April 24 2013 Step 2CS Score Report

I'm am sorry to hear that man. Truly I am. I've heard people say that good scores on Step 1 do not necessarily translate into a good CS score. The bright side is you are a US medical student, so the fail should not keep you from certain residencies like it would for IMGs. You'll blow the exam out of the water next time since now you'll know what to expect.

I am a US citizen going to a Caribbean school, and I just found out today I passed. All of my performances were above average or high. I don't know what else to ask or tell you, other than do you feel like you missed something in the CIS?

Me and my classmate were failed in the CIS portion as well, we took the test on the same day at the same site with the same rotation. Both of us thought patient interaction was our strong suit, and, of course, we studied. We are trying to consider our options right now but it seems like the USMLE is a behemoth of a company to take on and try to prove your case. 2/12 failing is simply more than just chance and certainly higher than their averages.

Philadelphia March 4th. We were thinking one of the actors may have graded disproportionately hard. Or a clerical error. In any case I think it merits sending in the recheck score paperwork. I was considering sending in a letter as well because score rechecks only look at the math, not the video or subjective grading. It blew my mind because patient rapport is not something I struggle with, I used to be a mental health counselor.

Will do. Are you signing up to take it again at the same time as submitting a recheck?

Did you guys perchance forget to counsel the patients appropriately? (For example: if the patient was coughing with pneumonia suspection and is a daily smoker did you counsel the patient to stop smoking?)

I counselled on anything and everything that was applicable. Went through First Aid CK with a partner.

I am in the top third of the class with HP or H in third and fourth year clerkships, great letters, great step 1, CK, positive unsolicited feedback from patients, etc. I have no problems seeing real pts and writing good notes. I made sure to use empathy in every case, ask questions to get at least 3 differentials and wrote a better letter than the sparse example they have on their website. Something is not right with this. I don't think I made enough mistakes to fail. This test is a scam and is just another way to extract money from students. I'm sure that their report of "more stringent standards" starting in January is code for "we need to increase our fail rate in order to legitimize the test". No AMG should have to take this somewhat subjective "test".

Now I have to give these parasites more money to take it again.

There are no available spots to retake it until the July 22nd. Anywhere in the country. I am totally screwed for the match, my score won't be in till October.

And to update, there is a third person from my group of 12 that was failed.

.

never had communication problems with any of my patients or anyone so far
and received Failed for CIS
cant understand what happened
i took it in philadelphia in jan

prznpremed said:

There are no available spots to retake it until the July 22nd. Anywhere in the country. I am totally screwed for the match, my score won't be in till October.

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Ask for help from your school. Get them involved.

cheruka said:

Ask for help from your school. Get them involved.

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Three people out of twelve failing is very suspect. I'd definitely pursue the case. I took the exam in July and passed easily. However, perhaps things have changed since the changes were introduced in January, which is worrying.

In an exam virtually devoid of objectivity, I feel the onus is on them to justify the reason for the failure, and why your performance was below-average. Albeit we all take Step 2 CS lightly, I feel that we as Medical Students generally have a very good feel for how we performed in an exam.

Someone made a very good point above regarding the NBME increasing the number of failures to legitimise the exam. This is complete and utter crap as, in similar manner to Step 1 and CK, the exam should be standardised historically.

If they're going to fail you and not give you specific reasons for the failure, that's very shady business.

Problem in these situations is they respond with generic responses. No one on their end actually cares about a couple of test takers failing. There's no one to even contact about it. Unless the court orders it, you'll never be able to see the checklists, etc. It indeed is a shady business. There is no transparency at all here. I believe they work on a failure quota system. They have to pick a certain number of people to fail every year. There are many AMGs and IMGs who do well but are still failed and are left with no answers. Only a flag on the resume, $1200 down the drain, and a hit to the residency app.

CDI said:

Problem in these situations is they respond with generic responses. No one on their end actually cares about a couple of test takers failing. There's no one to even contact about it. Unless the court orders it, you'll never be able to see the checklists, etc. It indeed is a shady business. There is no transparency at all here. I believe they work on a failure quota system. They have to pick a certain number of people to fail every year. There are many AMGs and IMGs who do well but are still failed and are left with no answers. Only a flag on the resume, $1200 down the drain, and a hit to the residency app.

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I agree - it's nonsensical.

