COMLEX COMLEX Level II PE 2017

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
RockDoc28

RockDoc28

Full Member
10+ Year Member
Joined
Feb 13, 2013
Messages
130
Reaction score
7
Hi everyone!

I couldn't find a thread about the 2017 COMLEX Level II PE so I thought I'd start one-- please comment a link to an official thread if one exists already.

I am starting to study for it and wanted to hear more about how the day went, what you used to study, etc. For confidentiality/ not getting kicked out of future COMLEX test reasons, some topics I'm looking for include:
  • Did you feel rushed during the testing, or did you have enough time?
  • What resources did you use to prepare and did you feel like they did a good job?
  • Any tips on writing notes you picked up along the way that you feel helped you save time?
  • Any technical difficulties on test day?
  • Where did you stay/ travel tips.
A list of topics to AVOID include:
  • Any detail about a patient case you saw on test day
  • Any detail about a patient case your friend saw on test day
  • OMT techniques you used on test day
Just to give a little more warning (even though I know you're all very good at not revealing improper info), here's the statement from the NBOME.

Alright, let's get this thing started!
Members don't see this ad.
 
Sort by date Sort by votes
Members don't see this ad :)
Hey I'm new here and stumbled upon this thread. I'm currently looking for advice. I just found out I didn't pass my PE and I'm perplexed as to why I didn't pass. Apparently my SOAP note and data gathering wasn't good enough. I made an example on how I was doing my soap notes up to my test date in March. I also thought I treated everyone with respect and asked all the necessary questions but I guess it wasn't enough. I'm really disappointed right now and I need advice. I looked at all the cases from the Kauffman COMBANK and typed like 10 SOAP notes a day. I'm not the fastest typer and I always run out of time when I type these notes but I make sure I add the important stuff on my SOAP note. For the Plan, I usually list the tests I would do for the patient and always relate them to my assessment but never explain what they are for.
 

Attachments

  • SOAP note.pdf
    104.2 KB · Views: 221
Upvote 0 Downvote
So question about performing OMM:

Let's say for example we need to do sacral OMM since the patient has some sort of sciatica or sacral pain. Would we need to diagnose the patient with a sacral somatic dysfunction DURING the physical exam, or do we say "hey, you have a sore sacrum, I can help you with that." Then, lay them down and diagnose something, then treat, then reassess.

This goes for any complaint. If they have neck pain, when do we diagnose a SD? Also, do we list a SD under OMM in the O section of the note or under MSK? If we perform OMM, do we also have to list "sacral somatic dysfunction" in the assessment portion?

Just confused as to the logistics of this...
 
Upvote 0 Downvote
drkube said:
the OAP portions of the SOAP note look fine to me. It looks like the S portion is missing surgical history and current meds, but looks OK otherwise
p
Click to expand...
I would also say an in-depth sexual history is important here for social history. I still don't understand exactly the logistics of the Assessment. For example, in the FA CS book for this case, they list molar and ectopic pregnancy as a ddx. However, Kauffman states that you must have some reason to think that in your history and physical. This patient has no signs of molar or ectopic in her history, physical, or labs.
 
Upvote 0 Downvote
Anyone good at OMM documentation?

Ex: Objective findings ->il have a section for OSE -> T4 Flexed rotated right sidebent right // Assessment => somatic dysfunction of the thoracic spine? // Plan => Treated with muscle energy.
Or
Objective findings -> HEENT -> sinus tender to palpation // Assessment -> sinusitis // Plan => Sinus pain treated with OMM (lymphatic effleurage) after pt consent blahblah.

Is that correct? And I don't think you are supposed to do OMM on everyone nor a quick screen. Just the ones that are obvious about it? Or should I do a quick spine screen for like lung problems and say facilitation at T3-T6 or something on OSE objective findings and not say anything about it in assessment/plan?

Sorry guys, but mine is next week and im so confused for the OMM portion.
 
Upvote 0 Downvote
SynapticDoctah said:
So question about performing OMM:

Let's say for example we need to do sacral OMM since the patient has some sort of sciatica or sacral pain. Would we need to diagnose the patient with a sacral somatic dysfunction DURING the physical exam, or do we say "hey, you have a sore sacrum, I can help you with that." Then, lay them down and diagnose something, then treat, then reassess.

