Sanjay Vinjamaram MD
University of Florida, FL, USA
Jitendar P Vij
Jaypee Brothers Medical Publishers (P) Ltd
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USMLE: CSA Comprehensive Review
© 2003, Sanjay Vinjamaram
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the author and the publisher.
First Edition: 2003
Publishing Director: RK Yadav
9788180610394
Typeset at JPBMP typesetting unit
Printed at Gopsons Papers Ltd., Sector 60, Noida
To
My Parents:
Who stressed the importance of education
My Wife:
Aparna, who brings love and balance to my life
Gopal, Ramu, Kranthi and Suneetha:
For their enduring support
5Preface
The Clinical Skills Assessment (CSA) is yet another hurdle to obtain ECFMG certification. It is not as easy an exam as many believe nor is it, as difficult. Given that it is a new testing area and deals with clinical - patient interaction modeled on American standards of medical care, international medical graduates often need special preparation and instruction to pass the exam in their first attempt. More often than not, students are overwhelmed by the information that has to be assimilated, in a short time. There is no ideal text available that addresses the demands of the CSA exam with the foreign medical graduate in mind. The books available are either too elaborate with irrelevant information for the exam or are too concise. I have made an attempt to make this book comprehensive yet precise, covering every aspect of CSA, thus making it self-sufficient, without any need for supplemental material.
The book is conveniently divided into major systems and covers all the important symptoms and cases. At the end of most chapters there are a few practice cases which have actually been on the exam, followed by a few assignment cases. Each chapter includes the “CSA Patient-Interview techniques”, history, differential diagnosis, labs and the patient education that is required for each symptom. Brief physical examination is covered in each system to hone your clinical skills. Well, that's all you need for the CSA exam.
I don't intend to criticize, but one should realize that a popular book (the one with only cases), erroneously focuses questions and information on one disease in contrast to what one is supposed to do in the CSA exam; ask questions in a broad sense covering more than one differential diagnosis.
The intention of this book is to allow rapid and accurate assimilation of knowledge, particularly in a limited time. Chapters covering Obstetrics and Gynecology and Pediatrics have been included, as those cases have begun to show up on the exam.
Though some questions in the history of present illness section and certain labs may seem excessive or unessential, they have been included for information only and appropriate questions need to be omitted as per the actual symptoms of the standardized patient (SP) in the exam.
Complete your assignment cases promptly before you proceed to the next chapter. It is advisable to take your CSA exam within a short time after studying the text thoroughly as concepts and information will be fresh in your mind.
It is my sincere hope that this book will simplify your exam preparation.
Your suggestions are welcome. Good Luck!
Sanjay Vinjamaram