wolvimd
Forum Newbie
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For over two months now, since I took my exam in Houston, I have been observing this blog, comparing notes, hoping beyond hope that I hadn't made enough mistakes on this test to fail. I took the exam on July 23, only a few days after the change in passing standards (07/15). I'm an IMG. This blog helped me, so I hope to return the favor.
I took the exam in Houston, proctors were reall nice, no problems with them, there is an air of tension though, created by the uncertainty of what lies ahead. I had studied for about a month on and off from UW and FA. I only practiced a few of the cases with my girlfriend. The test started right on time.
THE TEST: I was the last one in, and the first one out in ever single case. I took time before going in the room to write down the SP name in BIG letters on the top of my blank page, just in case my nerves betrayed me. I wrote down a few differentials on the other corner, and wrote PAM HUGS FOSS.
WHAT I DID WRONG: My nerves betrayed me. I made the silliest mistakes I could, I forgot to ask GYN history on the two cases that warranted it, I didn't have time to even start the mental exam and neuro exam on the patient that warranted it, didn't counsel about half the patients, I was just to worried about getting out on time and not being pulled out by a proctor. I totally blew a really easy diagnosis (my diagnosis could be ruled out with just the chief complaint). I didn't ask really relevant questions in almost all the cases, although the worst ones are the ones I mentioned. I was so nervous in some of the cases that I stuttered and became clumsy, but through it all I pretended it didn't happen and just turned around and kept on smiling.
WHAT I DID RIGHT: Now this is the key point of how I think I passed. First of all my English is ok, I have an accent but have been speaking it all my life, so that I don't think was a factor. Now for the interpersonal skills I was absolutely RELIGIOUS about this: knocking on the door, I smiled at every patient (including the ones that were in pain - gave them a sympathy look), I washed my hands every time before touching the patient, I offered to help when the SP lied down and sat up, I pulled out the leg rest every time, I asked permission to do everything (untie gown, examine, ask questions), answering the SP's questions with ascertiveness (even when I had no clue) and showing empathy about all of their problems.
In any case I advise you to be systematic about the things that will be the same for every SP, like washing hands and smiling, these are things that you can control, unlike what case you will get. I believe that it was this what helped me pass, because I know as an IMG that my clinicall portion of this test was pathetic. Best luck to all who are waiting to take the test and waiting for your grades, don't worry if you feel you made too many mistakes, not only am I a perfect example of the kind of big mistakes you can make and still pass but our brains also tend to retain the most traumatic parts of things (what we did wrong) and forget all the things we did right. I'll be happy to answer any questions or help out any way I can. I truly thought I had failed, and didn't. Remember, chances are you will pass.
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| salo
Forum Junior
Topics: 10
Posts: 52
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thanks man really encouraging!!
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| cadp
Forum Newbie
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I subscribe to what you said almost identically.
The first thing that surprised me about this test and myself taking it was the amount of tension I ended up feeling right from the the first case. I graduated in 1991, worked in Family Medicine for 10 years and them 6 years in public health research in the US. I have no problem speaking English, but when I started practicing for CS I found myself unsure of the pronounciation of common medical terms, then I suspected I am using too much of the "proper English" for the average American.
Except for the case of parent of child with enurezis, I ran out of time in all the cases, and usually it happend at the point where I was supposed to tell the patient what I think it's wrong and what tests I am planning on ordering. But I followed religiously all the non-medical matter that makes this test different: door knock, greeting by name with name, self-confident hand shaking (where appropriate), eye contact at all times, and almost exaggerated concern for the patient's comfort. I had this patient who complained of chest pain with every breath and me trying to listen to her breath sounds. I must have said after each of her "ouch"s, "Do you want me to stop, are you OK, I will be done in no time". And I have a number of "pearls", believe me: adolescent patient with secondary amenorrhea who tells me she never had sexual relationship and me flying out of the room (the bell rang many seconds before) and throwing over my shoulder that I am going to order a pregnancy test. I don't think I will see a bigger pair of brown eyes, not even she would have been pregnant for real.
The bottom line for me is this. If this test is not a joke, then it tests a different dimension that is hard to assess by using our clinically-oriented skills. It is not about coming to the RIGHT diagnosis by using differential diagnosis process a la carte, it feels more about communication in a way that at least partially is hard to describe in your own words. I think it is fair to say that most people who prepare decently will pass, but I could not say what needs to happen for someone to fail.
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| kochs
Forum Senior
Topics: 13
Posts: 141
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So well said ,all of you !
I truly felt thE SAME. Actually i completed all my cases five mins early ( SP perhaps happy becoz could relax longer before the next candidate came in )
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| sachagro
Forum Newbie
Topics: 4
Posts: 15
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LOL at the pregnancy test, but you know it was ok, as Dr. House says, 'EVERYBODY LIES!' so it's genuine to do the pregnancy test even though the pt said she never had a sexual relationship.
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| arlete
Intern in 2009!!!!!
Topics: 30
Posts: 2,217
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Congrats, thanks for sharing!
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When men make the rules, God decides the exceptions.
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| coolmavs
Forum Elite
Topics: 21
Posts: 327
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Congrats and thanks for sharing your experience.
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Yeh Zeher bhi, yoon piya hai.....Jaise sharaab ho!!!!
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| soniaquinteros
Forum Newbie
Topics: 2
Posts: 5
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Thanks wolvimd for ur post. It sounds similar to my performance on the CS test.
I took my test yesterday and to be honest... I think I could have done it better.
What I did right (I think) was: I tried to be nice, smiled, drape all of them, wash my hands in every encounter, did counselling in the ones that needed, and answer all challenging q's. Also finished all my encounters on time and my patient notes. Check main systems involved and did heart and lungs in all of them.
But... I blanked out when trying to remember easy dd such us disc herniation and chf (can u believe that?) :S, anyway, and didnt ask a OBGY when i had to. Also didnt do a mme on a LOC case (but did neuro) and other things that was necesary. Didnt have time to review my notes, i just finished right on time.
So what is my veredict? :S Im just waiting for my results....
I have faith that God will help me! yeah!
Any comments? thanks
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dr.W
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| arlete
Intern in 2009!!!!!
Topics: 30
Posts: 2,217
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sonia:
You don't need to be perfect. I think you did the essential and the result is going to be "pass". But I agree with you, since nobody knows for sure why people fail, let's wait before we celebrate!
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When men make the rules, God decides the exceptions.
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| hitesh
Forum Guru
Topics: 50
Posts: 492
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I havent taken the exam yet, but from all that i have read so far, it seems you should pass. Wish you all the best !
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One down, 3 to go...
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| soniaquinteros
Forum Newbie
Topics: 2
Posts: 5
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Thanks for all the encouragement!, really appreciate it!
Will let u know when I have the results!
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dr.W
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| vanshita
Forum Guru
Topics: 22
Posts: 821
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Congratulation
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| success3
Forum Newbie
Topics: 3
Posts: 4
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I took my step 2cs in Apr 5. I felt OK after the test. My big problem is the closure and counseling part. I have only finishd both closure and counseling in 4 cases and went halfway in 3 cases, In the rest of the cases, I have either NOT begin or just begin the closure. I am really concerned about this. Did anybody encounter the similar problem but pass recently? Thanks a lot.
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| hgheith
Forum Elite
Topics: 39
Posts: 268
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Thank you wolvimd and cadp for sharing your experiences, it helps to read good news about some of my own weaknesses. I was beginning to really panic but your posts have given me new hope
Thanks again!
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