Yup freaking out step 2cs

[Durrsauce]

Another freak out post. 2nd time taking this test because last time I barely failed the CIS portion just needed to have one more star in the borderline part and would have passed. The first time I took it, didn't small talk very much or ask patients What part of their life was most affected and didn't recap or summarize HPI with the pt., I think my closure was very weak the first time aka didn't ask if they understood the plan and if they were ok with it or ask any questions after.

I did that this time however I didn't get to closure on one pt. And at least 3 pts The time ran out and I got caught right in the middle of telling them my work up plan and then 7 of them I did close and always ask if they understood and were ok with the plan and if they had any questions. This time I made sure to make small talk, recap their HPI, ask them how they are being affected, asked them what they think might be associated, shook hands, smiled, showed concern, always asked to do exam maneuver, asked if they need water if it was a coughing patient.

Sigh... Just scared that not being able to close or getting caught up in the closing is going to screw me again especially since apparently this is the biggest part. Anybody not close for some patients? Most ppl on the interwebs seem to close on all cases and had like a min left after......

And for the ICE portion I have no idea how that went, felt I did well on data extraction and questioning and hopefully ok for the PE part. One patient took her sweet ass time with respiration when I was checking lungs and I had like a min left, I was soooo pissed. Can't really remember my PN at all, I know I def completed them all and had 2-3 ddx listed.

---

Members don't see this ad.

 

[Durrsauce]

dahhhhhh, i realized when I summarized what patients told me, I basically did it after I asked LIQORAAA OCDPF. I would encourage them to tell their story as much as I can, than start asking them whatever things that might be associated to their complaint then summarized to them and repeated everything they told me and asked if there was anything else that might pertain to what is going on. Did most of you do the summary after doing ROS and Past medical history??? GAHHHHHHHHHH

 

[Durrsauce]

anybody got any input?
Really scared. I know there is nothing I can do about it now, just wanna know if anyone had a similar experience or worse. I could care less if I barely pass just wanna know if its enough to pass.

closed on 8, but used the whole time to do it. On 3 of them I was in the middle of closing and telling them my work up. Then the last one, such an easy ass case, but i decided to waste time on counseling and all that good stuff and then right when I was done doing PE, didn't get to close...........

Freaking out about my notes also. 6 cases got 3ddx down with maybe 2-3 supporting facts to back it. Then 5 of them had 2 ddx and there was one where the diagnosis was so obvious I didn't know what else to put. Didn't order a buttload of tests like I should have. Fackkkk i'm scared. This is wierd. First time I took it, I wasn't even tripping, I was pretty confident. 2nd time I took it, all I see is mistakes................... It's seriously so f***ed up to put students through this exam, I know how to perform well in real life and act fast if it is an emergency situation, but this whole pressure and how it can affect your futures is ridiculous.

I know somebody who passed this exam with flying colors, but when that person dealt with a real patient, he decided to stalk her on facebook and try to ask her out and harass her................. He must have been overdoing the CIS portion in real life, yet somehow he will be more successful than I will............ FML.

This wait and test is BS. I don't mind having to take the test, but it shouldn't be what makes or brakes my future. I'm intellectually capable and I know how to connect with patients, but somehow I get the feeling I failed again. Seems like everybody closes on all their cases and had 3 ddx for each diagnosis. I was unable to get all that down.

 

[Rac65]

Addressing every single concern you brought up in your 3-post-rampage is going to take a long time and is frankly quite unnecessary. You seem to be thinking too much about what you have done wrong, something which is too often seen among those who choose to create these threads even though we all very well know that nothing can be done at this point. I can assure you that "closing" every patient (or even most of them, based on my experience) isn't necessary to pass. You need not have 3 diagnoses for every patient and you sure as hell don't need to order an excessive amount of work-up. (I often listed one Dx and one order, especially for MSK cases) As long as you did /generally, on average, as a whole/ well (i.e. not horrendously) and didn't do anything particularly stupid, you should be able to pass. We do not know the criteria they use, we do not understand what in God's name they want from us based on their vague "not everything can be listed, but here are 5 random situations which you should be able to address" in their booklet, and most importantly, we can't do anything once the exam is over. This examination is pure bull$%#@ and every person who has ever taken it understands it. It is very unfortunate that you've failed it but there's a very good chance you're going to pass it this time. Best of luck.

 

[Durrsauce]

Thanks man, as the days go by I'm letting it go, I really hope I do pass, would really hate to let my step 1 and step 2ck scores go to waste.

 

[Board Vitals]

OP, there was a thread several years ago about how to pass the CS exam with flying colors: http://forums.studentdoctor.net/threads/how-i-passed-step-2-cs.1046030/ The poster's advice is definitely more than enough to pass the exam, which is all anyone really needs to do in order to move forward with residency and licensing. If you have access to the popular CS prep books, those are also good resources for gaining confidence for the exam. The CS exam does not cover anything that you have not seen or done in your medical training; remembering that might help you stay calm and focused as you work through each scenario. If you stay calm and fall back on your medical training, you should pass the next time you take the exam. Good luck, and I hope this helps! M.D. author/editor with BoardVitals

 

[Durrsauce]

Thanks, but already took the exam. I pretty much followeod that guide, however, my question is in regards to anybody who had a similar experience such as not being able to close on multiple cases and having a mediocre differential with minimal diagnostic testing. It would be helpful to find out why ppl failed CIS or ICE or if they had an idea why

 

[Durrsauce]

Anyone who failed ICE figure out why they may have failed that portion??? Getting scared because of my lag of diagnostics and terrible evidence that i provided to back up my diagnosis.......................

 

[Durrsauce]

damn I must be screwed since nobody seems to have had a similar experience..............

 

[Board Vitals]

USMLE did change how the grade the ICE portion of the CS exam a couple of years ago. Most of the people who fail ICE now are doing the correct things as far as asking the right questions and doing the correct portions of the physical exam, but they fail to document all of it in their notes. Under the new grading scale, the patient notes should be like mini H&Ps. MD author/editor - with BoardVitals

 

[Durrsauce]

Yea I'm aware of that, Just wondering if people who failed in ICS was due to a lack luster differential or if it was because they didn't provide enough support from the history and physical or they just wrote a shotty HPI missing FH, SH, PMH, Meds, allergies. I think my differentials were correct, however in 2 cases I listed the top diagnosis at the bottom and my evidence from my history was poor. Only listed like 2 things for most differentials with possibly 1 Physical exam finding and I fear that may kill my score and cause me to fail. I think my HPI and Physical exam are fine, but my differentials and work up were sh**.