doc_harry18
Forum Junior
Topics: 13
Posts: 64
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Hi all, I have been a silent reader in this forum for a long time now. I intend to keep my silence until I receive my CS result. Now I want to return the favor to all those who made my journey a fruitful one by posting my exam experience. Here it goes...
I took my CS last March 20 in Houston. I reviewed for one month using FA (mostly) and UW (some cases there). And of course, the ultimate reviewer of all-time..CSPROTOCOL.BLOGSPOT.COM. I used most of the dialogues there and it worked for me. I devoted the first 2 weeks of my review by reading and digesting everything what's in FA. I didn't memorize though the counselling dialogues. I just read them and study them by heart coz I believe if you memorize there is the tendency to forget things because of anxiety during the actual exam, but if you did study it's content and meaning you have the knowledge to paraphrase it on your own, that's what I did. The next 2 weeks of my review I devoted to practice..practice and more practice. I had 2 yahoo/skype practice partners, one for FA and 1 for UW but most of the time, I practice using FA. I thank my practice buddies who were very much willing to practice with me from morning til evening. We were able to revised FA 3x, we took turns on each case. By practicing, we were able to muster everything that is written in the checklist. After each case, we discussed positive and negative points during the encounter, the mistakes made and things that should be improved. Then 2 days before my exam, i practiced writing the patient's note. I timed myself using the FA px's note provided on the book. I believed one should practice on both aspect, the encounter itself and writing the px's note coz both are essential in this exam.
So my exam day arrived. I stayed in Days Inn hotel near the center and went to the center at around 7:30 am. There were lots of IMG's in the center, mostly indians. some AMG's. I was the only Filipino IMG there so I felt a little intimidated. I wasn't that nervous during the exam day. I kept myself cool and talked to some of the examinees there. That relieved some of the tension building inside me. The exam started with the usual checking of the permtis and IDs and orientation. The exam actually started at aroung 9:30-10, i'm not sure coz I lost track of time, coz watches are not allowed. The procters were friendly and the food was great, though I lost my appetite the entire day.
The cases on my exam were very simple. Don't expect very hard cases because CS exam tests our ability to diagnose common cases encountered by a GP. Expect a lot of coughs, pain ( all kinds of pain-chest pain,abdominal pain, low back pain, arm pain), menopause, insomnia, px with sickle cell crisis, 1 pedia case (encounter with the mom) with DOB. Luckily i didnt have any neuro case, hehe. During your first encounter, I advise that you take a deep, deep breath before starting. That will relieved the anxiety and tension. But once you get started, you'll find yourself speaking with the SP spontaneuosly. I myself was surprised that words just came out of my mouth hahaha. Once the announcement "Examinees you may now begin your px encounter", write down the Px's name on ur paper, then the CC and the pertinent VS. Then write the mnemonics PAM HUGS FOSS SODA so you wont be able to miss anything. I tried to write some DDx but that took me some time to think. Don't forget to knock 3x, greet the px with a smile (though I didn't remember that I was smiling when entering the room all the time), introduce yourself and address the SP by his/her name. Then ask only the pertinent questions in the CC coz you dont have the time to ask everything, then move on to the rest of the mnemonics. Ask the SP if its ok to write down notes, i think that showed courtesy and respect to them. Then before moving to PE, ask if there is anything you missed to ask or anything that teh SP wants to say (one SP did ask me her challenging question the moment I ask that..keep your cool and answer as honestly and confidently as you can) Then move to hand washing ( I talked to all SPs while doing the handwashing-I asked them their occupation or asked them how's life been latey.That builds rapport between you and the px.) I suggest that you turn off the faucet using the tissue you used for wiping your hands, hehehe. Then during PE, start first with the pertinent ones, just focused exam. Don't forget to ask permission to SP evrything that you're about to do. One SP with chest pain asked me why am I doing the auscultation of the heart and lungs, carotid bruit, JVP. Don't ignore the SP, don't proceed right away, answer each query with a soft voice and you will see the smile on their faces and they will let you do the exam. Always assist the SP when lying down or getting up, tieing/untieing the gown, and don't forget to pull the leg extension when doing the adbominal exam or everytime the SP lies down. Say sorry when you elicit pain and dont repeat them. When doing abdominal exam in an SP with abdominal pain just palpate very lightly even when doing deep palpation coz so wll elicit pain no matter how soft you palpate the belly. Once you are done with the PE say thank you for each and every maneuver you did. Then came the closure part. You have the option to summarize important details in the HX and PE ( but what I did, I just told them this "Based on what you have told me and your Physical examination...I think this is enough and consider as if you are summarizing). After finishing off with the closure always ask the SP if they have any other questions and if they understood everything you have discussed. Then say you meet up again when the results came and discuss her dx and further managment. Then shake hands with the SP with a smile then say thank you. I finish all the encounter before the time is up.
