I passed -

[ArchivalUser]

yahya

I passed without studying any of the big books and notes people are gulping down their neurons. I was told by my friend not to study like a dog for CSA and I took their advice. I passed.

Guys, just practice your skills on a friend. Thats the only thing that helps. Also practice note writing.

[ArchivalUser]

tta

I also passed and somewhat agree with you. I bought OSCE and NMS clinical skills assessment exam. The latter book was relegated to curing the wobble on my table very quickly. The OSCE book I did find very useful as it gave an idea of structure and helped me focus on what was relevant within the USA. I spent a month going over their cases every other day with friends. No more than one hour each day. Then the exam!
But before that I need to say something about the introductory video they send out with the csa package. The one with the girl in it who concentrates on the guy's stroke three years ago when he has come with renal colic ! I mean are they deliberately showing someone doing it wrong or is she doing it correct? I know that here in the UK she would have failed because of that and also because her examination technique was poor.
Anyway the exam. I worried loads about this the night before and then until I got my result. I am lucky as have English as my first language and this helped me. No matter how hard they try to make it lifelike these are artificial situations. The cases are everyday occurrences however there was one with an atypical presentation-my first case. I had asked this guy every question relating to his presenting complaint and every review of system question I could think of and got negative responses to them all. So I am standing there thinking sh.. what is going on with you. After a 30sec pause decided to move onto PMH as had no other questions left and as soon as he told me this I knew what was going on with him. So do not worry if find yourself in that situation.
To be honest in the fifteen minutes you cannot take a full history, will forget to ask questions (everyone does!!) and cannot do a full examination either. My examination was shit on the day, I would have failed my finals here with it. RESP exam only percussed and listened to back if not respy complaint, otherwise if it was did front and back per, aus and vocal resonance. It was with one of these respy cases that I had my only positive signs of the day simulated by the patient. CVS exam only auscultated in four quadrants all day! No rolling, breathing in or out or any of that nonsense. Admittedly only had one true CVS case that day. ABDO exam quick inpsection, light palpation, deep palpation, look for organomegaly, bowel sounds. Nothing else, said PR in work up if appropriate. NEURO exam, had a system so was slick not thorough! Looks good to a non-medic i.e. the SP!

Other things I did was stand for all the cases ( except one, pure discussion and reassurance case ) and not use the seat provided. This kept me near the patient and at their eye level, hardly used my note paper at all to help maintain eye contact with them. Made sure I spent a good two minutes addressing their concerns at the end. A lot of what I did here was picked up from the OSCE book.

Remember to be sensible, if they have had a headache for three months and look well ( as most SP's do, some act ill and then it is obvious ) do not waste time doing kernig's etc as when was the last time you saw a healthy looking patient with a three month history of meningitis!

Also I did no health counselling if it was not relevant. I left the rooms usually with about two minutes to spare.

The amount of space to write up the history was not enough for me and whilst I tried to keep it ordered did struggle with presentation a bit. This was an area I could have improved upon.

On the day try to be relaxed and FOCUSED. Be nice, speak clearly and listen to the SP. Answer all their questions before you leave the room. I also cracked a couple of jokes from time to time to help develop a rapport and it seemed to work.

Good luck to everyone as you will pass this exam.