I think I failed Comlex 2 PE

[brownsoul]

hello everyone. I'm a nervous and somewhat anxious 4th year medical student, perhaps like some of you. I just took my comlex 2 PE recently. and... I screwed it up bad. I had some thoughts of postponing it until next week or later on. but I was in a catch-22. my thought process was that if I take it then and fail, then I won't be able to retake and pass and show a passing score to my programs. (I'm applying to MD programs in psychiatry by the way). if I take it in october and fail, I can scramble into a spot in december to take it and pass and get a passing score in by february. maybe not sound logic. also my roommate and other friends urged me that it's no big deal and they just walked in after 1 day of studying and passed. so... I was like 95% pass... and I did study a decent amount... what the hell?

I read like all the minicases and about 60% of the first aid cases and blitzkrieged through most of the kaufmann cases -- though a shortcoming in kaufmann is no differential. I practice like 4 or 5 cases with a friend. we were somewhat sloppy but I did not have issues with time... doing a focused physical exam is tricky because how many systems do you examine for it to be complete? and how about omm?

real exam:

I think I forgot a name on one patient. I ran out of time on like almost EVERY CASE. I mean I would get a decent history and come up with a differential and plan. but my physicals were BRIEF. I did heart and lungs on almost all and if it was abdominal I would do that. one time I didn't listen to HEART -- it wasn't relevant. but I was just so unrehearsed! for physicals or whatever, I did almost all systems but I didn't document heart and lungs. 2 patients specifically asked me about omm stuff. one guy I did just fine. the other, I didn't remember rib techniques so I just bull****ted counterstrain -- no response. and then just randomly did muscle energy. on maybe 2 patients I did not counsel them sufficiently. on MORE THAN A FEW, I forgot to ask do you have any questions. I do think I was quite kind and humane -- but who knows. My notes were awful. I ran out of time and for the first couple notes I forgot to put vitals. I sometimes ran out of time writing stuff down. and for dx and plan, I wouldn't always put ''doubt'', ''unlikely'' and for plan, it wouldn't always be specific. I don't think I "got" all the cases either. 2 or 3 patients were especially bitter. one diagnosis I realized outside the room and didn't counsel. I used disease names in counseling instead of being more simple... I did omm on only 3 PATIENTS -- no diagnosis or treatment otherwise. JUST NO TIME. I really don't want to fail but it looks like I'm headed that way.

consequences:

I have around 10 interviews... are program directors going to bring up step 2 pe and ask when I took it? do they need that score by rank list/day. when is that day? am I screwed if I failed this time? what if I pass in december and find out in feb 10 -- is that too late? it is before match, I know... if they ask me in january whether I took it or passed -- what do I say??? I'm just sad and freaking out a bit... this is like the last hurdle to jump through to graduate, match, get licensed. and I really want to be a psychiatrist... I almost dropped out of medical school thinking I was destined to be a rockstar. eh, not that mnay people want to listen to my tunes [they are good though; let me know if you want to listen].

any support? advice? thoughts? predictions on my failure or not?

sincerely,
brownsoul

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[koan]

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[hallowmann]

Don't worry about it now. Worry about it when/if you actually fail.

A lot of your mistakes seem like things people make on a regular basis. The OMM thing might be an issue, but honestly who knows, grading could be random and subjective.

 

[SLC]

I straight up didn't know how to do a lower extremity CS technique that I wanted to do. I should have done soft tissue like kneading and stretching or something but instead I told the patient that I didn't have a treatment for him and that I'd prescribe R.I.C.E. and NSAID and follow up in 8-10 days at which point I'd be prepared with a CS treatment if he was still bothered by the pain. I was certain this would result in a fail on the OMM portion. I also forgot to check a urine HCG before prescribing oral contraceptives on one case.

Result: Pass

Don't stress (like that's possible), but seriously don't stress. You'll find out soon enough and givng yourself an ulcer in the meantime isn't going to change anything.

I'll bet you pass, but make sure you come back and update this thread when you find out!

 

[as90]

Don't worry about it now. Worry about it when/if you actually fail.

A lot of your mistakes seem like things people make on a regular basis. The OMM thing might be an issue, but honestly who knows, grading could be random and subjective.

I sincerely hope you pass. Failing this exam has been one of the worst brunts I have had to bare in my short lifetime. I detest this exam and I sincerely question the competency of those administering this exam.

I took only COMLEX applied mostly ACGME and I get pimped about why I failed the PE on every interview.

I don't think the NBOME nor the $15-20/hr actors who failed me on the humanistic domain will ever know the damage they have done to me mentally and to my career. I sincerely do not wish this misery on anyone.

