Count down to Step 2 cs: 6 days left

I followed my normal morning routine so there's nothing to write about there. In the afternoon I did 3-4 cases with my sister and then 8-9 cases  back to back in the evening with my girlfriend. I was inconsistent in asking about the job, stds, drugs. At times I would ask at other times I would be so caught up in the case that I would forget. Also, I need to work on my DM and HTN follow up visits, and to work on being more observant of the patient, what they are doing and their environment. I might have missed things because I was exhausted but exhaustion is can not and will not be used as an excuse. I have to be on point always. Will review what i missed tomorrow morning in addition to the usual.

Today my best time for completing the patient section was 16 minutes.

modifications:
1)for chronic cases always screen for depresion
2)for each new complaint get a description ( if in ros there is pain somewhere else rewrite SIQORAAA, if there is another complaint rewrite DOCPAAA, and if there is vomitus get descriptions and ask if blood or mucous and ask to descrip.
3)for social history use pneumonic to remember alcohol use and drug use work etc.
4)for sexual history use pneumonic to remember std, protection, types of partners, counsel
5)counsel as you go along 
6)focus focus focus and pay attention to details around you.

Countdown to Step 2CS: 7 days left

Day 1 of step 2cs studying was fine. I took it a little easy to ease myself back into the groove of going hard, and to let my sister get used to the format. By easy I mean I did only four to five cases back to back. Tomorrow, I will do 6-7 cases back to back. I will now detail how I organized my day and what i have learned.

In the morning, whilst in my car  for an hour and a half awaiting the end of alternate side parking,  I reviewed/memorized the blue sheet structure and mnemonics outlined in laura's video. (check out my earlier post) When i got home i looked over some mini cases mainly to review differential diagnoses as well as the possible lab tests to run. I also read through the special scenario section, which details how to handle difficult patients, questions, ethics etc. Then i relaxed.

At 2 pm, I practiced 4 cases, with my sister being the standardized patient. Then we took a break till 8pm at which time we did the remaining 5 cases. I did not write up any patient notes today. The longest time I took to complete a patient encounter including the physical exam was about 22 minutes, with my best time being 18min (technically it was 12 minutes but that was for a short pediatric case so i'm not counting that.)

I noticed that I occasionally missed a few things: asking permission to start physical examination; counseling about smoking or sex (this was at the end so maybe i was tired); and for pediatric cases hearing, vision, vaccination, and last check up. I will make a list of the things that i keep forgetting to do and just review it everyday, especially on the morning of the exam. To make sure I dont neglect to counsel patients with bad habits i will place a big star beside the desired section (smoking, drugs etc) the moment i write down the information.

Neymar vs Celtic Away HD

Neymar was trully jostled, kicked, pulled elbowed  throughout the whole match against celtics today. If he can toughen up like messi  and grow from these rough matches he is bound to become a versatile weapon for barcelona. As a skilled striker a lot of teams will be using rough tactics to try and disrupt his momentum. Will he grow above that and still shine? That is yet to be seen. I will follow his games hoping upon hope that his true potential shines through. (side note: I'm not saying he sucks. He is a way above average player as he is now. But he can get even closer to messi/ronaldo status and thats what i want to see.)

How am I studying for the Step 2 CS

My CS is scheduled for October 8th, 2013. Thats right around the corner; about 7 days to D day. Luckily for me, I just finished my pediatric allergy rotation in the bronx ( a rotation I really enjoyed so will write a blurp about it later). Since, the exam is right around the corner everyday from today is going to be crucial and as a consequence must be structured.

I will be using two resources: First Aid for the USMLE Step 2 CS and laura Miranda's youtube video. The essential sections of first aid that i will use are mini case section (to review ddx and appropriate lab tests) and the full length practice cases which i will go through with my sister. Laura Miranda's youtube details how she structured her approach to each patient. I will follow her approach since time is short and it makes no sense to reinvent the wheel. I am already comfortable when it comes to performing interviews but since the step is timed a structured approach is needed, this is where laura's video comes into play. See below for a link to her video.
I watched laura's video today and jotted down the structure she used for her step 2 CS. Thats it with the video.

For the next five days I will eat breath and sleep CS. Every morning, I will review the structure that i will be using (check laura's video), review my physical exam plan, and review the mini cases in first aid. For the rest of the day I will go over full length cases with my sister, 9 in total for the day and if i can i will do more.  As with all studying plans, i will change and focus on specific things as time moves on, but this is the overall plan of attack I will use. Pray for me. haha.

Resources:

1) Laura Miranda's video:

2) First Aid for step 2 cs

How to succeed in medical school: Medical School is hard

            For some students medical school is a breeze but it is not for the majority. For most of us medical school is quite hard. I have to work really hard to do well, to succeed. Even then there are stumbling blocks. You might feel you are not good enough, you might  fail an exam or even fail a class. However so long as you stand back up, put your head back in the books you will succeed. Make a plan on how you'll study and follow it. Get help if you need to, get help from counselors, friends, the internet; dont be too proud. And the most important thing I would say is test yourself. Always test yourself by doing sample questions, sample practical exams sample everything to see where you lie. Enjoy this motivational video and listen to the words of Gary Raser in the back ground. It is not about medical school per se but principles of success are universally applicable.