Posted by worried from IP 64.79.73.166 on February 28, 2006 at 16:53:20:
MY CCS Cases
Latino coming with infiltrate multiple sexual partner.. Did not manange at all did not do gram stain.. to see for PCP..
Juaundice 2 nd day with cephalhematoma.. gave phototherapy Bili 15 to 12 in 2 - 3 days..
Child abuse
CHF
MVA spleen rupture and rib #
18 year old coming for physical (before army recruit)
pregnancy with UTI
Duedonal ulcer
TIA
My background studied 2 months prepared UW scored 54 %.
As doing residency I took for granted that CCS is ok, it seems to be ok with CHF, TIA, like doing daily admission in floor.
But others like neonatal jaundice I knew that we need to patch the eyes but I did not know how to order like getting Erythromycin ointment that is where UW comes to our help. Similarly in PCP did not order gram stain silver stain. So I did pathetically bad in PCP, jaundice, 18 year old recruit, in Pregnancy I got preg but ordered UA and scheduled for next f/u then only I realised that I had not checked UA analysis and give Abx the result gave Abx on the 8 th day.. I was disgusted myself..
I only wish the CCS cases where either like CSA or like Tofle were we can put written orders.. It is like learning "CCS software" rather than Medicine.. USMLE should know that every hospital has there own computer program and dont need us to learn there way.
But unfortunately it is their way or the Highway..
Please study UW CCS throughly and it is the best we can do and I really regret now. It is worst than MCQ becos once order entered we cant take back or change like going back in MCQ and changing answer.
If I pass it is really just Gods grace..
Regarding MCQ well UW and Kaplan had couple of Q in the exam but what I realized is that they atleast orient our mind to look the MCQ in certain angle..
Becos this is second time I am repeating step3 and this time I realised that if I have not done Q specially for Ethics or management of pt then I would have looked differently.
Anyway finished is finished need to get to floor work tommorow and will pray to God ernestly that I did try my best and leave for his grace and mercy to just pass.
GL to all and having been very helpful.