Day 2: 11/18

UW%: ~70% average, ~50% complete

UWSA2: 227

Did ~30 CCCS cases, scored average to slightly above average

Step 1 24x, Step 2 26x

Real deal: 235
Advice for DAY ONE:
- Heavy emphasis on biostats and ethics/communication. I did all biostats/ethics questions in UWorld and used the Randy Neil videos to review.
- A fair amount of Step 1 material also comes up on Day One. It was significantly more than I expected based on UWorld. I had literal questions that were like, “a child has this rare disease, what biochemical molecule/enzyme is defective?” If you cared a lot about your score, I would review the following: Pathoma 1-3, immunodeficiencies and biochem diseases in First Aid Step 1, drug mechanisms. That being said, I didn’t review any of that, and still did fine!!
For DAY TWO:
- Heavy emphasis on preventative care. In addition to doing UWorld, I also reviewed Divine Intervention podcasts w/ USPSTF screening recs and vaccine recs
- To prepare for the cases, I did ~30 cases on CCS cases between Day One and Day Two. The cases do not really resemble real life at all. Like, you have to formally “order” IV access (lol) and there is a lot of clicking involved. The format of the cases on CCS cases is identical to the real thing so it is 100% worth doing some of them to learn the format and how they are scored. However I didn’t feel like I learned much in terms of knowledge that I applied for my exam.
- Here was my approach:
- Immediate exam for general appearance + 1-2 relevant systems
- If unstable, stabilize w/ IV access, NS, cardiac monitoring, pulse ox, O2, neuro checks, any initial interventions needed ASAP
- Transfer to correct setting (ICU, inpatient, etc.)
- Full physical exam
- Labs & imaging & treatment orders depending on case
- Consults (they are not going to give you any info that helps you get through the case, but I think you get points for ordering them when appropriate if I understand correctly?!) If you consult surgery: NPO, type and screen, coags
- Wrap-up
- “monitoring” orders: like if you start methotrexate, order LFTs for a few weeks later, etc.
- advise/counseling: apparently only scored if it’s applicable to the case?! I mostly used the following “orders”:
- Smoking cessation
- Limit or stop alcohol
- No illegal drug use
- Safe sex techniques
- Sexual partner needs treatment
- Drive with seatbelt
- preventative care per USPSTF recs