In fact, the old system whereby the patient ticked off the number of items you'd covered seems far more objective.

Anyway, my sympathy extends to those who failed the exam. Keep the chins up - you'll recover from this.

I still wonder why they don't allow us to see how these exams are scored.

What's the reason to not show us the checklists unless they're using a failure quota with discriminatory criteria?

I wonder if anyone has even asked this and/or raised a legitimate case which went to the publics eye.

I know of 5 people, similar ethnicity, (IMGs) who filed a lawsuit against NBME and actually settled out of court for $25k each. They were initially failed for no reason, and then later were passed. By that time they had already re-applied, and re-taken it and lost a year.

So let me know if I got it right--a lay person (SP) can destroy your entire medical career due to some personal bias? So, if an SP goes rogue there is nothing you can do about it.
Apparently, someone is supposed to be watching behind the one way glass and there is video recording for "Quality control" but are they really doing that? They might not have the resources ( since it costs $$$) to watch the videos or hire an MD to observe behind the glass. One may never know and we just have to trust them.

Transposony said:

So let me know if I got it right--a lay person (SP) can destroy your entire medical career due to some personal bias? So, if an SP goes rogue there is nothing you can do about it.
Apparently, someone is supposed to be watching behind the one way glass and there is video recording for "Quality control" but are they really doing that? They might not have the resources ( since it costs $$$) to watch the videos or hire an MD to observe behind the glass. One may never know and we just have to trust them.

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It is very possible, yes.

They could claim you didn't do a bunch of things on the checklist (they never regrade the encounters) or maybe they make some comment like "I'd never go to this physician."

What's the worse that could happen to them? They lose a gig as a SP? Maybe they were already planning to quit or were previously pissed at doctors for not saving a family member and take it out on the examinee.

End result: We get our medical careers derailed. Knocked out of the running for certain residencies.

I don't know about the behind the glass thing, that would be way to shady. Then again, CS is shady as it gets. Im sure some lawyer could spin that into even being illegal.

Yeah, the videos are done for "quality control". Or if something goes horribly wrong, and someone subpoenas them to produce them in court.

I'm so sorry to hear that, guys.
I took mine in late January in Philly and I talked to friends who took it in other places and our experiences were apparently very, very different. I remember leaving the site wondering why every patient was so obnoxious and belligerent. Most of the stuff I had been practicing in my head- how to be supportive etc- just didn't apply at all because half my patients told me they wanted to leave and they were sick of being here and I was late, etc. I passed, but my CIS score was definitely a good bit lower than the other 2, and frankly I thought I'd failed just because of how difficult my patients were. None of them looked particularly comforted by what I told them at all. So maybe there's just something to that site...none of my classmates had that experience at all.

Why are people having this experience in Philly? This is where I'm scheduled, and I now have a feeling of impending doom about doing it there!

Did anyone else notice this about that site?

Syncity said:

Three people out of twelve failing is very suspect. I'd definitely pursue the case. I took the exam in July and passed easily. However, perhaps things have changed since the changes were introduced in January, which is worrying.

In an exam virtually devoid of objectivity, I feel the onus is on them to justify the reason for the failure, and why your performance was below-average. Albeit we all take Step 2 CS lightly, I feel that we as Medical Students generally have a very good feel for how we performed in an exam.

Someone made a very good point above regarding the NBME increasing the number of failures to legitimise the exam. This is complete and utter crap as, in similar manner to Step 1 and CK, the exam should be standardised historically.

If they're going to fail you and not give you specific reasons for the failure, that's very shady business.

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I appreciate the supportive and rational words. We're all heartbroken. I just received a very generic response back from the USMLE regarding the three of us failing in the same section. There is not much one can do to pursue it further, they have carte blanche. As I mentioned above, we sent in the score rechecks but the likelihood of our scores changing is very slim.

I feel like my application and reputation are ruined. I was, previously, a pretty solid applicant and patient interaction was really something I took pride in. A few interns during clerkships commented that I wouldn't need to study after seeing me in mock-CS exams. Of course, I did because I'm overly-cautious.

Never felt so deflated. Not being able to take it until late July is almost equally as tough. I would feel quite a bit better if I could get a Pass on there before ERAS goes in. Thanks for the advice about checking for cancellation... we'll certainly try.

It's insane that its gone on this long.

