layla
Forum Senior
Topics: 16
Posts: 84
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Hello there
I have been out of practice for 3 years, My exam is on Dec 17th and I was wondering if I can get ready by then.
so basicly how long I need to practice in oder to be fully prepared? How many hours a day is needed?
How long one needs to get through UW and how long for FA?
I heard somebody mentioned repeating all the UW case 3 times is a must? is that true?
How practicing with a study partner over the phone usually is?
I would be very thankful for your feedbacks
thanks
Layla
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| jazmil
Forum Elite
Topics: 13
Posts: 298
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I studied for 2 weeks for 8-10hrs a day, using FA and UW. I did all the cases twice.
You have more than enough time. Just keep practicing till you're comfortable.
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| SSCOOL
Forum Senior
Topics: 10
Posts: 121
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My simple advice is practise with a partner,keep fifteen minutes as ur target to finish,
I don't stress on 10 or 12 hours study,b'coz this is not an exam to find how much stuff u know,
This is for ur communication skills if u r IMG, data gathering for AMG!!(he he ).
So,common guys we r strong in data gathering unlike AMG's,so practise,practise to develop ur communication skills,do FA
Waiting to see ur pass report soon,bye now
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| Doc750
transfer:step 3 prison
Topics: 52
Posts: 636
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2.5 weeks
go through FA, and then UW .. dril, drill drill with a partner, and be sure to time yourself
___________________
Experience is a hard teacher because she gives the test first, and the lesson afterwards.
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| mildanemia
Forum Newbie
Topics: 3
Posts: 90
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You have to divide the tasks of the exam and spend the appropriate amount of time on each one. You have a lot of time, that is for sure.
D.D's:
I think it's essential to know them all by heart, when you are pressed for time there isn't enough time to think.
Specific questions for each one (3-4 for each D.D)
Communication Skills (How to interact with the patient - FA has a section about this)
Answering challenging questions (Be diplomatic and honest - you will often respond saying it is too early to tell, we must run some tests first, etc...)
Counseling
Practice with a partner to simulate the exam
Try writing/typing several PN to time yourself
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| layla
Forum Senior
Topics: 16
Posts: 84
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Jazmil,SSCOOL,DOC750, Mildanemia
Thanks for taking your time and writing all the helpful advices
God Bless you all
Layla
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| layla
Forum Senior
Topics: 16
Posts: 84
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Its me again,
It took me about 3 weeks to finish FA with a study partner over the phone.
I still sometime forget to wash my hand and worse than that in the last 2 days I forgot to introduce myself to the patient and I have this problem that when I take notes during patient encounter then I will have touble with time!!!
I am going to start UW from Monday but I am worried sick that I might not be ready by Dec 17th when I have schaduled my exam.
what should I? any advice?
thanks
Layla
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| Doc750
transfer:step 3 prison
Topics: 52
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you need a live person to drill with,timed. If your in the US, head down to the kaplan center, post a small note in the lounge area that your looking for a CS partner. Or grab a family member, they work just as well.
Then you need a draw up a checklist. Start with 1) knock, and introduce yourself properly 2) ask pt what brought them in 3) show concern ... etc .... your SP will then go through and mark everything if you did it or not. The key here is to practise over and over.
When I did it with someone. We would go through the checklist and give/mark off points on the checklist. And then evaluate ourselves. Anything less then 85%, meant that you had to repeat the encounter again the next day.
It's all about repitition. Just relax. Pretend that your really in an office. You would never walk in and not say "hello, so&so my name is Dr. such-n-such" in the real ward. Or you would never examine a pt without washing your hands (I hope). So then why is it any different here? Seriously, just relax. Make it a routine, and then you won't have to make an effort to think about it. It'll become second nature, and you'll have more time to think of questions to ask, and work on your d/dx.
___________________
Experience is a hard teacher because she gives the test first, and the lesson afterwards.
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| Doc750
transfer:step 3 prison
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I put up the outline for a pt note in this thread
http://www.prep4usmle.com/forum/thread/63687
there isn't much else to write down outside of this. your notes doesn't need to be neat. it just needs to make sense to you, so that you can draw up the real note outside.
___________________
Experience is a hard teacher because she gives the test first, and the lesson afterwards.
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| layla
Forum Senior
Topics: 16
Posts: 84
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Thanks Doc750
I have read your post, lots of wonderful stuff there. Thanks for sharing.
Is it important how many times you review cases in FA and UW.
I guess I am paniced because I hear people reveiw each at least 2 times, on the other hand there is Kaplan courses that make you ready just in 5 or 6 days!!!
and one more question, how important it is to write down your DD before you step in the room!?
thanks
Layla
Is it possible you miss a question With
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| layla
Forum Senior
Topics: 16
Posts: 84
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Is it possible to miss questions if you dont write done 3 DD at the beggining?
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| Doc750
transfer:step 3 prison
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the d/dx becomes second nature to you after you do the mini cases in FA. So you don't need to write anything down. If the CC is cough, you start thinking "ok bronchitis, URI, smoker, etc" .. and just keep it in the back of your head. No need to write anything down.
then on that link I have you there is a list of questions for cough. So at some point during that interview you need to go through all those questions, specific for cough.
I went through all the UW/FA cases twice. timed.
You are going to miss questions. No matter how well you prepare. There were times, I came out and started writing my note, and I was thinking .. "Shit I forgot to ask menarche, or number of pads used" .. or some other BS stuf like that. But the most important thing is that you go in there, make the patient feel comfortable. Show concern, and go through a basic H&P.
There is already a thread about the kaplan course. And I posted my views in there already. But basically, they tell you to do the exact same things UW and FA do. If you find that your not able to go through FA and UW and still not feel comfortable that you can do a basic H&P, and have the cash. Then sure, go for the kaplan course.
