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  1. #1
    Chopdoc's Avatar
    Chopdoc is offline Senior Member 528 points
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    My Experience and Advice

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    SPs are amazing people. My hat is off to them. They work very hard and take this very seriously. Did you know they have a professional association?

    Med students can be donkeyes.

    I will tell my story in reverse.

    When I left the exam I was engaged in a conversation with a very nice physician I met there. Nothing about the exam, just some general chat. As we walked out of the building we were accosted by a young man holding pen and pad at the ready. "Did you guys just take the exam?"

    Uh Oh........!!!!!

    Yup. He was serious.

    I simply told him...."Ya know they can yank your credentials for that and stop you from getting a license." And then quickly walked away.

    Right there in front of the doors, as the SPs left to go home, he wanted to violate his agreements with the testing body. Worse than that he was asking me to do it.

    Rant over. The test was nice. Really nice. I left feeling beat up....really beat up. A few hours of CS was like 12 hours of heavy ER work....at least for me. Not that the patients were that difficult, they were not....but exam stress was heavy for me. Nonetheless I smiled and I don't think the stress showed through.

    The cases were all covered in First Aid. Well, almost all. They do throw some twists in there as well and the possibilities are simply endless. If you need more than First Aid for this, then what did you do in med school?

    Honestly, the cases are easy from a medical point of view. They have to be because not much is expected of you yet in terms of that. Coming up with a reasonable differential and having appropriate testing to match is not difficult. Counseling a patient about drugs, alcohol, or sex is not difficult. Eliciting additional symptoms or significant social history is not difficult. Smiling, greeting somebody by name, making sure they are comfortable....not hard at all. Taking a focused history and doing an exam should be a piece of cake. Facing challenging questions isn't even really a challenge......really. Writing an H&P note, DD, and a few tests is simple stuff.

    BUT. And that's a big BUT. Doing all that while timed, and being evaluated, can tend to cause stress and degrade your performance.

    The solution?

    Review First Aid. Review it well. And PRACTICE. PRACTICE. PRACTICE. That means in person, in timed circumstances.

    Hmmmmm....makes you reflect on why exactly they call it medical PRACTICE. LOL!

    Again....hats off to the SPs.

    Now the nitty gritty. You wanna know cases. Well. I'll mention one....sort of....but maybe not what you want to hear......

    There was one teary eyed mother of a child presenting with a condition. She was so good she had me convinced. Really convinced. And that probably helped me more than anything else. She was my first case and I will always remember her and appreciate what she did for me by being as great as she was at her job.

    I made mistakes, and I know what they were. None of them were glaring mistakes and I think my work was relatively complete and my rapport with SPs was good.

    I think I passed but I can't tell you I know I did. I pray I did. I hope I did. I got myself behind this year because of family matters so I am up against the wall to get all my credentials filled by the deadline.

    To the guy with the pen and pad standing at the doors of the building of the testing center in Chicago: I hope you find a better way my friend. I really do.

  2. #2
    Chopdoc's Avatar
    Chopdoc is offline Senior Member 528 points
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    Another bit of perhaps valuable advice:

    The guy I was talking to as we left was a European. He had been practicing for years already in Europe and decided to try to come to the US. He made a 99 on Step 1 but failed CS. He felt it had a great deal to do with subtleties of language. My impression was that his English was excellent, but he said it was less so on the previous attempt and that in the circumstances of the exam it was worse.

    At any rate, this was his second attempt at the same testing center. He said that several of the SPs were the same and seemed to recognize him. He also said that they seemed to be "easier" for him this time.

    It is possible (likely?) that this impression was simply due to his own recognition of the SP and that they may not have recognized him at all or may not have acted differently at all if they did recognize him. Regardless, he had a better experience.

    So for those of you who are making a second attempt and trying to decide if you will go to the same center, his experience may factor into your decision.

  3. #3
    Lucy May is offline Member 537 points
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    Quote Originally Posted by Chopdoc View Post
    SPs are amazing people. My hat is off to them. They work very hard and take this very seriously. Did you know they have a professional association?

    Med students can be donkeyes.

    I will tell my story in reverse.

    When I left the exam I was engaged in a conversation with a very nice physician I met there. Nothing about the exam, just some general chat. As we walked out of the building we were accosted by a young man holding pen and pad at the ready. "Did you guys just take the exam?"

    Uh Oh........!!!!!

    Yup. He was serious.

    I simply told him...."Ya know they can yank your credentials for that and stop you from getting a license." And then quickly walked away.

    Right there in front of the doors, as the SPs left to go home, he wanted to violate his agreements with the testing body. Worse than that he was asking me to do it.

    Rant over. The test was nice. Really nice. I left feeling beat up....really beat up. A few hours of CS was like 12 hours of heavy ER work....at least for me. Not that the patients were that difficult, they were not....but exam stress was heavy for me. Nonetheless I smiled and I don't think the stress showed through.

    The cases were all covered in First Aid. Well, almost all. They do throw some twists in there as well and the possibilities are simply endless. If you need more than First Aid for this, then what did you do in med school?

    Honestly, the cases are easy from a medical point of view. They have to be because not much is expected of you yet in terms of that. Coming up with a reasonable differential and having appropriate testing to match is not difficult. Counseling a patient about drugs, alcohol, or sex is not difficult. Eliciting additional symptoms or significant social history is not difficult. Smiling, greeting somebody by name, making sure they are comfortable....not hard at all. Taking a focused history and doing an exam should be a piece of cake. Facing challenging questions isn't even really a challenge......really. Writing an H&P note, DD, and a few tests is simple stuff.

    BUT. And that's a big BUT. Doing all that while timed, and being evaluated, can tend to cause stress and degrade your performance.

    The solution?

    Review First Aid. Review it well. And PRACTICE. PRACTICE. PRACTICE. That means in person, in timed circumstances.

    Hmmmmm....makes you reflect on why exactly they call it medical PRACTICE. LOL!

    Again....hats off to the SPs.

    Now the nitty gritty. You wanna know cases. Well. I'll mention one....sort of....but maybe not what you want to hear......

    There was one teary eyed mother of a child presenting with a condition. She was so good she had me convinced. Really convinced. And that probably helped me more than anything else. She was my first case and I will always remember her and appreciate what she did for me by being as great as she was at her job.

    I made mistakes, and I know what they were. None of them were glaring mistakes and I think my work was relatively complete and my rapport with SPs was good.

    I think I passed but I can't tell you I know I did. I pray I did. I hope I did. I got myself behind this year because of family matters so I am up against the wall to get all my credentials filled by the deadline.

    To the guy with the pen and pad standing at the doors of the building of the testing center in Chicago: I hope you find a better way my friend. I really do.
    Did you look into other review resources such as the UW videos before deciding to just stick with FA?

    Thanks! I'm just trying to forumlate my CS study plan.

  4. #4
    Chopdoc's Avatar
    Chopdoc is offline Senior Member 528 points
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    Oh yes.

    Sorry for that. I did view several videos, but just the free (legally) ones available on the web. I didn't buy or subscribe to any.

    And I went through all the materials the USMLE gives as well of course.

    When I advised FA I was really just talking about the reading material and cases. Watching videos is helpful of course.

    The best thing is timed practice I think. Get on video as well if you can, watch yourself and see that you may not have smiled when you thought you did etc. You will see things you didn't realize you did or didn't do.

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