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Sometimes, I am lazy. - Nobody wears a white coat any more... — LiveJournal
...a tribute to becoming a doctor.
Sometimes, I am lazy.
Tonight, I simply lost track of time. I had a good day, I will write about my good day, but I am currently distracted. There is an e-mail in my inbox:
Dear Students,
We want you to be aware that some students have failed the USMLE Step 2 CS. It is not a given that you will pass this examination and you should take some time to prepare yourself for this examination.  Based on our statistical analysis of our students’ results thus far, if you scored less then 70% cumulatively on your checklist or post encounter scores on your Senior OSCE exam, you are at five-fold increased risk for failing your USMLE Step 2 CS.

Now I know I didn't score less than 70% on my checklist or post-encounter scores for the OSCE. I had two below-average ones that dragged down consistently above-average scores on the others, although for the life of me I can't find my scoresheet, but I came out pretty well. I had bad dreams for two days about the one patient I have never been able to form a rapport with, and I did poorly on one because I was wicked nervous. Nonetheless, I am suddenly consumed with terror that I failed the Step 2 CS exam, that I did not ask enough questions or the right ones, that I did not gather sufficient data, that I did my exams wrong, that I missed past medical history questions.
My score report, according to the website, should have gone out February second. I haven't seen it. Is it late? Is it (tiny paper that it is, most likely) somewhere in the mail slot still? Where is it, and did I pass?

Suddenly, I can hardly sleep.

Edit: I went downstairs, because I couldn't sleep, and sorted through the mail slot. There was a tiny folded paper from the NBME. Inside: "Pass". I am so relieved.

now feeling:: worried worried

15 whispers echo . o O ( ... ) O o . whisper a word
kesil From: kesil Date: February 18th, 2005 05:02 am (UTC) (etched in stone)
They grade you on rapport? How awful.

Our school instituted 2nd year practice standardized physicals to help prepare us for the new COMLEX CS exam. I nearly killed someone with a blood pressure cuff. It was awesome.
ayradyss From: ayradyss Date: February 18th, 2005 12:36 pm (UTC) (etched in stone)
The ICE subcomponent includes assessment of:

• Data gathering - patient information collected by history taking and physical examination

• Documentation - completion of a patient note summarizing the findings of the patient encounter, diagnostic impression, and initial patient work-up
Data gathering is scored by checklists completed by the standardized patients. The checklists are developed by committees of clinicians and medical school clinical faculty and comprise the essential history and physical examination elements for specific clinical encounters. The patient note is scored by trained physician raters. Copies of the patient note template, sample patient note styles, and software to practice typing the note are available on the USMLE website.

The CIS subcomponent includes assessment of:

• Questioning skills (eg, use of open-ended questions, transitional statements, not interrupting the patient)

• Information sharing skills (eg, avoidance of jargon, responsiveness to patient questions or concerns, provision of counseling when appropriate)

• Professional manner and rapport (eg, concern for patient's comfort and modesty, examinee's attention to personal hygiene, expression of interest in the impact of the illness)
CIS performance is assessed by the standardized patients using rating scales. The domains included in these scales are, in part, based upon the scales used in the Clinical Skills Assessment (CSA) of the Educational Commission for Foreign Medical Graduates, with enhancements based upon national consensus statements on essential communication skills and upon review of other commonly used rating forms.

The SEP subcomponent includes assessment of:
• Clarity of spoken English communication within the context of the doctor-patient encounter (eg, pronunciation, word choice, and minimizing the need to repeat questions or statements)
SEP performance is assessed by the standardized patients using rating scales and is based upon the frequency of pronunciation or word choice errors that affect comprehension, and the amount of listener effort required to understand the examinee's questions and responses.

It's a horrible exam.
quinby From: quinby Date: February 18th, 2005 05:10 am (UTC) (etched in stone)
Love you, Nykkit. I knew you'd pass. I have all of the faith in the world in you. We really need to get together soon. I really have to stop being a bum. Bumness is bad.
ayradyss From: ayradyss Date: February 18th, 2005 12:36 pm (UTC) (etched in stone)
We do. And I'm dropping you an e-mail with three things we need to address.
From: dr_bobbie Date: February 18th, 2005 10:47 am (UTC) (etched in stone)
Ha! I did the same thing!

Passed, too. Father, forgive me for worrying!
ayradyss From: ayradyss Date: February 18th, 2005 12:32 pm (UTC) (etched in stone)

You know what? We're going to make it, Bobbie.
From: dr_bobbie Date: February 19th, 2005 01:42 am (UTC) (etched in stone)
We are! :)

If we've made it this far...
amasashi From: amasashi Date: February 18th, 2005 11:36 am (UTC) (etched in stone)
Nykki, Nykki, she's our woman. If she can't do it, no one can!

Congratulations :-)
ayradyss From: ayradyss Date: February 18th, 2005 12:32 pm (UTC) (etched in stone)
Woo! My own cheering squad!
Do I get to see you in a little skirt?
amasashi From: amasashi Date: February 18th, 2005 01:08 pm (UTC) (etched in stone)
Uh, no.

But I can offer you this:

Personally I'm sick of Asia Asians. Pack me up a white chick and I'll trade ya ;-)
ayradyss From: ayradyss Date: February 18th, 2005 01:37 pm (UTC) (etched in stone)
I'll look for some boxes. :)
ellisande From: ellisande Date: February 18th, 2005 02:08 pm (UTC) (etched in stone)
Why do I suddenly fear? ;)

I second the cheering, by the way. You'll be just fine, pretty-lady.
serennig From: serennig Date: February 18th, 2005 05:13 pm (UTC) (etched in stone)

Positive spin?

Relief when worried is all the more delicious than simply passing when you always knew you would.
mdrnprometheus From: mdrnprometheus Date: February 19th, 2005 11:13 pm (UTC) (etched in stone)
Er, so, would you happen to know what percentage of people in your class failed? We're trying to get an idea of this up here in Secret AMA Land.
ayradyss From: ayradyss Date: February 20th, 2005 12:46 am (UTC) (etched in stone)
You know, I don't know. But I'll see if I can get a credible estimate. I'd love to help out if I could.
15 whispers echo . o O ( ... ) O o . whisper a word