This goes for any complaint. If they have neck pain, when do we diagnose a SD? Also, do we list a SD under OMM in the O section of the note or under MSK? If we perform OMM, do we also have to list "sacral somatic dysfunction" in the assessment portion?

Just confused as to the logistics of this...
Click to expand...

From what I know, if you think its OMM appropriate case ->OMM screen during physical exam. Then when you sit the patient down to talk about your assessment and plan, you talk to them about how OMM works then ask if they would like to be treated. Treat them while talking about the allopathic assessment and plan. Can anyone confirm? Cause that's my take on it right now. Yes, I think if we do perform OMM, you list it as sacral somatic dysfunction then in the plan you wrote what you did. This is my understanding though, i need more people to confirm :\
 
Upvote 0 Downvote
So I have been thinking about this a lot because I was also spazzing out on it (and my exam is Tuesday) and I think my plan is this: (using knee pain as an example)

Start a physical exam and perform heart and lung sounds, then I would move to the knee and do AROM/PROM and the knee-specific tests (Lachman, McMurray, varus/valgus). Then, I would say something like, "I noticed that you have what we can a posterior fibular head. I would like to talk to you about what we can do for your knee pain, but there is something I can do right now that may help alleviate some of your pain. Would you like to try that?"

They would, of course, say yes. Then, I would perform the muscle energy right then. After that was done I will sit back down and go over the plan.

The reason for this, in my mind, is that if I sit back down, I will either forget to do OMM, or it will be awkward having them get back into position for diagnosis/treatment of the SD.

Just my thoughts. Comments would be helpful.
 
  • Like
Reactions: 1 user
Upvote 0 Downvote
How would you document it? Objectives = OSE -> posterior fibular head. Assessment = somatic dysfunction of LE. Plan = treated with muscle energy? And I always introduce myself as full name -> 3rd year medical student
 
Upvote 0 Downvote
Members don't see this ad :)
Can someone post a sample soap note with OSE structural findings (like no T2-T8 spinal facillitation). I'm pretty confused on normal findings for a simple screen.
 
Upvote 0 Downvote
Like if your doing lower extremity, you wouldnt palpate spine and put no spinal facilitation? So it would just be (under objectives) OSE = posterior fibular head? Am i thinking too much? Lol im terrified of this exam
 
Upvote 0 Downvote
blah2468 said:
Like if your doing lower extremity, you wouldnt palpate spine and put no spinal facilitation? So it would just be (under objectives) OSE = posterior fibular head? Am i thinking too much? Lol im terrified of this exam
Click to expand...

No. If it was a knee problem I would do heart, lungs, and then do a knee exam with my posterior fibular head documented under OSE in the physical exam area.

You don’t need to do spine evals on everyone. Problem specific.
 
Upvote 0 Downvote
Also is posterior fibular head indicated for knee pain and ankle pain? Like it could cause both right? I'm omm deficient lol.
 
Upvote 0 Downvote
Took and passed the test recently on first try. Used Kauffman book and videos as well as going over cases with practice partners. OMM I looked up every system that could be tested and got good at a technique but not really basic ones like only knowing counterstrain because that gets you few points.

My advice is to practice with a partner and try to get down your OMM. Use techniques like muscle energy but not long complicated ones like Spencer’s. Furthermore, ppl said the cases were vague on purpose, imo they all had a correct best diagnosis. PM if you want more help.
 
Upvote 0 Downvote
SynapticDoctah said:
Does anyone still have access to Kauffman vids? Wanted to see if it’s worth buying?
Click to expand...

I didn't have many people to practice with (weird time in the year, also I took it somewhat early compared to my peers so it was hard to get a classmate to practice with, and my family lived 1500 miles away). These videos were spot on for me. I needed them, because I basically would put myself in his shoes (or try to) and do the encounter.

I helped someone in the year below me study, and he watched one video and was like no thanks because he had someone (me) to actually do the cases with. its much better to do the cases and have someone tell you what you did wrong than to passively watch the videos. But as I said, I didn't have anyone to really work with, so the videos were perfect for me. My school is also pretty stringent on our practice SP's, so I had a general sense of what to do not to do, but the videos definitely brought some clarity.
 
Upvote 0 Downvote
I do have a question about documentation/diagnosis.