I have spent in excess of $5000 applying to the most undesirable programs in the country and have yet only been able to secure 7 interviews across very non competitive specialties. I am sure this has to do with my failing PE.

My COMLEX written exam scores were low but at least I passed on the first attempt. Regardless, it is my sincerest wish that everyone and their enemies passes this exam on their first attempt so that you do not feel the mental anguish and tarnished reputation that I am dealing with today.

 

[Doctor Bob]

I have spent in excess of $5000 applying to the most undesirable programs in the country and have yet only been able to secure 7 interviews across very non competitive specialties. I am sure this has to do with my failing PE.

My COMLEX written exam scores were low but at least I passed on the first attempt.

A one-time failure of the PE isn't good for sure and will raise red flags. But if you interview well and otherwise have good marks it's usually not a death-knell.

Combining it with low written exam scores though...

 

[Cookie427]

Don't worry about it now. Worry about it when/if you actually fail.

A lot of your mistakes seem like things people make on a regular basis. The OMM thing might be an issue, but honestly who knows, grading could be random and subjective.

some of you will be horrified to hear this ..but..yes the scoring by actors of the 'humanistic domain' is indeed random and subjective. I failed humanistic domain only four times....homeless and destitute.....

mine is a sad story....after years of toil, study, etc....i never was able to graduate....failing 'humanistic domain' only....of course they are wrong as all my clinical preceptors saw it differently...yes the test is NOT a valid test of one's empathy and compassion...and subject to the prejudice, bias, and whims of ...and lets face it...people hired off the street...with a headache....

if my lawsuit is successful...everyone who was required to retake due to HD only...will get a refund....

 

[as90]

I'm sorry you failed and I wish you the best with your future endeavors. However, I have to be honest with you, a lawsuit against the NBOME, a national organization with abundant resources, will likely never be successful. It is completely biased, I agree, but unfortunately we live in a society where power is abused.

Medicine is a field where hierarchy and power is always maintained.

 

[user3]

some of you will be horrified to hear this ..but..yes the scoring by actors of the 'humanistic domain' is indeed random and subjective. I failed humanistic domain only four times....homeless and destitute.....

mine is a sad story....after years of toil, study, etc....i never was able to graduate....failing 'humanistic domain' only....of course they are wrong as all my clinical preceptors saw it differently...yes the test is NOT a valid test of one's empathy and compassion...and subject to the prejudice, bias, and whims of ...and lets face it...people hired off the street...with a headache....

if my lawsuit is successful...everyone who was required to retake due to HD only...will get a refund....

I'm sorry you failed and I wish you the best with your future endeavors. However, I have to be honest with you, a lawsuit against the NBOME, a national organization with abundant resources, will likely never be successful. It is completely biased, I agree, but unfortunately we live in a society where power is abused.

Medicine is a field where hierarchy and power is always maintained.

this is highly troubling. There have been serious complaints about COMLEX level 2 PE grading going back several years on this site! Something needs to be done.

 

[costales]

I'm sympathetic to people who failed PE, but here are the hard facts:

BTW First timers who failed had an 88% pass rate on their next attempt, so it's pretty hard to fail PE twice if you're paying attention.

 

[JRO38]

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[hallowmann]

The hard facts don't matter when they won't provide you with any sort of constructive feedback or guidance what-so-ever on what you need to do to improve by their standards. You are left to guess and figure it out on your own. If every practicing physician in the US were graded by the NBOME I'd guess close to 20% would fail for not being humanistic enough (yet somehow, they are still effective physicians - go figure!). It is an arbitrary category shrouded in secrecy and unless there are extreme gross deficiencies (swearing, doing something very inappropriate, vulgar joke, etc.) the NBOME should treat a fail more as remediation (instead of punitive) and work one on one with the student to "correct" problems. Students are 300k in debt, nearly 4 years of graduate work into it, and extremely invested at this point. A PE fail is a flashing stigma that devastates people psychologically and can ruin career paths.

I am top quartile in class rank, COMLEX 1 and COMLEX 2 CE scores, and I was still physically ill with anxiety/nausea the entire 10 weeks I waited for my PE result just because of how ridiculous this exam is and the significance it carries only if you do fail. My hands were literally shaking as I read the words "Passed Exam." Granted I have an obsessive personality, but I can't imagine how the bottom quartile students feel during the wait. Medical students already have a higher rate of depression, anxiety, and suicide. I personally feel these exams only add to that stress.

