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 CS tips and tricks 4 beginners  



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  #1

Hi my forum fellows!

I gave CS a few months back and passed, Alhamdolillah...... in Houston! Since then I helped my class fellows and other colleagues practice for the CS.

There are stunning guielines and experiences in this forum, plz review those; however, I will share some stellar stuff that should your form your CS prep material.

Dr Hasan Arif a Dow graduate gave this to us. Forms a good prep skeleton:

INFO on the CS exam

CS EXAM :
12 cases
Scoring on 10 + 2 ( experimental cases )
Each case
Time breakup:
15 min for Pt encounter INCLUDING Door time .
10 Min for NOTE

NOW all have read at least U word
And some have done the First aid as well
LISTEN TO THE LECTURES :
AND PLEASE PRACTICE

The cases are very OPEN ENDED as all of you have seen
Meaning the differentials are too many and your provisional could be any thing

A) IN THE EXAM the
The cases will be close ended
I.E: Consider the case of a 55 yo wm with co of CP

Looking at this your door diffs are :
1. MI
2. Angina
3. Aortic dissection
4. GERD
5. Pneumonia

Seems like a good list

The case will be a classical text book case

Your questions and the patients responses will take you comfortably to one of these 5 cases
I.e: If its GERD , its gonna be a classical case of GERD, If its MI is a classical case of MI

So your Hx should be targeted

B) Like in U world and first aid , almost all patients require councilling pertaining to SOMKING , SAFE SEX and or ALCOHOLISM .

That will be not the case in the EXAM

1 or 2 of your 12 cases may have ONLY ONE of these concerns .



For the Pt encounter :

This is how the exam goes

You will each be assigned a ROOM NUMBER . EITHER 1-12 or 13-24 ( either way 12 cases ) which you will roytate bw
NOTE if some one has room 12 , after finishing it he goes to room 1 then 2 ,3,4 …and so on

You will also be provided 12 BLUE sheets for jotting down notes
The template for the Hx is on the FORUM :
One BLUE sheet for 1 case
YOU CANNOT PREWRITE ON THEM
YOU CAN ONLY WRITE AFTER The OVER HEAD ANNOUNCEMENT “ EXAMINEES START ENCOUNTER”.
EACH Blue sheet for one pt encounter will be taken from you after you have written the PT NOTE .

There will be an over head announcement
“ SP’s get ready “. You will be standing in front of the door but will not be allowed to look at the DOOR info

The next announcement will be “Examinees get ready “

The next one will be “ EXAMINEES start Encounter “

That’s when you will be allowed to look at the DOOR INFO .

WRITE the PTs name on the top of the BLUE SHEET
It will help you while taking the pTs hx as you will have to address him / her by their name
Also write the PRESENTING COMPLAINT

Write OPD , LIQORAAA , WAS , PAMHUGSFOSS before going in

IT should take you no more that 30 secs to do this

NEXT :
KNOCK LOUDLY .
DO NOT ,,,,,,,, DO NOT wait for a response from in side before going in

Open the DOOOR
BIG … SMILE
GREET the Patient , Hi Mr/Ms. ……………. My name is Dr. …………. .
SHAKE hand
NOTE : you will come across a NEURO PT which will have Rt. Sided Paralysis . DO NOT SHAKE HAND .

DRAPE THE PATIENT .
Tell them that you are doing this as the room is chilly and it will make them more comfortable

SIT DOWN on the stool .
Let them know that you’ll be taking down notes

Start Hx : as in

AGAIN like stated : it will be a targeted Hx ; 8 mins TOTAL for Hx and EXAM

Try not to repeat your questions

Once Hx is done :
Tell tha patient that you need to examine him/her
Wash YOUR HANDS, Show them that your washing your hands , TAKE YOUR TIME .
Continue to talk to the Patient while washing hands , LIKE
“ So what do you do for a living ? “
Make EYE CONTACT as much as possible

No Exam :
VERBALLY TELL THAM WHAT YOUR GOING TO DO
HEAT YOUR HANDS BEFORE TOUCHING
RUNNIG COMMENATRY HELPS

Spend more time on the relevant system , the rest just use your steth for AUSCULTATE .

There WILL BE AN ANNOUNCEMENT FOR when you have 5 MIN LEFT .

THIS IS YOUR QUEUE to Start with the SUMMARY and COUNCILLING .

TRUST ME IT WILL TAKE YOU 5 Min for that .

Once finished ……… ASK IF THE PT HAS ANY CONCERNS …………………

Then the ANNOUNCEMENT :
PT ENCOUNTER IS OVER
You will have 10 secs to get out of the room .
OR THE EXAM PROCTER WILL COME IN TO GET YOU


Patient NOTE :
You will have 10 min for the NOTE ;

LIKE I STATED EARLIER , you will get typical cases . Your PT NOTE SHOULD REFLECT YOUR PROVISIONAL DX….
And obviously since your Hx has ruled out the rest , those will be your Differential s,
You do not need 5 just bc you have to fill up the space
JUST PUT DOWN THOSE YOU HAVE RULED OUT

LABS , INVESTIGATIONS
Should be in order .
Simple to test of choice .

Outstanding resource: http://csprotocol.blogspot.com/

Other than that, i am attaching Neeraj Notes and Nanaki's USMLE sheet.

Add FA to all this and you are all set to go!

And oh the most important secret for CS prep is Practice (self/mirror) Practice (skype/phone) Practice (live partner) and more Practice (live partner).

I found that some folks who are good in their studies are a bit arrogant. Plz remember, during CS, and in real life, our patients are everything to us. So being nice (meaning polite), helps save onself from failing.


All the best!


Attached Files:
Neeraj_s_CS_Notes.pdf (96 KB, 211 downloads)
USMLE_and_matching_for_IMGs.doc (64 KB, 237 downloads)



  #2

Hey dowjunk, great post. Really puts things into perspective.

Got to ask you however, how legit is it that only 10 out 12 cases are graded? I mean is this a commonly known thing or something that is assumed?

Thank you!


On Aug 20, 2010 - 5:42 AM, dowjunk responded:
i guess usmle.org website might answer ur query very well! I believe that they do have experimental cases. GL





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