Let’s say someone comes in with lower back pain. We do range of motion, straight leg test, muscle strength, and then can we just palpate the muscles and say “your muscles seem pretty tight, we will talk about what I think it going on but before we do that there is something I can try that may make you feel better”

Then do soft tissue to lower back.

Do I have to make a diagnosis like Rotated right blah blah or can I just say your muscles are tight?

Also, would I document “tenderness to palpation” under MSK or OSE in the physical exam?

For assessment, lumbar somatic dysfunction?

Plan: soft tissue to the lumbar muscles
 
Upvote 0 Downvote
SynapticDoctah said:
I do have a question about documentation/diagnosis.

Let’s say someone comes in with lower back pain. We do range of motion, straight leg test, muscle strength, and then can we just palpate the muscles and say “your muscles seem pretty tight, we will talk about what I think it going on but before we do that there is something I can try that may make you feel better”

Then do soft tissue to lower back.

Do I have to make a diagnosis like Rotated right blah blah or can I just say your muscles are tight?

Also, would I document “tenderness to palpation” under MSK or OSE in the physical exam?

For assessment, lumbar somatic dysfunction?

Plan: soft tissue to the lumbar muscles
Click to expand...

So for this you obviously are doing the right things but before you even start moving them look at the area where they are in pain because visualization is the first part of the exam. Afterwards you do the proper range of motion and special tests. The actors will make it obvious that they want OMM so your response about doing something on their whatever is appropriate. You should always verbalize when doing OMM at least thats what I did just to make sure the proctor reviewing the video knows you're not just making stuff up.

No need to put in the OMM diagnosis (ie. L3-4RRSR) except in the OMM section in the objective portion, I had a separate OMM and musculoskeletal objective but honestly you can do what you want, just make sure its in there somewhere.

For the assessment I would put down lumbar paraspinal muscle strain, spinal stenosis, lumbar disc herniation, lumbar somatic dysfunction and whatever secondary diagnosis you can think of that he presents with ie. diabetes. Just make sure you have at minimum 3 ddx for the points, past that you get more points if you can come up with reasonable differentials. If you start making up weird nonsense differentials like spinal abscess in a non IVDU with no recent infection and no spinal back pain at night, then you'll get docked points.
 
Upvote 0 Downvote
Pretty sure I just failed the PE. That was the worst experience I’ve ever had. Was planning on applying ortho, but now not so sure after that. Really sucks.

How does rescheduling work? Can I schedule now just in case I do fail so that I can retake as early as possible so my scores are in before interviews?
 
Last edited:
  • Like
Reactions: 1 user
Upvote 0 Downvote
Also I didn’t re drape patients after examining their heart. It wasn’t until after listening to lungs when I realized and quickly draped them again. Is it over for me
 
Last edited:
Upvote 0 Downvote
tqtraq said:
I didn’t shake hands with a lot of the patients in the beginning. Also I didn’t re drape the front of some male patients after examining their heart. It wasn’t until after listening to lungs when I realized and quickly draped them again. Is it over for me
Click to expand...

I’ll take your day over mine anyday
 
Upvote 0 Downvote
I took this exam a week ago and each day that goes by, I remember stuff that I didn't do or did wrong sigh..
  1. Physical exams consisted of 4 heart lung sounds, 6-8 lung sounds, and usually 1 other pertinent system. Worried that my P.E was too simple. Rarely did special tests except for abdominal complaints
  2. Forgot to reassess OMM once, but stated in soap note I'd go back and do it
  3. Patient got mad because I forgot to re-sanitize my hands after contaminating my hands during 1 physical exam portion :(..
  4. 1-2 differentials were probably off with plans that aren't correct
  5. Review of systems was really ****ty.. like I just asked fever, night sweats, chest pain, shortness of breath. I think I forgot to ask this in a couple encounters and forgot to document as well. Other than that my soap notes were completed fully.
  6. As i was helping the patient back up from the table, i accidentally hit her breast area with my pen. I barely noticed but now that I think about it its giving me nightmares. I dont think I even apologized :(
Things I always did -> introduced myself, washed hands before shaking patients hand, OLDCAAARTS SMASH FM (fed tacos modified), P.E, and always counseled patient on smoking, drug use, etc. Gave a plan for the patient at the end. Any opinion would be greatly appreciated :( I hope I didn't break any rules. Anxiety through the roof.
 
