当前在线人数16233
首页 - 博客首页 - 美国医学教育博客 - 文章阅读 [博客首页] [首页]
yoghurt: Finally it comes, I do make it--step 2 CS!
作者:USMedEdu
发表时间:2009-04-29
更新时间:2009-04-29
浏览:1459次
评论:1篇
地址:10.
::: 栏目 :::
现代医学vs“中医”
社会、艺术与医学
住院/FELLOW单位
中外医学网站精选
国内外医学交流信息
生物医学人物
力刀美加医学教育专
临床见习/实习/义工
医学生理学诺贝尔奖
医生助理(PA)职业
医学书籍照片及图谱
社会与医学瞬间定格
医学典故/医史杂谈
USMLE复习和考试
申请和面试住院医生
住院医生生活和工作
FELLOWSHIP
医生就业、工作及生
医学科普及问题解答
美加医学院申请/MCA
中美医学临床教育比
医学新进展及新闻
社会医学伦理

发信人: yoghurt (yes I can!), 信区: MedicalCareer
标 题: Finally it comes, I do make it!
发信站: BBS 未名空间站 (Wed Apr 29 10:38:43 2009)

Just got the CS result , I passed after second attempt! All the suffers in
the past 10 months gone with wind. This moment , I only want to cry.

Thanks for all the help from this forum. Thanks cyclin MM and LUZM and my
kaplan couse roomate( I need to try to find your ID first.) and other IDs( I
should figure out ID first). You raise me up!

In the past 10 days, I try to calm my nerves and write some Qs and As
according to recent Qs from this forum. hopefull it help. Definitely I will
write some unique thought I summarized from this 10 month's prep later on
after work. Let me pass the torch on.....

Q:
huitong09 (hong):How to ask tenesmus?
A:
Do you have incomplete feeling after the bowel movement?
Q:
tanjiacai (caicai): CS PN打字有什么不好的吗?
A
Typing is better than handwriting; however, make sure your spelling is
correct. There is no proofreading function in the exam. A lot of ppls I know
chose typing. Be prepared for both, last time ,the computer system in LA
down for 30 min , at that time, you don’t have any choice but writng.

Q
tanjiacai (caicai): CS neuro cases question and more.
A
Focused exam. You should have enough time to finish, I will skip fundalscopy
exam in CN2-12 exam. It is only one mark and takes a lot longer to complete
compared with others. For dizziness, definitely you should ask pt to walk (
quick walk). But before doing anything, brainstorm it and clarify it is
neuro case or cardio case, if you suspect orthostatic hypotension, don’t
touch neuro at all. Don’t do both, you have plenty of time!
About the order, you are right.

Q
Hahaha: After you notice RLQ tenderness, how to check for rebound tenderness
and
Rovsing's sign? Isn't that repeating painful maneuver?
A
Excellent question!
Don’t repeat painful maneuver, not the exactly the same place. That is
the point. For Rebound tenderness , you should press the other site , For
example, if it is appendicitis, you should press left site. NOT right site!.

Always leave rebound tenderness the last. And it is best time for you to
show sympathy! I can imagine you are suffering a lot of pain (eye contact!),
but it is very important for me to make the Dx, I will be quick and gentle.
I love this moment!

Q
balloon123 (气球): CS exam date change?
A
Be ready and take what day comes up in the schedule in the desired day, that
is my partner did, She only prepare for 20 days ! I noticed that the date
is always available if you use Yeye’s method.

Q
abcdefg2008 (jasmine):Am I ready for CS
A
I don’t know the answer , that is the most difficult one…

Q
leap1993 (leap): A patient comes for fever and sore throat, but also
complains headache and
joint pain when you take HPI, do we need to ask LIQOR AAA about the pain?
A:
I will ask for LIQORAAA for both, but let the SP guide you, if you found pt
show impatience during the conversation or he or she tell you,wow,Dr, it is
not that important, or not that bad, it is just like common cold, stop
there, go ahead. The sp knows better than you regarding to the case. But if
you have plenty of time during the PE, continue to finish you rest of your
LIQORAAA.

Q
tanjiacai (caicai):how to speed up in CS encounter?
A
You can’t fake the exam. You must wait for one full breath cycle. DO
focused system.
Abd exam: the gown is not yours, it belongs to the sp, only the tie is
belong to you. Don’t touch the gown,” could you please raise up the gown
for me, I can help you with that.” The sheet is yours; raise the sheet to
make sure the sp’s body is not exposed inappropriately.

Q
abcdefg2008 (jasmine): CS telephone interview开场白怎么说啊?
A
Good morning, may I speak to baby boy….’s mom? (According to door
information).
After confirmation, I am Dr….I will physician to talk to you regarding to
your son’s condition.