Many older physicians (45-50+ years old) didn't have to take any board exams during medical school and only had to take certification boards for their license (and they were/are competent physicians despite that fact!). We have just been groomed to accept that we must pay $4,000 for 4 board exams (soon to be 5 when COMLEX 3 splits into 2 parts in 2018 - more $$) in order to prove our worth. Many companies sustain themselves on the loan money of medical students, and we're told that this is normal and everything is OK.

Personally, I think there should be Step 1 on medical knowledge (classroom and clinical aspects) after your 3rd year - necessary to help residencies know how knowledgeable you are and compare you to other students. I think your clinical grades in year 3-4 do enough to demonstrate your humanistic domain (eval comments and LORs reveal this too). Then there could possibly be a Step 2 during residency to again demonstrate medical knowledge before applying to fellowships (but only if you want to apply to a fellowships, otherwise you can skip Step 2). Thus, I'd like to see at most 2 national standardized board exams (instead of the proposed 5 coming soon to a Prometric center near you). Just my opinions though, which obviously will never come to fruition given the current state of medical education.

Any idea when in 2018 that split will happen? Anything wrong with rushing step 3 if say we will be starting PGY1 July 2017? Do you need a year of internship (experience/knowledge) for Step3?

 

[JRO38]

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[hallowmann]

Thanks for the info. That cuts it close, but hopefully I'll manage to get it done before 2018.

 

[NurWollen]

Thanks for the info. That cuts it close, but hopefully I'll manage to get it done before 2018.

Holy crap, me too. I had no idea Level III was being split into two.

 

[MLT2MT2DO]

Thanks for the info. That cuts it close, but hopefully I'll manage to get it done before 2018.

Currently on residency interviews I have ran into PGY-1 who have already completed their step 3s. You should be fine

 

[as90]

The hard facts don't matter when they won't provide you with any sort of constructive feedback or guidance what-so-ever on what you need to do to improve by their standards. You are left to guess and figure it out on your own. If every practicing physician in the US were graded by the NBOME I'd guess close to 20% would fail for not being humanistic enough (yet somehow, they are still effective physicians - go figure!). It is an arbitrary category shrouded in secrecy and unless there are extreme gross deficiencies (swearing, doing something very inappropriate, vulgar joke, etc.) the NBOME should treat a fail more as remediation (instead of punitive) and work one on one with the student to "correct" problems. Students are 300k in debt, nearly 4 years of graduate work into it, and extremely invested at this point. A PE fail is a flashing stigma that devastates people psychologically and can ruin career paths.

I am top quartile in class rank, COMLEX 1 and COMLEX 2 CE scores, and I was still physically ill with anxiety/nausea the entire 10 weeks I waited for my PE result just because of how ridiculous this exam is and the significance it carries only if you do fail. My hands were literally shaking as I read the words "Passed Exam." Granted I have an obsessive personality, but I can't imagine how the bottom quartile students feel during the wait. Medical students already have a higher rate of depression, anxiety, and suicide. I personally feel these exams only add to that stress.

Many older physicians (45-50+ years old) didn't have to take any board exams during medical school and only had to take certification boards for their license (and they were/are competent physicians despite that fact!). We have just been groomed to accept that we must pay $4,000 for 4 board exams (soon to be 5 when COMLEX 3 splits into 2 parts in 2018 - more $$) in order to prove our worth. Many companies sustain themselves on the loan money of medical students, and we're told that this is normal and everything is OK.

Personally, I think there should be Step 1 on medical knowledge (classroom and clinical aspects) after your 3rd year - necessary to help residencies know how knowledgeable you are and compare you to other students. I think your clinical grades in year 3-4 do enough to demonstrate your humanistic domain (eval comments and LORs reveal this too). Then there could possibly be a Step 2 during residency to again demonstrate medical knowledge before applying to fellowships (but only if you want to apply to a fellowships, otherwise you can skip Step 2). Thus, I'd like to see at most 2 national standardized board exams (instead of the proposed 5 coming soon to a Prometric center near you). Just my opinions though, which obviously will never come to fruition given the current state of medical education.

Very well written, unfortunately, I will nevr know why I failed the humanistic domain and competitive Cali residencies wont care to even investigate. I honestly dont know why this happened to me when my OSCEs all commented on my wonderful humanistic skills

 

[as90]

I'm sympathetic to people who failed PE, but here are the hard facts:

BTW First timers who failed had an 88% pass rate on their next attempt, so it's pretty hard to fail PE twice if you're paying attention.

paying attention to what? my question is in regards to the humanistic domain.