Then I wrote the Px notes. I started by writing the DDX and Work ups then proceeded with the Hx. There wasnt enough space so maximize the space provided. Follow the format in writing the PX note in FA. I had some erasures and my px note looked crowded but as long as it is legible I think you dont have to worry. In the PE section write only the pertinent PE that you did. I forgot some maneuvers and I think its ok to write some things that you missed but I advice that you be honest in this. So practice writing px note coz it counts on your total score.
I guess I had written so much about my experience. I want to thank God almighty for this wonderful journey. Looking back, i made a lot of mistakes, forgot things that shouldve been done and mess up with my Px note. But i think the important thing here is that you should be courteous and respectful with all the SPs. They look more on how we communicate with them and establish rapport with them. If I pass this exam, I know that everyone will pass too. It is normal to feel anxious after the exam and I tell you, waiting for the result is much harder than the exam itself, coz you never know how the SPs will grade us. Just always pray and put your Trust in the Lord. Don't be too confident if you think you did good. Nothing is impossible with God. Prayers do move mountains. God bless and Good luck to future CS takers.
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If you set your mind to achieve a goal, then you can do it! Aiming for 2009 Match!
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| anujaise
Forum Newbie
Topics: 6
Posts: 28
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Congrats doc_harry18.Wish you all success for Match2009
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| hitesh
Forum Senior
Topics: 42
Posts: 160
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Congratulations! and thank you for sharing your experience.. 
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| godfather1212m
Forum Senior
Topics: 16
Posts: 72
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HI DOC HARRY,
congratulations for passing i see that you really worked hard for it. I have a aquick question please. is the paper they provide you in the exam of the same size of that in FA? I tried to practice using that same one in FA but everytime i ran out of space. my exam is next week and i am kinda freakin about that.
thank you
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WHAT ONE MAN CAN DO ANOTHER CAN DO
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| hitesh
Forum Senior
Topics: 42
Posts: 160
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hey godfather, I havent yet taken the exam, but I think the space available on the exam is not a lot different from that in FA. But, what i try to do is, I practice on the sample sheet provided on the USMLE website. Just print out page no-15 (appendix A) of 2008 USMLE Step 2 CS Content Description and General Information Booklet. I guess, that's the sheet they provide you with on the real exam.
Harry or someone else who's taken the exam already, please correct me if I am wrong.
Good Luck!
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| doc_harry18
Forum Junior
Topics: 13
Posts: 64
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The patient note provided on the actual exam is pretty much the same as that in FA except that in the actual sheet, there is ur ID number written on it at the top, along with some other info. I didnt use the sample px note in the usmle website and have no idea how it looks like. I suggest that you dont write too big for the space is really, really not enough. Nevertheless, you should write the complete hx with the ROS, ALL, etc in the space provided coz they check for its completeness. Practice, practice and practice. God bless on your exam. I know that you will be fine. Just be cool on the exam day. Good luck!
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If you set your mind to achieve a goal, then you can do it! Aiming for 2009 Match!
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| godfather1212m
Forum Senior
Topics: 16
Posts: 72
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thank you Harry and Hitesh. you were great help. i am trying to write small these days.
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WHAT ONE MAN CAN DO ANOTHER CAN DO
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