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 For those who failed/yet to do CS  

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My aim for doing these coaching sessions:
To be able to help many IMG as possible to clear CS, which I believe is a exam with a twist. I say T-W-I-S-t because it is so easy to pass if you prepare with the right people and it is so easy to fail also if you don't know the right approach. The KEY is to practice with people who have passed....but those who have passed often don't have the time or motivation to help those following in their footsteps....and they are not to blame as they have to take all the other USMLE steps and do well in them. As for me I have done all steps and am waiting to apply for the next match.
My story in brief:
I had done step1 and 2ck prior to 2cs.I had good scores [94/99] and lot of clinical experience in ER and Internal Medicine. Now the twist came into play, I foolishly gave the exam with 6-7 days of preparation and had done cases with people I met on the forums. I totally misjudged this exam and underestimated it. Lot of people who had worked under me in my hospital passed with 2 weeks prep and this gave me the illusion that it will be a cakewalk. It was anything but that the first time around.
After failing in my first attempt I was in a state of shock, but I managed to get out of the shock and prepared for almost 2 months....not because I was scared, but because I could not get an earlier date. In the process I joined a paid coaching session on skype and I benefited a lot from that. During these 2 months I did so many cases and read all available info/books on was almost like doing a thesis on CS.I had 14 partners all passed...most were giving the exam for the 2nd time. Many were from China, India, Peru, Nigeria and Iran and I am glad that I was able to help them with the language skills needed for this exam. And they helped me as well.
Why I failed:
I failed due to overconfidence and lack of proper practice with the right people(someone who has passed the exam).I now want that no IMG shall needlessly suffer due to these 2 reasons. I have decent English language skills and I failed the ICE -part....that is though my questioning skills were good ,my data gathering and patient note were below par.This happened because all the time I was wound up with ''mnemonics''....which work for most but did not do the trick for me.I was also having a hard time thinking of the next Q to ask the SP and so did not register all they told me.Now in retrospect I feel that failing was the logical conclusion of my haphazard prep.I say this not to scare u but to give u another viewpoint.I STILL MAINTAIN THAT MOST PEOPLE ARE BRILLIANT AND NEED ONLY 14 DAYS PREP TO ACE THIS EXAM.They don't need coaching.
After failing my cs I did an observership in a Internal medicine private practice and that also taught me the US way of dr-pt interaction.Though I maintain it is not at all necesarry to do observership to pass...but it surely helps.I will be able to use all my experience to help you pass with confidence.CS is a confidence thing.
How this works:
I do sessions on skype, which starts with a lecture for few hours, then one of the candidate acts as doctor and I act a patient, I give my inputs so that everyone in the group can listen and benefit. I try to do one to one practice but that may not always be feasible and the max no. of students in a class can be 4.I analyse the weakness and strengths and give tips accordingly.
All those interested in joining my sessions can leave their ID here or mail me [email protected]
{dr underscore puma}
My skype ID is: dr_puma_cs_coach
Be sure to mention your exam date and time zone.


For a free session Join me on skype.Please send in your skype request with a brief note about the dates of your exam.

my skype id is :dr_puma_cs_coach



CC=Abdomen pain x 2 weeks,

HPI=48, yo, f, has upper mid-abdomen pain, getting worse, burning type, non radiating, relieved by milk+antacids,aggravated by-fatty ,heavy meals. Intensity=7/10,can go down to 0/10.Has nausea, vomited once yesterday-yellow,sour,non bloody.

ROS=[-]fever,headache,chest pains, irregular heartbeats, joint pains. Bladder/bowel=no problems

PMH=RA=on brufen, OTC multivitamins

PSH=2 c-sec


FH=Father=pancreatic cancer

SH=monogamous, married,[-]cig,ETOH,Recreational drugs

LMP=1 week ago, regular, 30 day cycle



VS=NL, not in acute distress

Gen=[-]paolor,icterus,clubbing,rash,palmer erythema,flapping tremor

Abdo=scaphoid, scar+, soft, BS+, No organomegaly/tenderness/rigidity, resonant=all quads

Chest=B/L clear

Heart=RRR, PMI=not displaced, [-] m/r/gallop




Peptic ulcer


Functional dyspepsia


UGI endoscopy

barium meal



HIDA sca

CT abdomen


Edited by dr_puma on May 30, 2010 - 7:28 PM

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