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should have changed my sleep wake cycle 2 weeks earlier so that i would not have felt
sleepiness in first few cases
1. first case disaster...cudnt even complete PE
2. did not have time to close in 2nd case
3. did not counsel in 3rd case
4. twice the proctor came in and dragged , and warned if i repeat she will report
5. became hopeless by 4th case and dragged myself along
luckily the lunch break gave some hope to reorganize myself
then was able to smile ,talk like a fren to remaining 7 SPs
5. even then missed 2 clear cut diagnoses
6. did not mention p/v and p/r exams
7.my spoken english was a complete nuisance but even 2 SPs had worse english than
mine...i had to make them repeat thrice what they said in two cases....they seemed to
mind...
8. do not want to give this exam again even if i have to..
so i suggest u to quickly reenergize urself from the very first case...being informal yet
professional will help....no need to overrespect this exam....
but honestly i dont think i will pass....
results:
lord's supreme mercy on me
just pass.....(all performances low)
Thanks God i passed it. I took my exam in Philadelphia and did major mistakes like
*Forgot hand washing in 4 cases
*Never counselled about alcohol but did in some cases about smoking
*Messed up with differentials in some cases
*Messed up with physical examination in some cases
Still i passed
))))))))))))))
one.
- My feet hit the examination table with a loud sound and i did not even say sorry.
-Did not ask Menstrual history in one or two female cases.
-2 or 3 cases i took pauses when i was asking the patient.I stopped and thought while I
was looking to the patient.
-Give one wrong diagnosis to a mother of child.
- I did not complete PNs in all cases ...about half of them I missed past Histroy,Social
history ,allergy surgical history ,Surgical hx,Sex hx.
-I missed many positive data in HPI.
-write wrong first diagnosis in 1 or 2 cases PN.
-I torn two gloves in 2 cases and tell the the patient i changed my mind and washed my
hands.
-Did not do auscultation of heart and chest in 4 cases .
-Write wrong chest auscultation data in one case.
May be i have done more ...But i am sure that i did this.
I GAVE MY CS IN HOUSTON. NICE EXPERIENCE BUT MAN, TEXAS HAS HOT SUMMERS AND
I'M FROM INDIA !!!
IST CASE- COULD NOT FINISH,IT WAS MY ONLY NUERO CASE OF THE DAY. ACTUALLY , I
STARTED MY PE WHEN THEY SAID 5 MIN ARE LEFT AND THOUGHT THERE WOULD BE
ANOTHER ANNOUNCEMENT WHEN 2 MINUTES WOULD BE LEFT. THE CASE ENDED
ABRUPTLY. WAS VERY PISSED OFF AND WROTE A LESS THAN PERFECT PN. I REALLY HOPE
THEY DO NOT SCORE THIS.I MISSED A PART OF PE AND COMPLETE CLOSURE AND
COUNSELLING FOR THIS CASE BUT I HAD SUMMARIZED BEFORE.
2ND CASE- GOOD PERFORMANCE,NO ISSUES.FRIENDLY SP
3RD CASE- GOOD, although I think I messed up the order of d/ds in PN.FRIENDLY SP
4TH- GOOD- THIS SP HAD A LOTTA COMPLAINTS AND WAS VERY DISTRESSED. I had to
empathize a lot.SP WAS A GOOD ACTOR.
5th-GOOD- ALTHOUGH I missed one important d/d in PN. Totally slipped my mind and
thought about it only when I came back from the exam to hotel.I am not sure if I wrote one
imp w/u or not.SP WAS VERY COOPERATIVE AND I ASKED 3 IMP QUESTIONS BECAUSE SHE
GAVE ME THE HINT.
BREAK- WAS STILL PISSED ABOUT THE FIRST CASE.
6TH- THE 'rude' PATIENT OF THE DAY. FORGOT ONE IMP POINT IN COUNSELLING BUT
WROTE IT IN PN. COUNSELLED HIM ABOUT ALCOHOL INTAKE EVEN THOUGH HE DRANK
VERY LITTLE,IT WAS EMBARRASSING!!.
7TH-GOOD-ONE OF THE BEST OF THE DAY.FRIENDLY SP
8TH- ASKED ABOUT SEX HX AND WHEN SHE TOLD ME SHE DID NOT WANT TO TALK ABOUT
IT-DID NOT TRY TO CONVINCE HER(MISTAKE).FORGOT TO DO ONE IMP EXAM.-SO
AVERAGE.I REMEMBER , SHE ASKED ME TWO CHALLENGING QUESTIONS. SLIGHTLY
GRUMPY SP.
9TH-GOOD ENCOUNTER BUT MISSED ONE IMP D/D IN PN BUT WROTE GOOD W/U.-GOOD.
10TH- COULD NOT ESTABLISH GOOD RAPPORT WITH THIS SP. HE WAS KINDA GRUMPY.
WHEN I WAS COUNSELLING HIM, HE GAVE ME THE LOOK- WHAT ARE YOU TALKING
ABOUT? I THINK I ALSO MISSED SOME IMP POINTS IN DATA GATHERING.HE WAS TRYING
TO GIVE ME SOME CLUES AND I COULD NOT PICK THEM UP.IN MY DEFENSE,THE CASE WAS
EXTREMELY VAGUE- BARELY AVERAGE.
TAKE CARE.
Mistakes:
- I forgot to ask about rash in a ped case, after leaving the room I realized it could be
relevant to the Dx
- one patient refused to answer my question about sex Hx & I couldn't convince her too
- forgot to ask about menst Hx in 2 female pt
-I couldn't finish PE in 2 neuro cases, especially one of them was the 1st case, so I had to
say "I'll be back as soon as I get the test results, nice meeting u" & leave, although I didn't
give any idea about the DDx or Ix !!
- my closing was pretty much the same in all the cases, I gave the 1st 1 or 2 DDx, draw
blood for lab tests,imaging studies, I never gave any details about the Dx work-up, that's
why I got the lowest performance in information sharing skills, so I would really recommend
that u spend more time in closing, even if u have to cut PE short.
- I forgot to counsel about coffee & energy drinks in a relevant case.
- I missed an obvious Dx, should have been the first in the list
- in 2 or 3 cases I had less than 5 DDx & Ix.
- There was a case I had no clue what the Dx was, I asked all the questions possible, I had
to go with a close one.
- I was very nervous so I couldn't fake empathy in most cases, I was always thinking about
the Hx & what PE I have to do,couldn't look at the clock, coz I thought it would be
inappropriate.
Outcome:
PASSED !! sooo happy !!
amand
USMLE Forums Newbie
Mistakes:
-Did not have time to do physical examination in the first case
Steps History: 1 + CS
Posts: 9
Threads: 0
Thanked 19 Times in 7 Posts
Reputation: 29
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