Even got a horrible review in NEJM recently. Its just a matter of time until they randomly fail someone who has the backing to expose it, inside-out.

No real regard or care for ruining so many hard working peoples lives. Just..."Sorry, the actors on this day felt you weren't good enough even though your real patients and fellow doctors actually love you and know you're great."

Without knowing how this exam is actually scored, no patient or doctor is being helped even remotely by this exam or process. Many strong students are being failed on this exam, really does seem like luck of the draw.

I took the exam in Houston and Failed along with 3 other ppl. We are all from Puerto Rico & were on the same side of the testing center. 4/12! this is ridiculous!

loli said:

I took the exam in Houston and Failed along with 3 other ppl. We are all from Puerto Rico & were on the same side of the testing center. 4/12! this is ridiculous!

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I'm pretty sure the SPs don't know your school of origin during the exam?

Damn yall got me scared, got my exam in philly next month

Im just saying that is really strange we r all from the same place, all failed and were on the same side! 4 out 12 ppl that I know of.

je355804 said:

I'm pretty sure the SPs don't know your school of origin during the exam?

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The SPs may not know but ECFMG and NBME certainly do.

They could very easily be filtering according to a failure quota. If not, whats the basis behind hiding the checklists and the secretive scoring?

There's a lot of stuff behind the scenes with this exam we just have no idea about.

loli said:

Im just saying that is really strange we r all from the same place, all failed and were on the same side! 4 out 12 ppl that I know of.

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Out of curiosity, which portion did you fail?

I do find it odd that people are failing in "bunches."

we all failed in different parts! if course for it not to be suspicious! 1 ICE 1 CIS 2 SEP

Hey guys, I feel bad for the people that failed. I received my score on April 24th and after much gut wrenching concern, found that I passed it fine. It historically failed 1-2% of US MDs, but they are expecting this new format we took should be failing approximately 6-7% and should increase the number of IMGs failing by a further 18%. The problem with all this is that these are just predictions. They actually dont know what the failure rate will be until afterward. There may very well be further changes made and discrepancies discovered. US grads shouldn't be taking this exam based on the enormous cost for such little benefit.

sinequanon said:

Hey guys, I feel bad for the people that failed. I received my score on April 24th and after much gut wrenching concern, found that I passed it fine. It historically failed 1-2% of US MDs, but they are expecting this new format we took should be failing approximately 6-7% and should increase the number of IMGs failing by a further 18%. The problem with all this is that these are just predictions. They actually dont know what the failure rate will be until afterward. There may very well be further changes made and discrepancies discovered. US grads shouldn't be taking this exam based on the enormous cost for such little benefit.

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It's not a matter of not knowing. They know and want a certain % of people to fail every year, otherwise it wont be seen as a real exam and they can't justify administering it. It was already ripped apart by the NEJM article for that very reason alone.

Failures = Revenue.

RCA said:

I just received my Step 2CS score and it just came out that I failed.

I really just don't understand this and feel like there must be a mistake. I attend a US medical school, scored in the high 240's on my Step 1, and came out of the CS exam KNOWING that I passed. I actually practiced and studied for it, and did everything I practiced.

On my score report, it says I failed the CIS portion - which doesn't make sense to me. Has anyone else received their score and are surprised?

I'm in shock right now

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Hey this is bizarre, I also got my result on April 24th and I failed on the CIS component also. Took it in Philly on March 11th. I was totally in shock as I studied, felt I counselled every patient well and all the patients seemed really pleased e.g. "thank you doctor, I feel relieved now", or "I feel so much better after discussing this with you". I don't even feel like I had any difficult patients at all.
Seriously I could not believe I failed. I am also asking for a re-score and am in the process of signing up again but as mentioned, no spaces until July

[email protected]

send him an email

JasonE said:

[email protected]

send him an email

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?

chair of nbme

there is no reason you shouldnt be told why you failed the exam. how are you supposed to know what to do better the next time?

if you fail step 1 or step2CK, they give you a breakdown so you know what subjects you did poorly on.

JasonE said:

chair of nbme

there is no reason you shouldnt be told why you failed the exam. how are you supposed to know what to do better the next time?

if you fail step 1 or step2CK, they give you a breakdown so you know what subjects you did poorly on.

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They do give you a feedback report like 1 & CK. You'll know if you failed ICE, CIS or SEP.