Upvote 0 Downvote
So here is the summary of my exam that I took a few days ago:


-Forgot to reassess on one OMM after doing ME(most of the time I just asked if it felt better and they would say it did
-did the exact opposite movement for OMM that I was supposed to on one case. For example, if they were rotated a certain way, I rotated them the wrong way for muscle energy.
-was so rushed on most of the cases I didn’t have time to sit and close with the patient how I would have liked to. Most was just ok I think this is what’s going on, id like to change this med and order this test and follow up/admit to hospital. I had the plan to go over MOTHRR like in Kauffman, but rarely had time to go through that due to timing.
-physical exams were crap IMO. Didn’t have any abnormal findings. Not sure if that’s because I was doing the wrong exams or if that’s just the way it was. Was so rushed I couldn’t think through which would be the best test to do. Didnt look in anyones ears. Just no cases that I felt needed it.
-forgot to document a ton of physical exam stuff I did (for example PMi of heart or thyroid palpating)
-didn’t get 3 ddx for most cases( but added tobacco use disorder or obesity, or fx of diabetes or something to make the list longer)
-wasn’t able to counsel on smoking on every case where the patient smoked
-left out stuff on plan that was easy to get. Just blanked.
- completely rushed the entire time and my humanism lines that I was gonna drop were pushed to wayside and didn’t realize it till
After exam

Stuff I did do:

-Shook hands of all patients and asked how they would like to be addressed
-performed OMM on 4 cases when asked (deferred one due to the nature of the injury and felt it shouldnt be done)
-washed hands before starting.
-asked to tie/untie gown/place steth on skin or do abdominal Exams
-draped whenever i did abdominal exam
-listened to heart/lungs on skin on every patient
-whenever someone said someone died I said I was sorry and it was hard to loose a parent
-tried to be empathetic when they asked challenge questions
-felt like I got a thorough hx (which is the reason I was running out of time.)
-completed all notes with something in every box.


Idk. I just feel absolutely horrible. I went into this exam after studying for over a week, watching Kauffman videos, reading the book, reading FA CE and even meeting with a faculty member to go over four cases a few days before the exam. I put my STEP/LEVEL 2 exams on hold to prepare for this and feel it was an absolute waste of time.

I just feel like the timing really screwed me. Probably 9/12 cases I was in the middle of physical exam or OMM and the two min warning was announced. I was so stressed i always forgot the little empathy things like asking if the plan worked for the patient. I was so stressed I’d sit down to type the note staring at the assessment and plan. Idk what happened. I know my stuff, but literally the easy things were blanking me.

I’m just so mad at myself. I felt like I ruined everything I’ve worked for the last 3 years.
 
Last edited:
Upvote 0 Downvote
crazyboi1993 said:
I took my PE in March, in PA, walked out thinking it was actually very fair, and tbh some parts were kind of easy. That worried me, because I though I might have failed, or something, bc the stories I hear, was not what I had happened. Everything was straight forward. Luckily I only had to wait 3.5 weeks for the score, and passed. It is very straight forward, and just treat it like a normal patient interaction.

Some tips:
- Watch Kauffman videos, read the book, and his soap notes. This helped out a lot
- Dr. Weston's videos are really good for counseling stuff, because I had stuff asked about it.
- I suggest counseling patients during when your asking social history, so it flows better, and you don't forget when discussing plan. Dr. Weston does an excellent job with this, and TBH made the encounter really well.
- Discuss plan while doing OMM technique, so you don't run out to do it I only did 3 OMM , and they were very basic af, that worried me too. You will know when its indicated
- Hand sanitize once you get in the room, before you start the exam, drape everyone, do physical. (Whenever u touch feet, re handsantize). Help with each positional change, laying them down, and putting them back okay. Ask permission to undo gown. Ask if they are comfortable, or ask them if this is okay. Say sorry my stethoscopes cold, always sympathize with them on everything (someone died, or they are stressed about something). Always smile, and make good eye contact. Exaggerate and show emotion. When you leave, make sure they understand the plan/assesment, thank them for coming in today, ask if they have any questions, ask if they need a note or excused letter, or if you need to contact someone or tell a significant other whats going on. hand sanitize when you leave the room
-PAY ATTENTION to your setting. If your in a ER, don't say, well Im gonna call an ambulance, etc. If they are an ER, you are gonna CONSULT GI or Surgery, if in Outpatient, its refferal
- Practice soap notes. I am very fast typer, and barely finished each time. I worked backwards, did A/P first, then Objective, and Subjective. Save vitals for last they are so annoying to do. I finished all my soap notes with like legit 5-10 seconds left. If I forgot to do anything, I mentioned in Plan, will do next visit- did not address it this visit (I had patients w/ high BP, like many but didn't even mention it to them, but mentioned in my plan, will recheck on next visit)
- Do Focused PHYSICAL. Always do HEART and LUNGS on SKIN, and one additional pertinent body system. DO RECHECK BP its a waste of time.
- Dont freak out. Those 8 hours felt like 8 minutes. I actually thought it was pretty easy, and did not run out of time on any case. If you hear the 2 minute bell, immediately stop, and go to your closing, if your doing OMM, talk about it while doojng it.