 

[as90]

this is highly troubling. There have been serious complaints about COMLEX level 2 PE grading going back several years on this site! Something needs to be done.

thats the problem. i doubt the NBOME even knows what effect their scoring and retake grade timeframe has onpeople participating in this match.

 

[JRO38]

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[as90]

It was a surprise to come into this exam and have no mouse. Using the shift button and a touchscreen to change between sections of the note was quite challenging especially since I am used to having a mouse at home and at the hospital where I write my notes at.

 

[brownsoul]

hello everyone. so... I failed. I'm not shocked. I am surprised that I failed so badly. it was in the middle of one of my interviews that I found out through e-mail. like a shot in the gut. I somehow failed both domains. this was definitely not good and pretty much poor perfmance in everything except OMT which is ironic. bottom 1%. my school said I couldn't register so I didn't... and when I looked the other day everything was filled up.

somehow even further ironically, the nbome called me to sign up for a date in less than a week. [they actually helped me] I took it. it's against school rules possibly and I'm not super prepared. but I'm going to watch a ****load of videos tonight. meeting with professors and people good at PE on friday and doing a kaplan course on saturday. I wish the date was later in december [scores come out b/w jan 30 - feb 9] but the available dates I saw earlier were in january which would come out in march... after ranking and around match results.

I feel a little pissed off and more confident now. I was anxious and dealing with some personal **** last time and didn't prepare/practice adequately. I was hoping. I feel like around 5 days is enough. what do you guys think? what should I do? my school said failing twice is like a death knell to matching but I figure without a score, aren't I knocking myself out from most programs anyways?

or... is it possible that a good number of allopathic psych programs won't care that my score is missing?

looking for some ideas/thoughts here. thanks

 

[microshar88]

My sincerest condolences regarding your failure. My heart aches for you. Believe me, I know how it feels, I was in the middle of my audition rotation starting off a perfect morning when I got the failure result. I failed humanistic but passed biomedical domain. It felt like my ileum was twisting into a million loops and I contemplated ending my career in medicine by pursuing a lawsuit against my school and NBOME for ruining my career thanks to $15/hr actors and falseley passing me on OSCE's.


The good news is, I passed my retake, NO THANKS to my school. I am not sure if I can offer you much advice but I will say that videos only helped marginally. I did that my first time around and failed humanistic.

I think you need a mnemonic CODIERS SMASHFM and IVINDICATES or something for the notes. Always listen to heart and lungs.

For humanistic make eye contact and summarize A&P with patient when 2 minute time comes. YOU MUST DO THIS. ASK THEM IF THEY have questions and if your plan will work with them.

I don't know what specialty you are going into, but a lot of places want a passing result come rank day, I don't know if they will see the failing result before they rank you, but I would try and retake ASAP and get that passing result to the programs as soon as you can.

You are in a better position as I was however. I only took COMLEX and found out a couple of weeks before I submitted ERAS. As a result, ALL Programs saw the failure, many places through my application aside. I spent in excess of $8000 just on application fees, $7000 on traveling expenses to places I would never dreamed of going to just to not take a chance on scrambling. I'm doing Psych interviews and have interviewed at places where enemies wouldn't even go.

I am just NOW starting to get some interest from programs within my state but its to F**ing late as all interview are full and I have my ICU rotation in January and my school will not let me take time off to attend interviews.

So in summary, I think this is a rotten exam and I am being forced to pay the price for someone's inability to assess humanistic skills (HUGE BS). Also, for one of my interviews, I was required to write a letter of explanation indicating why I failed. It was quite humiliating as the other IMG's who were there all passed step 2CS and the tears were rolling down my cheeks. THEY ALL WANT TO KNOW WHY DOES ONE STUDENT FAIL AN EXAM THAT 93% OF PPL PASS!!!?!?!?!

why does the NBOME feel they have to screw us up? why is one day in F*ing conshhocken more valuable than the 2 years worth of OSCE's? Why did I have to spend $5000 travelling to conshy and staying at the noisy expensive nex to the traintrack mariott residence inn and taking the stupid test? Why did the NBOME do this to me? Why did I pass all my OSCE's? Why did the actors at my OSCE's say that I completely blew them away with my compassion? Why did the NBOME not take my school's OSCE's into account when giving me a FAIL on my COMLEX PE? Why are the wonderful comments about my interpersonal skills and patient interaction skills completely disregarded? Why is it that I am living this nightmare?

Why does one exam ruin my life? Why do I have to be removed from my family/my home just because of one exam? I was an average applicant before this mess and I would have matched in a California ACGME Psych program, IMO.