发信人: xyyzm (xy), 信区: MedicalCareer
标 题: Update: CS experience
发信站: BBS 未名空间站 (Wed Aug 19 21:47:39 2009, 美东)
First, sorry to know that some people didn't pass. If you practice more, you
will make it.
I failed once, and I passed the second time. Very lucky. SEP is on
borderline. ICE overall is the same as first time. CIS improved a lot.
I am surprised to see that my performance on PN decreased so much.
Especially my data gathering is much better than the first time.
Possible reasons: 1. First time, I did a lot of chest and heart examinations
, and I put them in PNs, I didn't do these exam the 2nd time unless it is
heart or lung cases. 2. It was only two months after CK when I take CS the
first time, maybe I have a better sense of DDs at that time, even though I
felt I have a better sense of the DDs the second time. I really get confused
with how to perform better in PN. Hope this will provide a reference for
other people but not confusing them.
My CIS improved a lot. I think practices made me more familiar with the
questions to ask, so I can concentrated more on SPs. And omiting a lot of PE
saved me time to allow me to talk more with SPs. So pratice do help a lot
in this regard and for data gathering.
MY SEP: first time, I took it on Saturday, and it is in March, most of the
examinees are American medical school students, one of my friend said it
might matter. The second time, I took it on Wednesday in July, and a lot of
IMGs. And I am much more confident than the first time.
Following are experience I wrote right after the second exam.
Having get so much help from this forum, here is a little contribution I am
bold enough to make even though I don't know the result yet.
I failed CS in March. Failed both CIS and SEP badly; did the worst in data
gathering with star in the lower end, but good enough on PN so as to pass
ICE with one X above borderline performance shade. I retook the exam last
Wednesday. Feel much better than the first time, because I feel most of the
SP were satisfactory interacting with me, especially the first one, I felt
she tried hard not to give me a smile, but gave me one in the end. But this
doesn't mean I am sure about the final result due on August 19.
Here is some experience want to share.
There are a lot of good and thorough posts about this topic in the past one
to two month. They are very detailed and good. Reading them several times
helped me a lot. The most important message I got is to cut the PE to
minimum. I kind of feel I only spent around 2 min on PE, but 3-4 min on
closure, planning 2 min for closure is too rush for me.
The first time, I practiced FA once, and some cases in UW. Second time
, I developed my own protocol (not as complete as other people has posted,
so I won't post it here), practiced FA almost three times with a friend over
the phone and read MINI case carefully before exam. Practiced PN by copied
all the cases in FA.
Here is what I want to add which are not covered in the prior posts:
Most cases are still typical as in FA. But,
Chief complait won't necessarily be on the door way info. I met two cases
the chief complaint are different from the doorway info. So don't be too
surprised if you are in such a situation.
For some very simple cases, there is another thing hidden somewhere, I met
two cases have things hidden in PAMHUGFOSS part of the questioning. If you
miss this part, I believe it will only affect your ICE. But if you figure it
out, and cover it in the closure, the SP may be impressed, which can
strengthen your connection with him/her. So be careful about a relative
complete evaluation of the patients general health if you want to do better
in this aspect.
The review paper mentioned in Neeraj's notes is worth reading carefully.
Here is the link
If you have no experience of seeing patient before, this exam won't be that
easy to pass. You need to PRACTICE, and PRACTICE to get familiar with the
questions you need to ask on different kinds of patient encounter. At the
same time, you need to develope your own protocol for the exam (Steps to
cover and transition questions).
As to center selection, both of the time, I took the exam in Philadelphia. I
didn't feel bad about that center even when I thought back about the SPs
after the first exam, during which I felt I would fail after the first 5
patient encounters and I failed badly. The message, if you are well prepared
, you should feel you will pass in any center. Otherwise, you may not be
confident enough with yourself.
Failing this exam added another piece to my still incomplete life. hehe
I will update this if I pass later in August.
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