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politically_incorrect
10-12-2005, 07:42 PM
took the exam the other day. here's what i think of it.

i understand why us school grads hate the exam. why? cuz it is **.

this exam does not test your ability to do a good physical exam or develop a decent differential diagnosis.

yes, you read that right. this exam has very little to do with how good of a physician you are.

what do i think that this exam is about?

we don't know how the usmle grades the stupid thing, but i'm pretty sure that the largest part of the exam is about communication and how you treat the patient. i'd even bet a serious amount of money that you could get the differentials 100% wrong and still pass comfortably if you did everything else that was indicated and communicated well with the patient.

before taking the exam, i took the kaplan 5 day class. what a waste of money...i think that i'll post on that on the main forum.

anyway, i did get to see a bunch of imgs preparing for the exam. no one told them that their english sucked. they kept on studying differential diagnoses like there was no tomorrow, but they did not understand that their english was really, really bad. if you are an asian and your english skills are poor, i think that you need to think about working on your spoken or written english before you take the cs.

okay, about the physical exam. basically, this is a joke. none of my attendings or residents would have let me get away with the physical exam i did on the pts during the cs. you simply don't have the time to do a real exam. that's something else a lot of imgs don't seem to understand. in other words, the sps are pretending to be pts and you need to pretend to be a doctor.

what do i think is the most important part of this exam?

outside the room

read the scenario, record name, vitals, chief complaint and do your memonics. i also put down my preliminary differentials and the exams i was planning to do. 10 out of 12 times, i did not have to adjust my plans. the amount of time i spent outside, i saved inside.

inside the room

knock,
shake hands, introduce yourself
drape
be very, very polite in every way and take a super complete history
wash hands
do indicated exams after chief complaint
treat your sps like they are china dolls while examing them
take their concerns seriously
counsel and say goodbye

seriously.

the cases i saw were all textbook. i had difficulties widening my differential beyond two or three diagnoses in many cases. why? because my history and physical findings would almost always rule out any off the wall diagnosis.

outside the room

another thing i think is a big deal is putting together a real pt. note under pressure. 10 minutes is often not long enough, even if you type quickly. what really annoyed me is how little room there is for physical findings on the computer version. i'd run out of room listing my negative findings.

another thing that annoyed me was the lunch they served. for 1200 dollars, i think that they would do a lot better than that.

also, when i compared the cs sps to the kaplan sps, i found that the kaplan sps were much better actors (probably why it costs so much). frankly, most of the cs sps sucked in their roles. if you'd take the time to ask them a non-standard question, they'd get stuck.

i'll post more when i think of it.

digitaldoc2002
10-19-2005, 01:04 AM
Yeah I agree on some points you mention ! Patient Note is definitely better hand-written than typed







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