11-10-2005, 08:16 AM
My terrible experience for CS in Houston center on Nov. 9.
Houston center, in general, is fine, or , I can say, good. I am an IMG. The SP is good, no bias to my accent and my color of my skin (at least I guess).
However, my performance is terrible. I made incredible mistakes during encounters. The most serious stroke for me was the first warning because I accidentally open the case box when the PA said œSP please prepare as I thought it was for the examinees. It happened in the second case. I entered to the room and tried my best to calm down and recovered myself from the warning and did my job. However, I still run out of the time for the second case! No counsel ling at all. Only had time to tell the diagnosis, no time to tell the next step of test.
Ever though the warning did not hunt me too much in the following cases, I was still anxious in each case,
(1), forgetting asking many important questions (such as fever, LMP, urine volume,);
(2), repeat painful maneuver in one patient because at that moment when he only said œen.. a little bit tender œ I did not pay much attention for what he was saying, continue exam him. At the last I realize and apology for that, but it has already been repeated.
(3). The last case, that SP did not have any œbad habits (such as drinking smoking). When finished, I have some more time, then I want to do consulting, but consulting what. My brain is empty. Finally, I had to randomly say that she should do mammography regularly because her relatives had breast cancer history. After I got out, I realized I should tell how to deal with her current uncomfortable.
(4), my patient note is totally unorganized and I am not sure if others can figure out what I am writing. Never come up with five differential diagnosis.
(5), it seemed that I interrupted with my few SP during their speaking. I did not mean to that, but, after they answer my question with NO, I thought that it is done and then start my new question. However, to my surprise, they still used low voice to repeat œI have no..( repeat my inquire). Then I had to apology for my interruption. It happened several times.
(6), have to delete many important exams during encounters because of time issue and leave time for consulting.
What I am keep doing during encountering, is:
(1). Always express my empathy,
(2) Wash hands
(3) drape before asking any question;
(4) when time allowed, consulting smoking drinking,
(5) ongoing support,
(6) praise patient for his quitting smoking
(7) ask one patient why he was in bad mood. He told me reason, supporting
I worry a lot. I thought I only have very slime chance to pass.