brave heart
Forum Newbie
Topics: 10
Posts: 24
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Dear Friends,
First of all I would like every single post writer who shared his experience and advice.
your fears and encourage were my back up and kept me forward...
Just yesterday I had recieved that PDF file on my OASIS that i opened 10 times and read it in all languages to make sure im really pass to spread my smiles and hapiness..
Im an IMG with good medical background and fair english langauge skills and conversation...
Today I would like to share you all guys, with my experience and advices.
My preparation:
Thanks are really a must now for First Aid my only source of preparation...
- I started by reading the concepts of the CS exam through USMLE, ECFMG, Your great forum and then through the USMLE orientation CD that you will recieve whenever you apply for that exam, this will make you ready and oriented about the atmosphere of the exam, procedures and also the room and centre enviroment that the vedio clip at USMLE CD will show.
So you are now ready to imagine the encounter while you are studying...
- Be prepared with you Visa issue 5 months a head before you schedule, since really it may cause you a headache, choose the date that you can and then be ready with the plan of the travel and airlines along with the accomidation with nearset cheapest hotel or motel you may book at the net..
- I studied for 2 weeks, know through 1st aid text, how to ask about every single symptom in each system, how to answer the possible challenging questions by the encounters, how to greet, introduce you self and how to examine each system.
- I did all the examination separately to master them as doing CVS alone then respiratory examination alone, i mean do the complete examination tips for each system separately to master these tips as a pecie of cake.
- you may make use some clinical skills vedio clips from any recommended site you wish as series of vedio clips of connecticus university.
- After you master all above, go to the minor cases about 140 minicases in first aid that orient you what you may ask or examine for each system and complians along with presumptive DD and work up, dont ever depend completely to what have been writen in the first aid minicases DD or work up plan, you are a dcotor and studied many years to be able to give thses by your confidience and knowledge.
- now after you are oriented and prepared and mastered the knowledge for the clinical skills of what and how to ask and examine , how to counsell and how to answer patients questions, along of how to close, IT IS NOW the time of your own plan to be prepared well and sticky with your own plan:
My own plan was :
- stand beside the door and when you hear the announcement to start, read carefuly what do they ask you to do with this patient: Write on your note book:
Patient family name and gender As: Mr kitty or Miss Nice
Only the abnormal VS.
Chief complian
patient age
If you find your self confidient and have time you may write quickly tips of history you may ask and tips of vital exams you may conduct ( this is in 1 min)
- Then knock the door and enter
- Ask direclty the patient as you are calling him: " Mr jayson ?" , he will say yes, just walk confident after closing the door toward him
- With A BIG SMILE: greet and introduce yourself to him (while you are shaking hand gently if not contraindicated as upper limb pain) : "Helloooo, Im doctor (your family name) , nice to meet you... Smile again and say: " Im a staff physician in this medical centre and I would like to ask you some questions and to examine you in the next 15 minutes, Is it okay with you" thank you
- say : " Im here to take care of you Sir or Mam"
- drape and drape and drape: Directly after you greet him dont ever forget to drabe and cover the patient with the sheet that it is put on the stool that you will sit on, so this will help you not to miss covering him, simply if you need to sit down to start history taking you will see on your cair the sheet so say : " Is it okay to drape you first with this sheet to make you more confortable?"
- Then sitdown or stand up and ask him or her " is everything in this room concering the temperature and lighting making you confortable? your confort is my primary concern"
- Then say: is it okay to take some note while im asking you my questions?"
- Start you history by saying: "Well, now , how i can help you sir/mam?"
- Take the history : chief complain dissect( open Qs) it wisely with the relevant associated symptoms and include the relevant Sys review in the present history for quick achievement.
- you may have any mnemonic that may help you, for me for the pain I used my own:
- FORDS PLAP ( Ford car and the british medical exam plap
 ) - F: frequency
- O: onset
- R: relieving factors, radiation
- D: duration, description, daily activity interfer
- S: severity scale
- P: progression, Pattern
- L: location
- A: aggreviating factors, assocation
- P: pericipitation factor
- Then after that do a transition sentence as : "Now, I would like to ask you some questions concerning you past medical history, or personal life style and hablits"
- proceed with the rest of history component with :
- PMH
- PSH
- FH
- Medications
- Allergies, blood transfusion
- Social history: (smoking, drugs, alcohol, sexula , eating - diet, wieght loss, appetite, work, home , stress, .....)
- Then move to say: " thank you for answering my questions, do you need to add any thing that may help us to draw you diagnosis?"
- Say: now, i would like to examine you , but fisrt i need to wash my hands, exusme" dont give the SP your back wash with water and soap , then dry with tissues, you may ask him while u r washing hands, "What type of work do u do mam?"
