still have any Q..u can ask n i can write abt it..
good luck guyz and keep praying for me...
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Freedom is not worth having if it does not include the freedom to make mistakes...... Mahatma Gandhi
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| seri
Forum Senior
Topics: 4
Posts: 190
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hey azygous,
been reading your tips with interest.
you are in my prayers.
i sent you a pm. please help me out.
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| azygous
Forum Senior
Topics: 15
Posts: 209
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hello seri....i am answering your PM here so it can be helpfull to others..i hope u wount mind it..plz find my msh in caplocks below ur questions..and good luck..
"""""""""""""" 4;"""""""hi
please advise me on some technical details for cs.
1) are 2-3 days sufficient to get over jet lag before the cs (i'll be travelling from india)?
I GUESS 2-3 DAYS ARE ENOUGH..SLEEP AS MUCH AS U CAN IN THE FLIGHT
2) how many days in advance did you book the hotel room in atlanta? please give the contact info for the hotel you stayed in/ any other useful stay info eg. public transport from airport to hotel.
I BOOKED 2 DAYZ BEFORE...THE NUMBER IS 001-770-996-4321..CALL THEM AND TELL THEM TO YOU ARE FOR CSA..THE TOTAL AFTER TAX IS 54$...YES THERE IS SHUTTLE FROM AIRPORT TO RAMADA IN CHECK ONLINE FOR THERE NUMBER ALSO WHEN U REACH THE AIRPORT U MIGT ASK THE HELPDESK ABT THE SHUTTLE...
3) for how many days did you book your room? just need to know if check in and check out time clash with the cs exam, in which case i'll need to take it for 2 nights.
I BOOKED THE ROOM FOR ONE DAY..I HAD THE EXAM ON MONDAY I BOOKED FROM SUNDAY 3PM TO MONDAY 11 PM..WHEN I WENT FOR THE EXAM I PACKED MY STUFF IN THE CAR AND KEPT MY CAR IN THE PARKING LOT..
4) is the room advance refundable?
YOU DONT NEED TO PAY ANY ADVANCE...
5) do you advice booking airtickets online/ using a travel agent?
WELL I CANT HELP U WITH THAT..I M HERE IN USA
digital doc's site recommends ramada at $55 but when i tried orbitz etc they quote $68 as lowest charge with taxes extra.
BUT I BOOKED LAST MONTH...JUST CALL THEM..DONT USE ORBITZ..
i've asked a whole lot of q's...please do help me - i'm at wit ends with my new job, ck prep and planning cs. any inputs from you will be greatly appreciated. one last thing - pray for me.
NO PROBLEM BUDDY...I WOULD BE MORE THAN HAPPY TO HELP...LET ME KNOW IF U NEED ANY MORE INFO...
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Freedom is not worth having if it does not include the freedom to make mistakes...... Mahatma Gandhi
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| seri
Forum Senior
Topics: 4
Posts: 190
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heartfelt thanks azygous!
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| Researchsurvivor
Forum Junior
Topics: 3
Posts: 39
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Hi Azygous - wish you all the best for your exam result (which I am sure is a pass!).
I have a question: you said " i just did the kaplan book" - I am also doing just the Kaplan book ( actually finished it as of yesterday and now I am going to review it, since my exam is middle of next week). I was wondering if you think I should buy UW or another book to study for the exam. I practiced all the PNs typing on the computer ( I plan to type- what did you do), I am thinking of playing out loud my HPI, PMH and Phys Exam during the last days (I kind of did this here and there, also last weekend and previous week in the evenings w/ hubby). Today and tomorrow will be mainly acting the SP encounter.
Do you think I should go through another book or UW on Monday and Tuesday or should I stick just w/ Kaplan?
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| Researchsurvivor
Forum Junior
Topics: 3
Posts: 39
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Could someone give me an advise or opinion? Please!
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| azygous
Forum Senior
Topics: 15
Posts: 209
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hi Researchsurvivor
thanz fr the wishes...i only did the kaplan book...i have no clue abt the UW or FA...so i may not be right person to answer...
PN ...i think i was OK with PN because i made a systematic structure for all the PNs based on cases and just added the info once i was writing in the exam...
i did handwritten PNs..my thought process is continous when i m writing....
at this moment what i would suggest is practise as many time as u can the same cases..rather then doing something new...watch the videos if u want to abt clinical exmination...
the links are
http://www.echt.chm.msu.edu/VideoLect/viewvideos....
http://www.med-ed.virginia.edu/courses/pom1/video...
and when ur practsisng ...be a real doc which will help u to be cocky...and confident...speak loudly and clearly...and practise doing all the examinations CVS,RS,ABD + GE....IN ALL THE CASES..AND CNS ONLY IN REQUIRED ONES...
sorry fr replying later...i was a bit busy..can i ask u some thing if u dont mind...whats with ur name Researchsurvivor??
well good luck..and let me know if u need any help..
azi
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Freedom is not worth having if it does not include the freedom to make mistakes...... Mahatma Gandhi
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