Relax, and don't let the "I think I failed" stories on SDN get to you. Be confident in yourself!
Click to expand...


I saw this and looks like you have a firm gasp on how to take this exam, any tips? My retake is in 2.5 weeks and I really want to pass this thing to move on with my life!
 
Upvote 0 Downvote
Nonam22 said:
Why did they fail you the first time?
Click to expand...
They said my data gathering and soap note was low performance. I'll admit I paused on a few of my patients because I ran out of questions to ask and i'm prone to stuttering at times but I felt my physical exams were perfect and was respectful to all my patients. I heard stories of others doing worse and still passed. It's frustrating that I don't know what they want.
 
Upvote 0 Downvote
Buckets25 said:
They said my data gathering and soap note was low performance. I'll admit I paused on a few of my patients because I ran out of questions to ask and i'm prone to stuttering at times but I felt my physical exams were perfect and was respectful to all my patients. I heard stories of others doing worse and still passed. It's frustrating that I don't know what they want.
Click to expand...

What do you mean “they said?” Did you talk to someone at NBOME?
 
Upvote 0 Downvote
SynapticDoctah said:
So here is the summary of my exam that I took a few days ago:


-Forgot to reassess on one OMM after doing ME(most of the time I just asked if it felt better and they would say it did
-did the exact opposite movement for OMM that I was supposed to on one case. For example, if they were rotated a certain way, I rotated them the wrong way for muscle energy.
-was so rushed on most of the cases I didn’t have time to sit and close with the patient how I would have liked to. Most was just ok I think this is what’s going on, id like to change this med and order this test and follow up/admit to hospital. I had the plan to go over MOTHRR like in Kauffman, but rarely had time to go through that due to timing.
-physical exams were crap IMO. Didn’t have any abnormal findings. Not sure if that’s because I was doing the wrong exams or if that’s just the way it was. Was so rushed I couldn’t think through which would be the best test to do. Didnt look in anyones ears. Just no cases that I felt needed it.
-forgot to document a ton of physical exam stuff I did (for example PMi of heart or thyroid palpating)
-didn’t get 3 ddx for most cases( but added tobacco use disorder or obesity, or fx of diabetes or something to make the list longer)
-wasn’t able to counsel on smoking on every case where the patient smoked
-left out stuff on plan that was easy to get. Just blanked.
- completely rushed the entire time and my humanism lines that I was gonna drop were pushed to wayside and didn’t realize it till
After exam

Stuff I did do:

-Shook hands of all patients and asked how they would like to be addressed
-performed OMM on 4 cases when asked (deferred one due to the nature of the injury and felt it shouldnt be done)
-washed hands before starting.
-asked to tie/untie gown/place steth on skin or do abdominal Exams
-draped whenever i did abdominal exam
-listened to heart/lungs on skin on every patient
-whenever someone said someone died I said I was sorry and it was hard to loose a parent
-tried to be empathetic when they asked challenge questions
-felt like I got a thorough hx (which is the reason I was running out of time.)
-completed all notes with something in every box.


Idk. I just feel absolutely horrible. I went into this exam after studying for over a week, watching Kauffman videos, reading the book, reading FA CE and even meeting with a faculty member to go over four cases a few days before the exam. I put my STEP/LEVEL 2 exams on hold to prepare for this and feel it was an absolute waste of time.

