arlete
Intern in 2009!!!!!
Topics: 25
Posts: 1,788
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Who creates the tags? Where did that tag come from? 
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| genbot
Forum Elite
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Hi arlette,
May be i'm a little late with this but first let me congratulate u on getting ECFMG certified. It sure is a helluva job accomplished.
Second, let me tell me you that i'm a great admirer of yours (like numerous others here ). You really are a super human being.
I wish u total absolute unending luck with ur future endeavours.
And no one i feel deserves it more.
Now a question or two...
I have my CS in 4 weeks time but if i cut out time spent travelling and jet lagging i'm basically left with only 3 weeks of prep time. From what i've heard around and read in this journal i have a feeling that this should be time enough. Being an FMG who's never been to America before i also intend to do some shadowing for 4-5 days before i go for the exam. Do u think that would help?
Also should i do FA and UW simultaneously or should i finish one and then start with another. I'm pretty comfortable with the clinical encounter part having finished my internal med residency recently. I feel i can explore most presenting complaints pretty extensively and quickly, so what all should i be concentrating on when i practice cases?
Coming up with diagnostic possibilites and evaluation strategies should not be a problem i hope, but how much does this count for in the exam?
What other prep materials would u suggest, if any?
Is accented English important or does a neutral accent work equally well?
When do u need to be smiling and when would u need a poker face?
Do u need to be very spontaneous with ur emotions or do u need to hold back a little bit?
Do the patients ever smile? Or cry?
I wasnt intending this long a list of questions but they just happened along the way!
Hopin to hear from u soon.
Thanks.
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Step1 267/99. Step2 269/99. Match 2009. MAY THE FORCE BE WITH ME (The one they call the strong nuclear force!)
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| ganesha123
Forum Junior
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Posts: 102
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hey arlette.. congratulations..!! i found ur thots really helpful... i guess thts how i practised an plan to go about my exam this friday.... the councelling shud sound as genuine as possible and giving it thru out the case in a flow seems to make a lot of sense to me..thats how it comes naturaly to doctors...(atleast me..!!) i hope i do allright considering i studied for 2 weeks after just finishing my C.K...
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| arlete
Intern in 2009!!!!!
Topics: 25
Posts: 1,788
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Dear genbolt:
Thanks for the compliments!
Yes, 3 weeks are enough if you make the most of your time and practice a lot. The shadowing is going to help you for sure. Apparently you are on the top of your game, you only need to learn what is expected from you specifically in this test. Read the csprotocol blog, FA (practice the cases at the end) and see a few PE videos for free on the Internet. I didn't use the uw, not sure it's really necessary.
I think the interaction with the SPs count more than the DD and workup, since in theory, you'll have the residency program to teach you those. But for PN, that's the part I wrote first to guarantee the points there.
I have a heavy accent. In a restaurant, I say "may you pass the salt , please?" and people are already asking me where I am from. Apparently, that was not a problem, but you have to do your best to be understood and reformulate things quickly if somebody says "I beg your pardon?".
I never made a poker face, but I was serious during the complaints (and said "I'm sorry to hear that" and smiled at all the other times, specially when the patient was talking about good habits and their family.
If I needed to hold back my emotions, I would have failed. After the first 2 patients (the tachycardia and stuttering, so not like me!), I was pretty much myself. With this smile you see in the avatar. And lots of willing to help (even though I knew it was only pretending). And maybe the SPs really lerned something from me, such as "drinking water is important for your health".
If you have Skype, send me your id, maybe I can help you when you are almost there.
Good luck! I bet you'll do just fine!
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| arlete
Intern in 2009!!!!!
Topics: 25
Posts: 1,788
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Hey ganesha...
Good luck! If you have Skype and wanna try a case with me, let me know!
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| angel23
Forum Elite
Topics: 31
Posts: 438
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hey arlete cud u plz tell the do we need to say while dng phyical examination....no pallor no cynosis no jaundice
n while checking rigidity do u hav to tell SP tht u r checking rigidity
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| ganesha123
Forum Junior
Topics: 6
Posts: 102
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thanx arlette.. travelling to houston today..will love to take tips tomorrow and thursday..!!
my hubby z been pretty much my only practise partner so it wud be good to practise with some one else for a change..
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| ganesha123
Forum Junior
Topics: 6
Posts: 102
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@ Angel ... i dont think its essential to say.. but if we do keep mentioning what we are looking for in simple language... like for tone.. u say im cheking if ur limbs are stiff.., it does make the patient involved and comfortable ..also i find it easier to remember stuff when i say it out loud...
tho i try not to make it too technical..!!
hope i am right...!!!!??
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| arlete
Intern in 2009!!!!!
Topics: 25
Posts: 1,788
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Don't say "cyanosis' or "jaundice", you'll take the risk of they asking you what you're talking about and you'll waste time explaining, plus they may think you are using too many medical jargons. I think "pallor" is OK.
