it getting tougher day by day to pass CS on first attempt.i want to
discuss few important aspect of this exam. which could help you some way
to get your goal.
what to study?
well there are not so many books for CS but most of the people read First Aid and i think thats a great book but not alone.
you should read the USMLE WORLD get it print out every page make a
folder. read all the topic starting from history taking, physical exam
and all the cases given into it.
reading alone is of no use for this exam even if you study for years. ok so try to practice with somebody again and again.
every case should be on your tips literally.
you will be given 12 Standardized patients. they are not real patients.
but keep in mind they are real examiner they will mark your performance.
so be nice to them.
every case will be given 25 mins
15 mis for history and physical.
10 mins for writing the history, physical, 3-5 possible D/D and diagnostic work up.
mostly people think thats is the work we need to do and will.
but do u think 15 is enough for history and physical.
try to practice a complete case just like the real exam situation. you will find its not easy.i know.
few advice-
1- feel confident and calm yourself.
2- read the information given at the door. try to make a picture what is case all about. think about the chief
comp and try to make 3-4 D/D BEFORE KNOCKING THE DOOR.
3- now knock the door.
4-give a good smile. m serious.
5- introduce yourself. try to speak with confidence.
ex- hello mr. douglous good morn, myself dr. k i am a physician here. nice to meet you. how you doing today?
ans- fine.
6- so what i can do for you?/ what brings you in today?-open ended q?
ans-tell chief comp
7-then you need to make eye contact and ask mr. dos would you mind if
write down some notes while m talking to you? this cast a impression
that u really care about him.
8-then you start the case- ask the relevant q? according to the case.
can use pnemonic-PAIN
L- OCATION
I-NTANSITY
Q-UALITY
O-NSET
R-RADIATION.
A-GGREVATING FACS
A-LLEVIATING FCAS
A-SSOCIATED COMPLAINS.- according to the system involved.
fever, chills, night sweats and et. al.
+
PAM HUG FOSS-
PAST
ALLERGY
MEDICATION
H
URINE
GENITAL
FAMILY
OBS
SEXUAL
SOCIAL
few other points
1-if pat starts coughing.
give him a tissue and ask would u like a glass of water mr.....
if he say no.
again- are u sure?
always take every encounter as real clinical situation.
2-if patient is angry bcoz he think you are late.
dont think he does not like you.
try to console him. say i am really sorry mr...for making u wait so long. actually i encounter unexpected
delay with one of my patient.
to be conti...
3- always speak very clearly and slowly. dont rush things because it
makes you look that you are not interested in patient problem.
4-lets the pt tell you whatever he want to.
5-once you are done taking history. dont forget to recap every point in
front of patient. ask him if want to add something that i might have
missed.
6-after taking history tell him that u are done with history and now i
need to examine you. say like will u excuse me mr.... while i wash my
hands. you can wash your hands while talking to him but make sure you
dont loose the eye contacts.
7- wash hands- look what you have at wash basin. is soap available or
not ? if not try to use gloves and also tell the patient and ask if he
has some kind of allergy to latex.
8-before you start exam- keep few things in your mind.
consent - what ever u do always ask the permission and reason why u
doing it. like mr.... i need to examine your chest, may i go for that?
mr... i need to untie your gown to examine your chest if you dont mind.
wait until he nods yes. then start untying.
try to expose as less part as possible to examine.
once you are done tie the gown up.
be gentle dont be too rough while examination. if patient is in pain be very very careful. and if pt complaints
pain always say sorry.
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