I just feel like the timing really screwed me. Probably 9/12 cases I was in the middle of physical exam or OMM and the two min warning was announced. I was so stressed i always forgot the little empathy things like asking if the plan worked for the patient. I was so stressed I’d sit down to type the note staring at the assessment and plan. Idk what happened. I know my stuff, but literally the easy things were blanking me.

I’m just so mad at myself. I felt like I ruined everything I’ve worked for the last 3 years.
Click to expand...

Fwiw - i took mine in February. I never counseled anyone on smoking, never reassessed on OMM, had questionable humanism at times and forgot to document entire PE systems in my notes. I passed. You probably will too. everyone feels like utter garbage afterward.
 
  • Like
Reactions: 1 users
Upvote 0 Downvote
tunicaexterna said:
Fwiw - i took mine in February. I never counseled anyone on smoking, never reassessed on OMM, had questionable humanism at times and forgot to document entire PE systems in my notes. I passed. You probably will too. everyone feels like utter garbage afterward.
Click to expand...
That makes me feel a little better. I just wish my brain would have been somewhat working for the assessment/plan sections. Those are literally one of the easiest parts and my mind was blanking...idk why.
 
  • Like
Reactions: 1 user
Upvote 0 Downvote
SynapticDoctah said:
That makes me feel a little better. I just wish my brain would have been somewhat working for the assessment/plan sections. Those are literally one of the easiest parts and my mind was blanking...idk why.
Click to expand...

I hope we both pass. It's going to be a rough 2 months. I'm feeling more and more horrible as each day passes :(
 
  • Like
Reactions: 1 user
Upvote 0 Downvote
Hey guys have any of you gotten results back yet?

This was a humbling 2 month wait.

I never reassessed OMM (5 cases). I only put 2 assessments on about half the patients notes. I didnt tie anyones gowns back up for them. I didnt counsel patients on lifestyle modifications when it was clear it was needed. I left all of "smash fm" off of 1 note.

I passed.

I looked on here for 2 months for reassurance and waiting is awful. Let me know if u have any questions...
 
  • Like
Reactions: 1 user
Upvote 0 Downvote
Nonam22 said:
Hey guys have any of you gotten results back yet?

This was a humbling 2 month wait.

I never reassessed OMM (5 cases). I only put 2 assessments on about half the patients notes. I didnt tie anyones gowns back up for them. I didnt counsel patients on lifestyle modifications when it was clear it was needed. I left all of "smash fm" off of 1 note.

I passed.

I looked on here for 2 months for reassurance and waiting is awful. Let me know if u have any questions...
Click to expand...
Thanks for the update! You give me hope! I forgot all of the SMASHFM on one patient too and had some other (hopefully) minor blunders (accidentally gagged a patient, didn’t look at opposite limb for comparison, did way less OMM than all of my friends and repeated the incorrect treatments I did do) that I’m hoping will net me a pass overall. I still have another torturous month to wait...

ETA: passed!
 
Last edited:
  • Like
Reactions: 1 user
Upvote 0 Downvote
I know that very few people walk out of the exam feeling like they nailed the PE. I felt disastrous and terrible after my exam, after:
1. Running out of time for many encounters
2. Forgetting to ask so many things (SMASHFM FEDTACOS, and whatever else there could be). And then definitely some questionable OMM.
3. Not being able to finish many of my notes. Actually, scratch that, I don't think I managed to fully finish a single note. Missed out on sections of the notes? You bet.
4. Not even knowing what on earth the pt even had, so having even more confusion on how to treat these pts. I'm talking like...at least 1/3 of the PE, I had no actual idea what on earth these patients had.
5. I forgot to sanitize my hands a few times.

Bottom line is that I still passed the PE. Rest assured, there is actually a decent amount of leeway on this exam. No matter how poorly you feel like you did on this exam, as long as you showed some semblance of knowing how to act in a clinic/urgent care/ER setting, your chances of passing are very much in your favor.
 