It just isn't any real help though. Theres no information on how the exam is actually scored, and where they claim you screwed up.

thats my point. they should give you more information

DEAR DOCS
i hav been going thru same stress. i am a fmg and a good student i never had any prob ever regarding any exam bt i took my cs on ist march in philly and failed in cis. all the patients were so happy from me were thanking me and it was best clinical encounter i had. i am planing for a recheck also . do guide me. can we all communicate to rthese people this is sum thing wrong going

dr pinks said:

DEAR DOCS
i hav been going thru same stress. i am a fmg and a good student i never had any prob ever regarding any exam bt i took my cs on ist march in philly and failed in cis. all the patients were so happy from me were thanking me and it was best clinical encounter i had. i am planing for a recheck also . do guide me. can we all communicate to rthese people this is sum thing wrong going

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Sorry to hear that.

They seem content filling their pockets off the failures ($1440) and rechecks ($80) so I really doubt anyone will care to listen.

I think something like 1/3 of IMGs will now be failed on this exam, and 1 of 10 AMGs.

PDs who run IMG friendly programs obviously know whats going on and will (eventually) take this into account when a bunch of their applicants have CS failures. (It'd look a lot stranger if an AMG bombed the exam since it was created to filter IMGs.)

"Lehman and Guercio suggest that perhaps international medical graduates, who account for approximately 22% of actively licensed physicians in the United States,5 should be assessed with Step 2 CS but that U.S. students should not. This approach would be antithetical to our nation's culture of promoting equity and to the history of legislative efforts to ensure nondiscrimination for all persons seeking a license to practice medicine in the United States. Allowing a person to bypass a licensing requirement solely on the basis of the location of his or her medical school shows a lack of concern about patient safety and the quality of health care."


These are the words of the chair of the NBME. If the above was true, then why was the test first implemented only for IMGs??

JasonE said:

"Lehman and Guercio suggest that perhaps international medical graduates, who account for approximately 22% of actively licensed physicians in the United States,5 should be assessed with Step 2 CS but that U.S. students should not. This approach would be antithetical to our nation's culture of promoting equity and to the history of legislative efforts to ensure nondiscrimination for all persons seeking a license to practice medicine in the United States. Allowing a person to bypass a licensing requirement solely on the basis of the location of his or her medical school shows a lack of concern about patient safety and the quality of health care."


These are the words of the chair of the NBME. If the above was true, then why was the test first implemented only for IMGs??

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Wasn't everyone required to take CS/CSA when the FLEX (for FMGs) was phased out? They discriminated perfectly fine before that. Now they get all holy and righteous? I'm not buying it. It's all about that money. Forcing AMGs to cough up $1000+ a pop adds up.

They somehow manage to justify an extra $200 fee for IMGs as well, for the same exam at the same center. So much for the nondiscrimination.

CDI said:

Wasn't everyone required to take CS/CSA when the FLEX (for FMGs) was phased out? They discriminated perfectly fine before that. Now they get all holy and righteous? I'm not buying it. It's all about that money. Forcing AMGs to cough up $1000+ a pop adds up.

They somehow manage to justify an extra $200 fee for IMGs as well, for the same exam at the same center. So much for the nondiscrimination.

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Yeah that extra fee is crazy. I know ECFMG wants a share of the pot, but whereas Step 1/CK has a clear international testing center fee, Step 2 CS just adds that 200 bucks without any explanation.

I find it funny that they justify giving it to AMGs to prevent discrimination. As an IMG I have no problem taking a fair exam to prove that I can deal with patients. And if its discrimination then so is the TOEFL and requiring higher Step scores from IMGs.

Anyone have any luck contesting theres? Updates?

nothing so far on my appeal/re-quest

I just came across this thread. I received my score back April 24th and I also failed. I took the exam in Philly. I was very shocked as I felt like I did not make that many mistakes to fail. I called the NBME and asked them if they could give me any feedback on what exactly I was deficient in but I was told they don't break the scores down any further than what they have already done. I think it's a bunch of crock that they charge the amount of money they charge for the exam and they can't even tell you what you did wrong. What exactly is the point of the exam then? I was going to do a score recheck but after reading what they do, I did not even bother. Just a waste of money for them to tell you that you really failed. This is the silliest exam ever.