___________________
Experience is a hard teacher because she gives the test first, and the lesson afterwards.
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| layla
Forum Senior
Topics: 16
Posts: 84
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Thanks again
Do you think it would be possible to go over UW twice and FA on more time during 4 weeks?
thanks
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| Doc750
transfer:step 3 prison
Topics: 52
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8 hours a day, doesn't even have to be continous. Is more then plenty.
___________________
Experience is a hard teacher because she gives the test first, and the lesson afterwards.
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| layla
Forum Senior
Topics: 16
Posts: 84
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wonderful, thnak you vey much, you helped me alot today
God Bless you
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| mildanemia
Forum Newbie
Topics: 3
Posts: 90
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Layla,
I think that the time you spend outside the SP's room jotting down the DD's, patients name and PAMHUGSFOSS is time well spent because when you're in the room you will be thinking about other things and there won't be enough time to analyze the symptoms/signs.I wrote 5 DD for each case. I forgot to write down the DD's with one patient and it caused me a few extra seconds which are really valuable, I also forgot to write the name of one patient and halfway through the encounter I wanted to address him I paused because his name was not on my draft sheet.
There is another issue I'd like to address, the exam is not clear cut like FA is, although writing DD's outside is useful it is not enough, you have to learn to improvise. During the next 4 weeks you have enough time to read FA at least 4 times, yes I am not kidding. By now you should know the DD's by heart and the rest isn't that hard.
Once you know the DD you should ask 3 specific questions regarding each differential so if you write down 5 DD those are 15 q's then PAMHUGSFOSS and you're done with the history taking. I spent 9min taking history, 2-3min on physical exam and the rest on Counselling and Closure. Physical is just routine, most cases are CVS, CHEST, ABD. Specific cases like Hyperthyroid require neck exam, DM requires Sensory Neural, HTN requires carotid auscultation and peripheral pulses, do you get what I mean ?
I would actually suggest you write one more thing on your draft sheet; a note about counseling. When you hear that the pt has been smoking for 10 yrs write it down or counsel on the spot because you will most likely forget to do it at the end when you are rushing. I forgot to counsel 2 or 3 patients.
I still don't know the results yet but this is what I did during my exam. CS was my first exam so DD's were essential in my case, other examinees were more relaxed during the exam because some attended the C3NY course and others had step 1 and 2ck under their belt.
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| layla
Forum Senior
Topics: 16
Posts: 84
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Mildanemia your advices are very good.
I feel that questions in UW are more targeted than questions in FA, if I am right, which approach is more acceptable?
How much notes you would take during your encounter?
sometimes I have to restate my sentences when I am intervewing the patient, how much is that harmful? any advice to correct this problem?
thank you a bounch
Layla
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| ShweHope99.9998
Forum Fanatic
Topics: 12
Posts: 2,574
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Hi Layla , key is practice as Doc said, in time frame , like we all did in all steps MCQ, with real time frame with real exm sense , though not in the real exm room yet, this is how you can traine yourself. Key is believe in self too, but do CS in time frame by some one check or for timer check ur time .
If got partner who had kap Cs training or done Cs even better , best shot as Doc said, find it at kap center, med library or online forum.
Still doupt, can take kap 1 day exm CS b4 real one to boost your confidence.
GL  
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| mildanemia
Forum Newbie
Topics: 3
Posts: 90
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I only did FA, I wish I had done UW as well but I was told that FA was sufficient. You can be the judge of the specific questions but as an example a patient with hyperthyroidism should be asked about; tremors, weight loss, skin changes, diarrhea, etc...
I took a lot of notes during my encounter, I suggest you stick to a check mark and an x mark for positive and negative data so you don't waste too much time writing. If you do not write the info you gathered during your encounter you will risk forgetting valuable information while writing your PN.
P x
A x
M atenolol
H x
U x
G x
S x
F father died 55 natural, mother alive and well
O menarche 12, regular, 2 pads a day, LMP 2wks ago, 2 children
S active, no std, uses condoms
S x smoke, x alc, secretary, marijuana in the past
I guess it would be better if you did not have to rephrase your questions, I don't know if you would lose marks for asking the same question more than once. Just use simple questions.
While asking general questions about other systems I rushed through them because they weren't essential. I was just asking them to cover all bases, better safe than sorry.
Do you have any nausea ? No
Any Vomiting ? No
Constipation ? No
Diarrhea ? No
Any Blood in your urine ? No
Any Blood in your stool ? No
Difficulty Urinating ? Yes
When did it start, etc............... ?
When I was getting a series of negatives about the other systems I would use that exact approach as above. When I ran into a question that generated positive information I stopped to inquire about the symptom.
I spent 4 days with a study partner practicing and simulating the exam. I started out at 18min then ended up with times of 12 and 13 which was good for the simulation. During the real thing I finished as they announced the end of the encounter.
You were worried about washing your hands, well if you get cold hands like mine then you will not touch the patient unless you warm them up and the best way is to use the hot running water available at the sink. I used HOT water and soap, my hands were that cold ! But it worked like a charm, hot water warmed up my hands to an optimum temperature that didn't cause the SP to curl or move as my study partner did, he always complained to me about my hands; we only simulated washing our hands.
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| layla
Forum Senior
Topics: 16
Posts: 84
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Wow, wonderful advice. THANKs, Shewehope99.9998 and Mildanemia :-))
Actaully I never forget to wash my hands in the first 25 -28 cases of FA but I tended to forget that recentlly. It might due to anxity sicen I am getting closer to the exam. I dont know!?
But yes, my hands gets ice cold too, thanks for the wonderful hint. I wouldn't think of using hot water to fix that on my own!
God Bless you all and good luck on whatever you are doing
Layla
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