theendinsight
Forum Newbie
Topics: 1
Posts: 7
|
OMG - totally freaking out. Just finished the exam today.
Totally bombed 2 CCS cases and made a big error on a third:
1- Had a pt in the office with new onset essential HTN (i think, but it was pretty high- like 170/100) and a K of like 2.5, but NO SYMPTOMS at all. Came in for routine checkup. So, without thinking I admitted him... did the whole HTN urgency work-up with nitroprusside the whole bit...but the case kept going and going... by the time i figured out i probably didn't need to admit him (just start a anti-HTN and replete K as outpt), it was too late.
2- Had a patient with acute Hep A. Again, I admitted him and worked it up as an inpt, but the case refused to end...
3- Accidently started heparin on an already hospitalized DVT pt BEFORE doing a doppler or CT and getting the results. Also, started the heparin late - did an echo, CXR, and some labs first without thinking.
I was SO mad at myself - these were like the first 3 cases and I was incredibly nervous...the rest went well and ended early.
SO, please give me your honest opinion, am I screwed? Are the above bad mistakes?? I probably did average on the MCQ (only scored a 410 on NBME and about 60% UW), so I really needed to ace the cases. =(
Thanks.
|
| mightydoc
Forum Senior
Topics: 19
Posts: 128
|
hey..........just got done with my exam today as well...............found the 2nd day mcws tougher.........ccs went okay.....but apparently so long as you dont make any major blunders in the ccs......should b fine...............besides...........there is apparently always at least 1 case which just refuses to get better !?!?!?!
anyways................g;luk to us all...........
___________________
99/92/83, 4m. US research exp., Grad. of 2003, Need Visa...........Impossible is NOTHING !!!
|
| theendinsight
Forum Newbie
Topics: 1
Posts: 7
|
i'm pretty sure it WAS a major blunder - i looked up the first case and hypertension with hypokalemia = primary hyperaldostoronism.
I put essential hypertension.
So I put the WRONG DIAGNOSIS.
Has anyone else ever done this??
|
| mightydoc
Forum Senior
Topics: 19
Posts: 128
|
dunno bout anyone else...........but from wot i know the FINAL DIAGNOSIS doesnt count for anything.................the management is the key..........i could be wrong though.............to be honest it was not the smartest thing to do................but still........admitting him wouldnt be worst mistake anyone ever made...........besides............i know of ppl who messed up upto 2 cases and got 90s scores..............so relax coz anyways nothin we can do bout it..........just pray i guess..........best of luk
___________________
99/92/83, 4m. US research exp., Grad. of 2003, Need Visa...........Impossible is NOTHING !!!
|
| Peace18
Forum Newbie
Topics: 4
Posts: 19
|
Hey, guys,
I felt the same when I was done wiht the exam. I totally screwed up on 2 cases. I even did Lavage on a stoke patient!. I felt horrible for days and could not imagine what if that was a real patient! confidence was totally destroyed.............However, I still got 99 which of course surprised me. so, basically, I wanted to tell you is that a couple failed CCS cases won't matter much. CCS only counts 30% of the test, and you have 12 cases in total. the math here is obvious. you are gonna be fine as long as you do generally OK.
good luck. peace 18
|
| theendinsight
Forum Newbie
Topics: 1
Posts: 7
|
hi peace - thanks for the words of encouragement... im so scared right now...
i think there are only 9 cases though- not 12. And it counts for like 25% i heard?
but anyway, if you got a 99 and you really did mess up 2 cases, then that gives me some hope! did you nail the MCQ though?
|
| bsmooth7
Forum Newbie
Topics: 2
Posts: 33
|
theend--
I had the same case with hypokalemia and hypertension, but it was in a young female with muscle cramps...
I wound up doing a million tests and replacing the K but did not give antihypertensives, she wound up having an adrenal tumor seen on CT and the case ended before I could get a surgery consult. They kept on telling me about the elevated BP and I didn't even treat it!
Your second case is also similar to one that I had and I didn't even admit the pt!
They kept on telling me he was having abd pain and I spazzed out and didn't give him any narcotics.
I never figured out what his diagnosis was, though I checked the Hep panels -- maybe it was autoimmune hepatitis, but I didn't give steroids or anything, I literally did nothing to treat the hepatitis or the abd pain and the case ended with this poor guy wailing in pain sitting in an outpt office with no diagnosis and no treatment.
I didn't get your third case but I did get a diabetic in ketosis and I forgot to give insulin until the 3rd time the computer told me his sugar was still 800!
I wound up scoring well above average on the CCS, anyway...
You have nothing to worry about, it seems like the average person screws up 4-5 cases on the CCS...
|
| mightydoc
Forum Senior
Topics: 19
Posts: 128
|
okay.......im startin feelin better by readin all this..............coz if ppl can mes up a bit n still get decent scores we have a decent chance...............i actually had more issues with mcqs on the second day for some reason.......time issues to be more specific.............anyways............g'luk to us all..........
