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CSEVIDEO - a critical review by an academician - drkelly
#1
I am writing about CSEVIDEO. One of my students suggested that I see the promo piece on their home page. My student is studying for Step 2CS and noted discrepancies in the way the video says to perform a history and physical from what she has been taught here in the USA.

I watched it, and I was so shocked at the poor interaction of the doctor with the patient as well as fundamental errors. These are not differences in style; the doctor is INCORRECT in her total approach. Step 2CS is a 15 minute per scenario FOCUSED exam. The patient shown is a young woman with right ankle pain. It took the doctor 3.12 minutes to find out that the patient injured her ankle while jogging! Not very good when the interaction is only 15 minutes in length. The doctor spent more time looking at her clipboard than looking at the patient. Not good style in the USA.

In a focused exam, why ask about headache, chest pain, breathing abnormalities, changes in hair or skin, constipation, appetite, oral ulcers, last menstrual period, etc.? Does the doctor think that the woman’s periods had ANYTHING to do with her fall???? The doctor never asked if the patient has had a history of falling which is certainly more relevant that her LMP!

Then to doctor began the exam without washing her hands, but did indeed put on gloves. American patients do not like to be examined with gloves. Has not the doctor heard about H1N1? This doctor…probably not! You MUST always wash your hands when examining patients. Where did this doctor train?

The doctor asked more than 30 times, “Is that OK?” What doctor in the USA asks a patient if it’s ok? Why would the patient be coming to the doctor in the first place if it’s NOT OK?

The doctor did a terribly cursory exam of the eye, chest, heart, and abdomen. The doctor said when examining the patient’s abdomen that she was examining “vessels in your belly.” WHAT? Statements like that on the Step 2CS exam can only jeopardize your CIS and your SEP scores.

Finally, after 12.5 minutes, the doctor decided to turn her attention to the patient’s ankle. When the patient described pain on touching the ankle, the doctor said that she would examine only the other non-injured ankle. WHAT??? Why not direct your attention to where the problem is?

At the end of the encounter, the doctor said to the patient that “I think you sprained your ankle.” Is the patient stupid? The patient told the doctor that information 12 minutes earlier.

So I write this note, after much consideration, as a teacher to share my frustration of what is being offered by CSEVIDEO to candidates preparing for Step 2CS. Please use your better judgment. This video and perhaps all the rest of the CSEVIDEOS can only make passing your exam more difficult. Just my opinion! Good luck on your exam!
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