Q:
skysunder (skysunder): 如果心肺exam,病人是坐着的,上半身是不是全是exposed?
how to do
draping?
A: minimized exposed area. If 心肺 exam,yes all exposed . it is necessary.
But remember, let pt to pull down the gown, you only help the pt untie the
gown. This way, the sp will feel comfortable. When you listen to lung from
the back, just untie the gown, you don’t need to expose the front chest.
Minimized the exposed time and exposed area.

Q:
cs66: 心脏检查坐着,还是同时需要查躺着的。 肺部前后都查吗? 查pulse 是听心脏
还是摸脉搏,坐着还是躺者?
A:
If heart disease, full heart exam. That means: JVA bruit+ heart two position
(sitting and 30 angle)+ pulse . Pulse :one position is enough. For heart
case, only listen lung from back.

--

※ 来源:·WWW 未名空间站 海外: mitbbs.com 中国: mitbbs.cn·[FROM: 70.240.]

[上一篇] [下一篇] [发表评论] [写信问候] [收藏] [举报] 
 
共有1条评论
1   [USMedEdu 于 2009-04-30 08:13:41 提到] [FROM: 10.]
发信人: yoghurt (yes I can!), 信区: MedicalCareer
标 题: Re: Finally it comes, I do make it!
发信站: BBS 未名空间站 (Wed Apr 29 21:35:10 2009)

A couple of points I’d like emphasis on:

1 know what the exam is about:
They only care about communication skill! All the evaluation is done by
patient except for patient notes.
Majority people will focus on questionnaire and PE, like step1 and step2.
According to my understanding about this exam, why PE, they want to see how
you wash your hands, how you perform the draping, how you show the empathy
to the patient when SP is in the pain! So treat PE as the extension of
communication skill. Do focused PE. One system! No more than 2 systems.
Cause there is the most important part ahead, closure! That is the king of
king of this exam.

2 Why spoken English, it is also part of communication. There are only 2
points:
1) SP can understand you
2 )you understand SP.
1) Try spoke slowly as VOA. That is what I failed on. If you are not sure,
try to find personal accent trainer to help you with the encounter. I paid $
300 for an American tutor, he help me word by word with my encounter. It is
very important. An another way to overcome this problem is find multiple non
-chiniese partner, they can pick your problem and correct you.
2) that is easy part: every 3-5 questions, stop and ask “you said…., is
that correct? Paraphrase is the only tool that can convince the SPs that you
understand .

3 Karlan course is really good, I totally agree with Mom’s suggestion, go
there one week before the exam and the true exam just like extension of your
class. But before that , make sure you are done with FA , at least FA mini
cases. Personally I don’t think UW is good compared with FA. You can skip
it even you have time. All my 3 partners didn’t have a think of UW and all
of them passed with the first attempt.

4 centers selection:
I truly believe that Houston center is much easier than L.A. center. If you
have choice, chose Houston center.At least better than L.A.. I know majority
of mid-east IMG chose Houston for its pass rate.

--

※ 来源:·WWW 未名空间站 海外: mitbbs.com 中国: mitbbs.cn·[FROM: 70.240.]


发信人: georgiall (georgia), 信区: MedicalCareer
标 题: Re: Finally it comes, I do make it!
发信站: BBS 未名空间站 (Wed Apr 29 21:37:17 2009)

When I got my score, I burst into tears too.
All my suffering in the past 100 days became colorful rainbow in my memory,
so rewarding.
--

※ 来源:·WWW 未名空间站 海外: mitbbs.com 中国: mitbbs.cn·[FROM: 192.17.]


发信人: yoghurt (yes I can!), 信区: MedicalCareer
标 题: Re: Finally it comes, I do make it!
发信站: BBS 未名空间站 (Wed Apr 29 22:33:33 2009)

谢谢楼上各位的鼓励,这个版的版友教会了我很多东西。不仅仅是方法攻略,更重要的
如何做人,看Cathy,Oldray,老刀的贴子很受启发。 考完CS,备考CS做的一个儿科ER
的OB,彻底死了申请其他科的心,发现自己得了patien phobia。 (先拍拍咱们病理师
兄师姐们的马屁先:)。
不过考过了,发现CS的训练对临床真的是很有帮助。 在儿科EROB时,一位mom面对自
己24个月的宝宝突发性小脑功能障碍不知所措,泣不成声,我的attending 用了经典的
CS 招数,沉默3秒然后轻抚右臂, 刹那间医生和患者之间的conection变建立起来的。
再谈eye contact:我总认为这个太过了,KAPLAN班上有一个老美跟我分到了一个group
,很普通的一个女孩,为了进皮肤科,多读了一个phD。当她做练习的时候,尤其是但
她跟SP交流的时候,我觉得整个屋子都被她眼神里的关注照亮了。全程eyecontact 非
常重要。

--


发信人: yoghurt (yes I can!), 信区: MedicalCareer
标 题: Re: Finally it comes, I do make it!
发信站: BBS 未名空间站 (Wed Apr 29 22:39:04 2009)


【 在 georgiall (georgia) 的大作中提到: 】
: When I got my score, I burst into tears too.
: All my suffering in the past 100 days became colorful rainbow in my memory
,
: so rewarding.