___________________
99/92/83, 4m. US research exp., Grad. of 2003, Need Visa...........Impossible is NOTHING !!!
|
| Uuku7
Forum Newbie
Topics: 0
Posts: 2
|
Hi theendinsight,
Did you get your result yet, I bomed 3 of my cases with on case the pts mms pains actually got worse and I couldn't figure out what his diagnosis was.
I am really freaking out .
|
| mightydoc
Forum Senior
Topics: 19
Posts: 128
|
g'luk to all whos results are on their way...........pls pray !?!?!!??! tc all.........judgement day is very close 
___________________
99/92/83, 4m. US research exp., Grad. of 2003, Need Visa...........Impossible is NOTHING !!!
|
| doc_harry18
Forum Senior
Topics: 14
Posts: 121
|
Good luck and God bless to us. We will receive our results tomorrow.
___________________
If you set your mind to achieve a goal, then you can do it! Aiming for 2009 Match!
|
| doc_harry18
Forum Senior
Topics: 14
Posts: 121
|
I passed. Got 90 eventhough i screwed my ccs (i got higher performance). If you do good in your mcqs, u will pass. God bless.
___________________
If you set your mind to achieve a goal, then you can do it! Aiming for 2009 Match!
|
| mightydoc
Forum Senior
Topics: 19
Posts: 128
|
i got an 83........slightly annoyed but still quite happy to be done n over with the steps !?!?!? ...........
___________________
99/92/83, 4m. US research exp., Grad. of 2003, Need Visa...........Impossible is NOTHING !!!
|
| doc_harry18
Forum Senior
Topics: 14
Posts: 121
|
That is still a good score mightydoc. I think just passing step 3 is a big accomplishment. Now let's focus on the match. God bless.
___________________
If you set your mind to achieve a goal, then you can do it! Aiming for 2009 Match!
|
| theendinsight
Forum Newbie
Topics: 1
Posts: 7
|
I passed!!! thank you God! I got an 81, no where near my step 1 and 2 but who cares.
For those interested, I did Crush and all of the usmleworld once. Also did the CD a couple times and the UW CCS. Got a 410 on the practice exams.
Just wanted to pass my thoughts along in case it helps anyone:
1 - don't underestimate this test!! i took it cold the first time, thinking that i did well on the other two, and this one everyone said was supposed to be a joke. I failed by 2 points and it really freaked me out, and added 3 more months of anxiety/stress to my life while i prepared to take it again.
So, just study like you did for the other two and you WILL pass.
2 - MCQ is key. I messed up 3 of the cases this time around, but did much, much better on the MCQ bc of all the practice questions, and had a better overall score. You need to do well on both parts, but remember MCQ is worth a lot more.
3 - Practice questions are KEY. You have to get into the mindset of the test, learn to play the multiple choice guessing game. On about half of the questions, I narrowed down to 2 and then guessed. You have to do tons of questions so you are familiar with the WAY things are asked - reading alone is not enough (at least it wasnt for me).
4 - Pace yourself. This is a total endurance test. The first time around, I was SO exhausted, had not slept well the night before, and had brain fog by the time the afternoon rolled around.
Drink coffee, take B12 supplements, energy bars, etc. - whatever it is that you have to do to stay alert. It seems like a small thing, but it makes a BIG difference. Make sure you sleep ALOT the night before, and go in prepared for a marathon. Mental and psychological preparation is really important, or the test will wear you down.
Hope this helps!! Now I'm taking some well-deserved down time - BYE BYE USMLE!!
 
|
| Uuku7
Forum Newbie
Topics: 0
Posts: 2
|
Congratulatons....... to you all
|
| vanshita
Forum Guru
Topics: 26
Posts: 881
|
Congratulation
GOOD LUCK
|
| doc_harry18
Forum Senior
Topics: 14
Posts: 121
|
Congrats theendinsight! Goodbye USMLE, Hello 2009 Matching!
___________________
If you set your mind to achieve a goal, then you can do it! Aiming for 2009 Match!
|
| mdclaros
Forum Newbie
Topics: 0
Posts: 4
|
now here is a question for those who had done the test already....
I just did my step 3 last week and on the second day I finished very fast. I was out the room at 2:30 pm and all the cases ended really fast.
Has this happened to anyone here???
|
| bsmooth7
Forum Newbie
Topics: 2
Posts: 33
|
mdclaros--
No, you are the first person I have ever heard experience this, there must have been a computer error and now your test will NOT be scored.
Unfortunately, you will have to take the test AGAIN.
Just kidding, this happens all the time, no biggie.
|
| mightydoc
Forum Senior
Topics: 19
Posts: 128
|
haha .................yeah second day end earlier ...................g'luk
___________________
99/92/83, 4m. US research exp., Grad. of 2003, Need Visa...........Impossible is NOTHING !!!
|
|
| |
| | | | | | | | | | | | | | | | | | | | | |
