consultant does not agree. - tauko

[ArchivalUser]

Guys whenever i ask the vascular surgeon to do a carotid endarterectomy after a carotid doppler, he/she never agrees. this is on Usmle world CCS software. Please help

[ArchivalUser]

http://slink.co/4a515

[ArchivalUser]

In CSS consultants are not programmed to give you any opinion. It only a test if a candidate knows when to seek for help.

Consult will say
The consultant has no explicit management recommendations at this time. Please order any additional tests, therapies, or procedures if needed.

Be sure consult was placed after result of carotid doppler

and

Surgical order was placed after cosultant saw the patient.

there will not be any opportunity for consultant to refuse care of YOUR patient.

Only patient can refuse a procedure. And they will do if you put an order in wrong patient or that case will simply end.

[ArchivalUser]

yes, but in this case the patient should be accepted for carotid endarterectomy right?

Is it always like this in the CCS software? of USMLEWORLD?

[ArchivalUser]

This is a fantastic explanation I found while browsing Student Doctor forum :

" Consultants give a real response on the exam. UW does not tell about sequencing of orders and did not incorporate this sequence in to their software algorithm. Exam step 3 software is cleverly designed to change surgeon's responses based on sequencing of your orders. You can practice the following example on NBME exam software and see how surgeon's response changes.
I learned this on a demonstration shown on Archer CCS video. Step 3 software tests us if we are capable of meeting Surgery criteria before calling a Surgeon. If you do a surgery on a patient who does not meet criteria, it will fail us because we are removing an organ from a patient or invading a patient who does not need it. With regard to what Archer showed, he gives a clear example in aortic dissection case on the step 3 software how surgeon accepts the case when criteria is met ( CT scan results show ascending dissection and then we should sequence consult order). In the same case, he calls surgery consult before ordering a CT and the surgeon says "no recommendation" . He calls surgeon after ordering CT and after result comes in for the CT, then same surgeon accepts and says "patient will be scheduled for surgery". So, it is important to sequence orders to meet surgical criteria first and then call surgeon if required. The criteria for surgery in dissection is the location - ascending aorta - CT needs to be read before calling a surgeon. "

[ArchivalUser]

got u.

Thankx a lot

[ArchivalUser]

thx,,,this is helpful

[ArchivalUser]

this is why lot of people recommend completing ARCHER before touching UW ccs

[ArchivalUser]

I do not know if anyone noticed...these errors are still same oin the UW software, no fix. Consultant is accepting on USMLE.ORG exam software