  • Like
Reactions: 1 users
Upvote 0 Downvote
blah12346497 said:
I took this exam a week ago and each day that goes by, I remember stuff that I didn't do or did wrong sigh..
  1. Physical exams consisted of 4 heart lung sounds, 6-8 lung sounds, and usually 1 other pertinent system. Worried that my P.E was too simple. Rarely did special tests except for abdominal complaints
  2. Forgot to reassess OMM once, but stated in soap note I'd go back and do it
  3. Patient got mad because I forgot to re-sanitize my hands after contaminating my hands during 1 physical exam portion :(..
  4. 1-2 differentials were probably off with plans that aren't correct
  5. Review of systems was really ****ty.. like I just asked fever, night sweats, chest pain, shortness of breath. I think I forgot to ask this in a couple encounters and forgot to document as well. Other than that my soap notes were completed fully.
  6. As i was helping the patient back up from the table, i accidentally hit her breast area with my pen. I barely noticed but now that I think about it its giving me nightmares. I dont think I even apologized :(
Things I always did -> introduced myself, washed hands before shaking patients hand, OLDCAAARTS SMASH FM (fed tacos modified), P.E, and always counseled patient on smoking, drug use, etc. Gave a plan for the patient at the end. Any opinion would be greatly appreciated :(I hope I didn't break any rules. Anxiety through the roof.
Click to expand...

EDIT - passed :)
 
  • Like
Reactions: 2 users
Upvote 0 Downvote
SynapticDoctah said:
So here is the summary of my exam that I took a few days ago:


-Forgot to reassess on one OMM after doing ME(most of the time I just asked if it felt better and they would say it did
-did the exact opposite movement for OMM that I was supposed to on one case. For example, if they were rotated a certain way, I rotated them the wrong way for muscle energy.
-was so rushed on most of the cases I didn’t have time to sit and close with the patient how I would have liked to. Most was just ok I think this is what’s going on, id like to change this med and order this test and follow up/admit to hospital. I had the plan to go over MOTHRR like in Kauffman, but rarely had time to go through that due to timing.
-physical exams were crap IMO. Didn’t have any abnormal findings. Not sure if that’s because I was doing the wrong exams or if that’s just the way it was. Was so rushed I couldn’t think through which would be the best test to do. Didnt look in anyones ears. Just no cases that I felt needed it.
-forgot to document a ton of physical exam stuff I did (for example PMi of heart or thyroid palpating)
-didn’t get 3 ddx for most cases( but added tobacco use disorder or obesity, or fx of diabetes or something to make the list longer)
-wasn’t able to counsel on smoking on every case where the patient smoked
-left out stuff on plan that was easy to get. Just blanked.
- completely rushed the entire time and my humanism lines that I was gonna drop were pushed to wayside and didn’t realize it till
After exam

Stuff I did do:

-Shook hands of all patients and asked how they would like to be addressed
-performed OMM on 4 cases when asked (deferred one due to the nature of the injury and felt it shouldnt be done)
-washed hands before starting.
-asked to tie/untie gown/place steth on skin or do abdominal Exams
-draped whenever i did abdominal exam
-listened to heart/lungs on skin on every patient
-whenever someone said someone died I said I was sorry and it was hard to loose a parent
-tried to be empathetic when they asked challenge questions
-felt like I got a thorough hx (which is the reason I was running out of time.)
-completed all notes with something in every box.


Idk. I just feel absolutely horrible. I went into this exam after studying for over a week, watching Kauffman videos, reading the book, reading FA CE and even meeting with a faculty member to go over four cases a few days before the exam. I put my STEP/LEVEL 2 exams on hold to prepare for this and feel it was an absolute waste of time.

I just feel like the timing really screwed me. Probably 9/12 cases I was in the middle of physical exam or OMM and the two min warning was announced. I was so stressed i always forgot the little empathy things like asking if the plan worked for the patient. I was so stressed I’d sit down to type the note staring at the assessment and plan. Idk what happened. I know my stuff, but literally the easy things were blanking me.

I’m just so mad at myself. I felt like I ruined everything I’ve worked for the last 3 years.
Click to expand...

Passed.
 
  • Like
Reactions: 1 users
Upvote 0 Downvote
Made 100 mistakes but still passed. Worst part was waiting 2 months for the results.
 
  • Like
Reactions: 1 users
Upvote 0 Downvote
Pretty worried after taking mine:
The bad:
-felt really rushed, probably ran out of time 2 or 3 times
-did omm on 3/4 patients that requested it. Didn’t even get to the PE part on the one guy that asked for it and didn’t do it. The others I felt like I did an ok job but didn’t recheck.
-forgot to say I’d do a pelvic on one girl and document
- forgot a few times to document omm in A/P
-1 or 2 times I’d tell them to follow up but not document or vice versa
-forgot to document several PE findings
-probably sounded dumb when giving my A and P to the pt
The good:
-felt like my humanism was on point
-draped every pt correctly
-sanitized every time
-auscultated every patient correctly with lungs and heart and abd when appropriate
-5-6 ddx plus plan just as long
-felt soap notes were pretty good overall

Overall I feel what could fail me was my omm and forgetting to add little details here and there.
Now the ever eternal wait.
 
