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my exam experience - bnp1000 - ArchivalUser - 10-16-2011
Hello every body!
First of all Thank you to this forum for the support during my CS exam preparation.
my test date: 8th sep result date: 12th oct. thanks God i made it.
i am a final year med student from pakistan, and i have been to US for electives and i have taken my test after 12 days after the end of my electives.
some points i want to tell you about CS preparation:
* first Aid is the only book which i have used plus three four cases from U-world which were not present in First aid. (do compare both)
* secondly make your own plan of action, like opening statement, closing statement, some mneumonics which are really necessary in history taking.
* practice your opening for atleast 100 times.
* practice all the cases atleast once, ( i have only practiced 30 cases from first once) but remember i was familiar to the american patients and history taking during electives. if a person is coming from outside the US, he/she should practice more than i have done.
* Do try to show your case to a person who has passed CS already once when you are fully prepared for the exam atleast 4-5 days before exam so that your mistakes can be corrected. if any one is not available face to face, use skype.
* practice your cases on the live person.
* be very confident during your preparation and do hard work, its not that difficult.
* also type the PN on the software on USMLE.org and time it. and work on your typing speed accordingly
* 1-2 days before exam:
try to learn by heart all the differential diagnosis of the chief complaint which are there in First aid in Mini cases.
* last day before exam, try to relax.
* try to sleep well a night before exam.
* Go to center ahead of your reporting time. seriously it gives a lot more confidence and relaxation.
* just before exam, use rest room,
* before the start of encounter, control your nerves becoz after all you are a doctor and the person sitting on the other side of the door is a person who dont know any thing about medicine, you should have confidence on your self.
* after seeing the instructions in front of you on the door, write the last name, age and chief complaint. also write 3-4 differential diagnosis and your general plan of action on the blue scrap paper. also think that what specific examination you have to do this case. take atleast a minute outside. becoz this is the time on which your next 14 minutes will be based.
* knock heavily, and enter with a smile. be confident, you are the doctor. take history in 9 minutes along with counselling at the same point. at 5 minutes anouncment you should have touched the patient for the exam after washing hand.
* dont miss hand washing.
* be very quick in physical exam. do auscultate for breath sounds and heart sounds in every case. i have done very very brief exam but dont miss to listen neck in HTN and DM. also dont miss Fundoscopy in HTN, DM. along with that dont miss the couselling in both conditions. it gives very good impression and SP will really admire you.
* think of closure while you are doing exam.
* there can be discrepency of patient actual age(look) and the age written outside becoz some SPs look younger (specially females). so should be very careful while diagnosing becoz it happend in one of my case. i mis-diagnosed a female due to age difference.
* be very loud, bold while telling the diagnosis. even you are telling the wrong diagnosis you should have confidence of telling him/her. and tell 3 investigations and explain investigations and dont wait for SP to ask you about investigation( doc! what do you mean by endoscopy? )
believe me i have told wrong diagnosis in 3 of my cases during the closure which i realized while writing patient note and corrected there.
* greet the patients while going outside. i have completed all encounters around 15-30sec before the end of encounter. this shows your puntuality and adherence to assigned task in the given time.
* in writing patient note start writing from differential diagnosis and investigations, i have written 4 diagnosis in 2 PNs and 3 differential Diagnosis in 1 PN.
* during breaks, always engage in discussion with other people becoz it relieves your stress. use rest room must, you can take a few sips of coffee( i have taken in both breaks with some cookies)
* at the end of exam literally i was laughing that this was the exam for which i was so scared.... but after a day i was having mixed feeling becoz i recalled my mistakes and it was enormous. and i was scared for the result too.
but keep it in mind, Be bold, loud and fluent. you will easily pass this exam.
i hope it will help somehow to any body. Do Ask any question if you have one.all the very best to every one.
0 - ArchivalUser - 10-16-2011
THANKS A LOT AND GOOD LUCK!
0 - ArchivalUser - 10-16-2011
welcome kukolka
0 - ArchivalUser - 10-16-2011
hello bnp1000 congrats on passing exam. i want to take advice from you about proffesional rapport as this is the area i failed. I gave exam in july and gt my results on 12 oct. thanks
0 - ArchivalUser - 10-16-2011
thanks a lot and good luck...
0 - ArchivalUser - 10-16-2011
HI BNP1000
I TOOK my exam in philli , and i could not make that because i did not share my data well and QUESTION SKILLS [ WHAT DOES QUESTION SKILLS MEANS ]
0 - ArchivalUser - 10-16-2011
thank you so much!!
0 - ArchivalUser - 10-17-2011
Re: simar11
you should give importance to each gesture of SP and respond him/her nicely, for an example, you are draping the SP with the sheet and after draping SP says thank you, you must say welcome with a smile. like wise when you ask for the health of his/her parents, and if they are alive and healthy, you should say that it really nice to hear that your parents are enjoying good health with a smile to SP while maintaining the eye contact, and if they are dead, you should be saying that oh i am really sorry to hear about their death with grief on your face before jumping up to the question about what was the cause of their death. and similiarly in case of any challenging situation you should first satisfy the patient and then move on to your history and exam. dont sacrify patient comfort on managing the time for history and exam. i can bet you will pass the exam if you will hear the patient well, show concern to his every complaint and empathize him. while asking about the profession for example if he says that i am a school teacher, you should not jump to the other question. you should say that hmmm, teaching is a very noble profession with a smile. he will definatly give you a smile and this will make a good rapport.
in case you have done a painful manuver and you should stop your examination and say that i am extremely sorry for this, i will try my best not to perform this manuver again. this creates an environement of confidence and care between doctor and patient.
if you miss a closure while answering the concern of the patient wholeheartedly the patient will definatly admire you and will give you good score.
so my suggestion to every body is, dont try to rush and complete your encounter timely without appropriatly addressing the patient's concern.
0 - ArchivalUser - 10-17-2011
Re: malick
hello. questioning skills include some points...
* how simple and to the point your questions were.
* did you asked open ended questions or not?
* how many closed ended questions you have asked. try to use any few as possible.
for example: while asking for bowel habits there is two ways to ask, judge which one sounds better:
>>>> did you noticed any change in your bowl habits recently? or
>>>> do you have diarhea, do you have constipation? in a case where its not necessary.
obviously the first one is better and SP can answer it with a "NO" only once.
* whether you asked the case related questions or not???
believe me this is the most important thing, becoz when you will not be asking case specific questions,the SP's look will totally be changed and he/she will feel difficulty in answering your questions becoz your questions will not be in the SPs checklist and he will not be prepared to answer your questions. he will be annoyed with that. so dont do that.
so try not to beat in the bush. be specific, simple and open ended.
you will easily get through if you have missed 1-2 case specific questions rather than asking inapropriate and un-related questions... avoid to annoy the SP.
0 - ArchivalUser - 10-20-2011
very helpful experience..Thanks & good luck!