Say: "let me check your fingers... they look good/normal", "let me check your neck" (move it around gently "it looks good, no stiffness here"... You have to always use layman terms and indicate you are doing an inspection. In real life, we do the inspection really quick and do not mention it to the patient, but for the test you have to anounce what you are doing to get a point for that.
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| angel23
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so how wud the SP know u r checking for rigidity
rets all i say in layman language but there are some like anemia....like i think u can say pallor for tht.....there are some where i get stuck....
like for checking rebound tenderness i tell wen fingers come back to hav to tell whether u hav pain so its understood for SP to mark on check list
but wat for rigidity how wil SP know we checked it
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| genbot
Forum Elite
Topics: 11
Posts: 490
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Hey arlette thanks for all the invaluable advice.
I'm sure u must've smiled ur way through.
Dont have a skype id yet but will get one soon.
And hey i'm genbot not 'genbolt'! Like the sound of it though.
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Step1 267/99. Step2 269/99. Match 2009. MAY THE FORCE BE WITH ME (The one they call the strong nuclear force!)
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| arlete
Intern in 2009!!!!!
Topics: 25
Posts: 1,788
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What does "genbot" mean? Or "genbolt"?
angel: Say "stiffness" instead of rigidity. "Anemia" is a well known term, but "pallor" would be better. Instead of cyanosis, you may say "purple discoloration". For rebound tenderness: "did it hurt more when I pressed or when I let it go?" but explain before doing it: "I am going to press your belly deeply and let it go really quick".
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| angel23
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thanks arlete
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| genbot
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Arlete I would tell u if I knew!
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Step1 267/99. Step2 269/99. Match 2009. MAY THE FORCE BE WITH ME (The one they call the strong nuclear force!)
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| docdoc9
Forum Senior
Topics: 17
Posts: 105
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Hi Arlette
I had acouple of questions
How do u open a phone encounter?
For a peds case to ask developmental history do we need to ask all questions lke...when did the child walk ,sit,stand,say words etc?
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| arlete
Intern in 2009!!!!!
Topics: 25
Posts: 1,788
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What about "Hello? Who am I talking to?" Always confirm the mother's last name, sometimes it's not the same as the chid, and confirm the relationship, the child's name and age. For the test, the information will be always right, but it shows you are precautious. Then introduce yourself and tell your role.
For developmental Hx, ask if the child has been going to the pediatrician in regular intervals. If yes, ask what he says about the child's development. If she says "he says it's OK", write that down. If she says she doesn't know or the child is not being evaluated regularly, then ask the basic characteristics for that age (2 or 3 milestones will do, and you describe them on the PN).
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| akm
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I'm in desperate need for advice......My exam is on May 6th and I'm just starting (I just took Step 1 on Monday)...I have 18 days to do my entire prep from start to finish......I've heard thats enough but I've got to have a clear plan in order to use the time wisely
My main question is: How do I start? I have FA and UW.....I've read the introduction to history taking and now I have a feel for what the exam is about....However I'm not sure how to seriously start....
Should I first memorize Differentials?.....and save the last 10 days for practice practice practice..?
Your advice is greatly appreciated.....Thanks
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| arlete
Intern in 2009!!!!!
Topics: 25
Posts: 1,788
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Start practicing the last cases in FA right away.
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| akm
Forum Newbie
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Thanks......I'm going to go through them today......I'm going to read up on the cases for a few days then practice cases in real time with a person for the last 14 days or so...doing about 5 cases per day....
Do you think this is a winning plan?
Thanks again for all your advice....
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| arlete
Intern in 2009!!!!!
Topics: 25
Posts: 1,788
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| akm
Forum Newbie
Topics: 5
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Thanks......I'm working on Liqor aaa + pam huggs foss .....hopefully it will become second nature soon....
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| bioguy
Forum Guru
Topics: 36
Posts: 678
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Hi Arlete, I have a question. So after History taking, you come to a set of DD. Does that DD change with the findings that are revealed in PE? In other words, it was mentioned in this thread that PE is just a formality, so that means the DD is entirely dependent upon history. Can you comment on this based on your CS experience.
thank you.
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| arlete
Intern in 2009!!!!!
Topics: 25
Posts: 1,788
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In my experience, the DD didn't change after the PE, but the order (in terms of probability) did.
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| AnneGermany
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Topics: 7
Posts: 47
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Hi Arlete,
thanks for all your advise. I will take CS by the end of July. What if I can´t find a study partner, can I practice with my husband who is not in the medical field?
How does practicing with a phone study partner work?
Thanks again and have a wonderful day!
Anne
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| SOS
Forum Elite
Topics: 16
Posts: 521
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Congratulations arlete.
thanks for this great post.my cs is coming up too and i would like you to help me with a few cases.... but let me do the basics first.. i will pm you and then we can tak according to your convinience.
congrats again.
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