- Then go toward him/her and say : "Is it okay to untie ur gown in order to eaxmine your heart and chest "
- help him in any movement, make his position confortable for him, ask his permnit allways, and ask about his confort while u r examining. elevate the besd and extend the legd or the bed if u need him to sleep. allways drape him and never expose unwanted ares , just uncover where are u examining...
- every time you want to examine something say that and take permit: as:" now, i would like to examine you leg reflexes, is it okay with you mam" thank you
- Never repeat ur examination, once and once, be gentle...
- worm ur hand before touch body, may scrup ur stethescope with alcohol swap if u have time.
- After completion of ur examination, correct SP position, thanks him for letting you exaimining him and then tie his gown again
- Say: " after I have your data and examined you. si, I found that you said that u had ........... and in my examination i found these signs", Now i would like to give you my impression about your complian, give him with no medical words . 3 DD simple explanation and we need to do these test in order to bo able to find the final diagnoses along with the appropraite management, never give the final diagnosis...
- Answer any patient question
- Then try to see if he is smoker , alcoholic, drug user, uncontrolled DM, HTN, see if he/she has to do screening test as colonoscop, pap smear, mamography, .... so counsell SP in the last step.
- Finally say: Sir, Untill i have you results , please dont hesitate to contact me for any question, im here for your support"
- : Do you have any question before i leave?"
- It was so nice to meet you mam, take care of your slef, smile, and shake, and say bye.
- ABOUT THE TIME, JUST BE SURE THAT WHEN THAY ANNOUNSE THAT 10 MIN PASSED , PLEASE BE SURE THAT YOU ARE IN THE NMIDDLE OF YOUR EXAMINATION....
- be sure to address allways the concern of the patient and how to manage if SP is sad , stressed, crying, angry.....
- GO OUT on time not before nor after
- Write your PN...
- Start to write your history , important tips only
- then write examination tips starting with the pt VS
- then the DD and Workup
NOW PLEASE MAKE SURE TO PRACTICE THE 31 CASES IN 1ST AID WITH MEDICAL PERSONNEL 2-3 TIMES TO BE READY AND MASTERING THE PLAY. YOU HAVE TO BE AN ACTOR
SLEEP WELL BEFORE DAY OF THE EXAM
BE IT 7:00 AM AT THE EXAM CENTRE, DONT MISS UR id, AND SCHED, PERMIT
DONT TAKE FOOD STAFF THERE OS ALOT THERE, GO BATH EACH BREAK TIME AND BEFORE
STAY CALM. SAY GOD HELP MAY ALLWAYS
DONT TALK ALOT WITH UR COLLUEGES AT TIME OF EXAM.
i WANT TO SAY THAT I MISS ALOT AND DID PASS
I didnt do cerebellar test and gait examin in dizziness case
I didnt ask any thing about depression in a case it was important
I counselled only 4 cases where I saw important
I wasnt smiling all the time
I didnt do renal angle tenderness in acute abdomen case
I didnt examine cranial nervers in mandble trauma with bruises
I didnt look for tophi in ear pinna nor skin in gout case
I never gave summary for the patients
you need to be gentle only, good speaker , ask your plan tips, give fair DD and work up not even correct 100''|% and YOU WILL PASS AFTER GOD WISH
THIS IS MY SIMPLE ADVICE AND MY EXPERINCE , WISH U ALL GUYS TO PASS THIS CHALLENGING STEP OF UR LIFE
CHEEEEEEEEEEEEEEEEEEEEEEEEERS
Edited by new_n_lost on 12/11/07 - 02:08 AM. Reason: Changed the Font
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Life is the only book where you can't find the answers in the back...
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| layla
Forum Senior
Topics: 15
Posts: 82
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Thanks for sharing, thanks for the advice
God bless
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| Ardalan
Forum Newbie
Topics: 5
Posts: 10
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you covered everything
Thanks man,
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| xthine
Forum Newbie
Topics: 1
Posts: 79
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Thanks for the tip! Wish I could have read this before I took my exam in LA a few days ago. 
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| paheli
It'sAllAboutGoodKarma
Topics: 151
Posts: 1,980
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good write-up. thanks and congrats.
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Prepare as if you're the worst, Perform as if you're the best! As you dream, so you manifest. So, DREAM BIG!! When you face hardship, remember, God never gives you more than you can handle. Success is the best revenge! He's my boyf! And, yea, I'm lying...:-(
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| brave heart
Forum Newbie
Topics: 10
Posts: 24
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Thank you guys
I wish u all the succsess
I wish i could help u sooner or later
keep it up
___________________
Life is the only book where you can't find the answers in the back...
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| beiwen
Forum Elite
Topics: 21
Posts: 212
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Thanks for your complete description of your experience. I found it VERY helpful, indeed!!!
Having my CS exam on Feb 1st... kind of scared.... I'm afraid to remain speechless in all encounters, LOL!!!
Thanks for your words of support, as well!!
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BW
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