If I meet a patient in the Emergency Room, and it’s not emergent, can I just refer the patient to their PCP?
The answer to this question is No!!! This may come as a shock to everyone, but the USMLE Step 3 CCS Cases portion of the exam is not real life. While coming to the ER with high cholesterol is typically not treated in an emergency room setting, if someone comes to emergency room, you treat EVERYTHING YOU CAN FIND! You are the generalist and once you meet this patient, you do everything for them in all types of settings including emergency room, inpatient, ICU, and office settings. This is not realistic, but knowing the Krebs cycle is not used very much in clinical practice and is fairly useless in real life, but it’s frequently tested on the USMLE (Not on Step 3, but you get the point we’re making).
If you don’t believe us, here’s a quote taken directly from the USMLE website: “In the generalist role, you must manage your patient in both inpatient and outpatient settings. Sometimes this may involve management in more than one location—initially caring for a patient in the emergency department, admitting the patient to the hospital, and discharging and following the patient in the outpatient setting.” The reference is located here.
So, to summarize, if you can find it, you treat it. It’s important to get consults for specialist if needed, but if it’s a problem that can be managed by a typical generalist, then for the sake of your grade, treat every problem and do not assume that “they will follow-up with their PCP.” YOU are their PCP!
We hope that it is helpful. If you feel you need more practice on the USMLE Step 3 CCS Cases portion of the exam, you can try out our two free practice cases here.