Upvote 0 Downvote
PathoTurnUp1865 said:
Pretty worried after taking mine:
The bad:
-felt really rushed, probably ran out of time 2 or 3 times
-did omm on 3/4 patients that requested it. Didn’t even get to the PE part on the one guy that asked for it and didn’t do it. The others I felt like I did an ok job but didn’t recheck.
-forgot to say I’d do a pelvic on one girl and document
- forgot a few times to document omm in A/P
-1 or 2 times I’d tell them to follow up but not document or vice versa
-forgot to document several PE findings
-probably sounded dumb when giving my A and P to the pt
The good:
-felt like my humanism was on point
-draped every pt correctly
-sanitized every time
-auscultated every patient correctly with lungs and heart and abd when appropriate
-5-6 ddx plus plan just as long
-felt soap notes were pretty good overall

Overall I feel what could fail me was my omm and forgetting to add little details here and there.
Now the ever eternal wait.
Click to expand...
You passed
 
Upvote 0 Downvote
PathoTurnUp1865 said:
Pretty worried after taking mine:
The bad:
-felt really rushed, probably ran out of time 2 or 3 times
-did omm on 3/4 patients that requested it. Didn’t even get to the PE part on the one guy that asked for it and didn’t do it. The others I felt like I did an ok job but didn’t recheck.
-forgot to say I’d do a pelvic on one girl and document
- forgot a few times to document omm in A/P
-1 or 2 times I’d tell them to follow up but not document or vice versa
-forgot to document several PE findings
-probably sounded dumb when giving my A and P to the pt
The good:
-felt like my humanism was on point
-draped every pt correctly
-sanitized every time
-auscultated every patient correctly with lungs and heart and abd when appropriate
-5-6 ddx plus plan just as long
-felt soap notes were pretty good overall

Overall I feel what could fail me was my omm and forgetting to add little details here and there.
Now the ever eternal wait.
Click to expand...

Did you read my post? As long as you didn’t wish somebody a happy 4/20 on April 20th (I heard this), you will be ok.
 
Upvote 0 Downvote
PathoTurnUp1865 said:
Pretty worried after taking mine:
The bad:
-felt really rushed, probably ran out of time 2 or 3 times
-did omm on 3/4 patients that requested it. Didn’t even get to the PE part on the one guy that asked for it and didn’t do it. The others I felt like I did an ok job but didn’t recheck.
-forgot to say I’d do a pelvic on one girl and document
- forgot a few times to document omm in A/P
-1 or 2 times I’d tell them to follow up but not document or vice versa
-forgot to document several PE findings
-probably sounded dumb when giving my A and P to the pt
The good:
-felt like my humanism was on point
-draped every pt correctly
-sanitized every time
-auscultated every patient correctly with lungs and heart and abd when appropriate
-5-6 ddx plus plan just as long
-felt soap notes were pretty good overall

Overall I feel what could fail me was my omm and forgetting to add little details here and there.
Now the ever eternal wait.
Click to expand...

pretty sure you passed
 
  • Like
Reactions: 1 user
Upvote 0 Downvote
You must log in or register to reply here.
Next unread thread

Similar threads

H
  • Question
Comquest or COMBANK for Level 2?
Replies
0
Views
257
HappyDoc510
H
M
Step 2 or Level 2 Practice Test - High Quality but cheap - TruCurio
Replies
0
Views
567
MEDWINNER1
M
Smeralda Karameta
USMLE STEP 2 study partner
Replies
0
Views
420
Smeralda Karameta
Smeralda Karameta
CrazyHorseLady
  • Question
Step 2 went up, Level 2 went down- will this negatively impact my apps?
Replies
2
Views
1K
CrazyHorseLady
CrazyHorseLady
B
Do we really think USMLE will delay the step 2 scores by 8 weeks for people that took the exam the first week of June?
Replies
5
Views
3K
medschoolaspirant
M
Top