理解理解,无论是100天还是十个月,折磨是一样的呀,我的宝宝在我复习的最后几天
,最喜欢的游戏就是,敲门,握手,GOOD MORNING,IT IS VERY NICE TO MEET YOU, I
AM DR. LIU....
如果我在不过,我们家倒会真有一位医生产生了。
--

※ 来源:·WWW 未名空间站 海外: mitbbs.com 中国: mitbbs.cn·[FROM: 70.240.]
发信人: yoghurt (yes I can!), 信区: MedicalCareer
标 题: Re: Finally it comes, I do make it!
发信站: BBS 未名空间站 (Wed Apr 29 22:42:28 2009)


【 在 Oldray (麦地.prajnaparamitahrdayasutra) 的大作中提到: 】
: Great!You should come to Houston exam center for the first test.



这个强烈推荐。 跟我一起考试的一个中国jm就是从NJ飞过来考的。在KP上课的时候,
有一个中东的小朋友说他的同学全都来Houston考。 我个人认为Houston的容易很多。
--

※ 来源:·WWW 未名空间站 海外: mitbbs.com 中国: mitbbs.cn·[FROM: 70.240.]


发信人: yoghurt (yes I can!), 信区: MedicalCareer
标 题: Re: Finally it comes, I do make it!
发信站: BBS 未名空间站 (Wed Apr 29 23:04:26 2009)


【 在 harrywfu (天南海北山东人) 的大作中提到: 】
: 另能否说说你第一次的失误在什么地方?

揭伤疤了!
上一次,我的CEPandPN 很高,CIS 刚过,输在SEP上。第二次再练的时候,所有的人都
指出我说话太快,甚至中文都太快。 再加上口音,不输都不成。 上一次,我求全,唯
一能够达到目标的就是提高语速。
坦白地说,第一次我连这个考试考什莫都没搞清就上了考场。

上kp课的时候,我PE hurry SP,被老师单独训了半个小时,我都快绝望了。下周一马上
就要考了也! 那一周,我都不敢睡觉,到处拉着班上的同学练。 SLow ,一定要慢。
CSfailedonce 贴出了kp CIS 18 point,that is the most important part. Make
sure you finishe 18 points for each case.

--

※ 来源:·WWW 未名空间站 海外: mitbbs.com 中国: mitbbs.cn·[FROM: 70.240.]


发信人: ada (ada), 信区: MedicalCareer
标 题: Re: Finally it comes, I do make it!
发信站: BBS 未名空间站 (Wed Apr 29 23:29:55 2009)

Yoghurt,你也是专门飞到houston考的吗?Chicago离我近些,不知道难度如何?还是也
该改去houston考呢
--

※ 来源:·WWW 未名空间站 海外: mitbbs.com 中国: mitbbs.cn·[FROM: 74.128.]


发信人: yoghurt (yes I can!), 信区: MedicalCareer
标 题: Re: Finally it comes, I do make it!
发信站: BBS 未名空间站 (Thu Apr 30 00:43:59 2009)

I live in Houston right now.Just take the advantage of it. I have no idea
about other centers, but regarding to the cases and cooperation of SPs,
Houston centers is much more easier than L.A. In Houston center, all the SPs
just say no or yes, or repeat I do have stomach pain. or I don't have
diarrhea. yes Dr.
all the encounter is even easier than the practice . This time ,for every
encounter, I finished earlier, at least 2 min left. one of my Sp even tell
me "oh, Dr. you forget to ask me is there anything make it worse? " That is
really cool! one challenging questions one sp, no more than 2 ! If you must
fly , come to Houston. or you can ask other people's experience in Chicago
. I just feel I can get instant connection with SPs in short time here
compared with LA center. Maybe it is because my improvement?
--

※ 来源:·WWW 未名空间站 海外: mitbbs.com 中国: mitbbs.cn·[FROM: 70.240.]



 
用户名: 密码:
发表评论
评论:
[返回顶部] [刷新]  [给USMedEdu写信]  [美国医学教育博客首页] [博客首页] [BBS 未名空间站]
 
Site Map - Contact Us - Terms and Conditions - Privacy Policy

版权所有BBS 未名空间站(mitbbs.com) since 1996