View Full Version : In need of some objective assessment

08-05-2010, 12:36 PM
Hey guys,
so i took my cs yesterday in atlanta and i think that it was a bit of a disaster. On the first encounter i had a very pleasant patient and the case was pretty straight forward but i spent too much time on history taking (yet failed to get all the pertinent info), then i proceeded to the PE where again i missed at least one important part of the exam; during the exam the time ran out and i didn't get to close.
The next 7 cases were ok, i took a full history(more or less) and did a focused PE(more or less) and did my closure and counseling.

On case 9, i started with the getting the patient's name wrong, when she gave me a funny look, i repeated the name (this time correctly) and apologized. I proceeded with the history but by this point i had already been unnerved and i ended up not being to get the information accurately to the point that i had to ask the SP to repeat some things and she was getting annoyed. She mentioned that there was breast CA in her family and i failed to ask her if she had any mammograms. then i started the PE and after completing the one or two things, i realized that i hadn't washed my hands, so i stopped, apologized to her for not having washed my hands, washed them and then restarted the exam. By this time i was so unnerved and panicky that i did all the wrong exams and ended up running out of time so that I was unable to close, or counsell her on CA, alcohol or anything else.

The remaining three encounters were okay but as you can imagine i was out of my wits by this point.

Regarding my PN, i finished all my notes but not without some problems. In some I had 4 differentials and some tests that i wanted to order, i didn't get to do as i ran out of time.

Overall i think i had a really bad day and now i can't figure out what to do with myself, particularly since i'm taking my CK in 10 days and i'm having a heck of a time trying to focus. Has anyone else had similar experiences and passed? or should i just come to terms with the fact that I most likely failed it and start thinking about contingency plans.

Any feedback would be greatly appreciated.

09-01-2010, 09:26 PM
how is your English? Did you drape accordingly? Did you ask to perform the physical exam to the patient and do heart, lung, abdomen on ALL patients no matter the chief complaint? The patient has a say in the subjective part of the exam. They comment on your rapport, professionalism, english (can they understand you), and if you can "communicate" basically what a 4th yr student is supposed to know. Sounds like your not too worried about the PN, so I'm sure you passed that part. They grade you on alot of things man, you prolly passed. But doing the basic things like I was asking you at first almost guarantees a passing score. Missing one or two "closings" of the patient won't be a huge deal.

Did you pretty much know what the diagnosis was on every the patient? if you had an idea then you prolly ask enough of the right questions to at least pass. All mine were REALLY basic diagnosis's.... migraine, depression, meningitis ect. only one weird one was leukemia (i think lol). with all that said I felt like I messed one patient (the leukemia one) up but I passed with all high marks.

you'll pass...probably...maybe... idk lol

09-01-2010, 09:31 PM
also, forget about it seriously. Do not messed up CK. It's too important to be affected by you constantly stressing out and being distracted by CS. Odds are you passed CS and now destroy CK!
wish you the best!

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