USMLE Just took CS and worried

[redcharger2904]

just took in Atlanta. The exam is harder . I was always close to run out of time
I only did half closure in like 3-4 cases(Started though, just not that complete). Remember one I was just asking about concern, then time goes out. Then some cases (neuro especially) I had to chose to omit some PE I thought warranted on purpose, in order to save time for closure. I also felt time constrained for note typing, and I don't really know about the quality of note I wrote.
Forgot to counsel sometimes. I guess I'm missing some questions as well throughout the cases.
Couldn't complete note twice(Missed one line each, one ROS one SH in history section)
I took a 1-week course (USMLE Success Academy)prior to exam, I passed the entire assessment. I was good at ICE parts(Good notes), they pointed some minor CIS improvements I need to make, which I worked hard on in weekend. But today I think I'm stressed out, I don't know if that's hurting CIS. I tried my best to avoid the mistakes I made before.

Now I don't know. Worried. I don't know if it's normal for us to have all these mistakes.

These are just the mistakes I can think of now. Maybe a lot more.

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[redcharger2904]

Nobody?

 

[Ismet]

Everyone makes multiple mistakes or omissions on CS. It's really impossible to predict how you did, you most likely passed, but no one but the scorers will know for sure until your score is released. And there's really nothing you can do about it until the score comes out. I get that it's stressful, but what got me through the 2 month wait for my score was knowing that it was out of my hands, and it's really a waste of time and energy to perseverate over what you may have done wrong.

 

[redcharger2904]

Just want to say I passed. Borderline ICE(1in low, 6 borderline, 4 above). CIS all in higher performance(not far from borderline). SEP 1 borderline, rest high. Look at my mistakes
ICE:
1. Didn't complete note in 2. One was missing entire SH, the other incomplete ROS(Wrote "Negative exc")
2. Felt time constrained. Can't ensure quality of my note. Tried my best but might still missed something(I'm sure I forgot to write some maneuvers I did)
3. Skipped some maneuvers in order to save time for closure. Skipped CV&lung in one for neuro.
4. Didn't get some brand names of drugs. I probably just didn't write them in note.
5. Sure I Screwed DDX in 2-3 cases. Wrote lumbar disc hernia as #1 in someone with negative straight leg. Wrote chronic gastritis #1 in someone with lower abdomen pain(though she had diffuse pain in PE). What brain farts.
6. Didn't write any negatives in DDx section.
CIS:
1. Didn't finish closure in 4. Always started though. I mostly missed the challenging question part, or didn't complete answering. I do ask about concerns sometimes when washing hands before PE.
2. I asked a chest pain pt lying down for abdominal exam even though I knew from hx his pain worsens by lying down. He was unwilling at first. I still asked him to do so. As soon as he lay down, he screamed. I tried to help him get up, in the meantime I readjusted the bed, but didn't do properly and the bed moved fast. I probably slammed the patient on back. I apologized. The pt said thank you somehow when I left the room.
3. Didn't offer water for thyroid exam.
4. In one case was so nervous and I dropped clipboard and pen, then stethoscope. Looked so goofy
5. I washed hand in strange timing for no reason in one case.
6. One lady when I was asking ROS, she seemed annoyed and said" are these question relevant?" I said I'm doing quick ROS to have better idea.
7. Had pause between conversation in one case.
8. Not sure if I answered questions properly
9. Tried to do funduscopuc exam in a photophobia pt. I did imply there's light, and I stopped doing as soon as she said it bothers her, with apology.
10. Missed counseling ibuprofen for a suspected ulcer, but counseled something else for that one. Remember 1-2 I didn't find anything to counsel.
11. Might forgot foot step once when asking pt to step off the bed.
12. Did abdominal exam by 2-hand. Wasn't forceful, didn't repeat. ( I saw on sample video she did once with 2-hands)
13. A back pain pt when I checked ROM, and she had pain in all directions(This means 6 times!) not sure if this is considered repeating painful maneuver.
What I did right:
1. Always knock, introduce myself and call pt by name. Always shook hands in beginning, always asked if they're comfortable in room. Always be as pleasant as possible in beginning.
2. Asked to offer water and tissues in cough patients.
3. Tried to be empathetic. Always said"I'm sorry xxx is bothering you"
4. Turned light off in photophobia case(It was HA case and I asked her if light bothers her at first)
5. Always washed hands by sanitizer before PE. Always waited until hands dry. Did counseling when waiting.
6. Pulled leg rest when pt lay down. Might forgot one but remedied in middle.
7. Always be ready to help them sit up. (Most patients sat up by themselves but I always stood aside as I'm ready to help them anytime)

Sorry for long post.