step 2 cs / comlex 2 pe for MATCH/RANK

[brownsoul]

hi, I took comlex 2 pe recently and I'm quite worried I failed. do programs need that passing score before they rank? it seems like a few I'm interviewing at do while at others it's more ambiguous. I was in a catch-22 and didn't want to delay taking the comlex 2 in case I failed. because if I failed in the latter case, I would not be able to retake it and have the score available (scores would be available too late). I feel like if I do fail, I will have the option to retake it in December and get a score by February 10th showing I passed it -- I will go all out and study beyond hard to ensure I pass the exam. I studied the first time for around 4-5 days; my friends told me don't worry about it. I just kept running out of time and doing brief physicals.

I am just worried about how this will all affect me for programs ranking me and match. Is Feb. 10 too late (for rank list). will a retake look very poorly and hurt me greatly in ranking? is there anything now that I can do about it? lots of hypotheticals, I know. but it's driving me up the wall. I had an interview today and have around 10 -- so I feel like there's little anxiety about that... just this exam... and it slowly erodes my sanity. really appreciate the help in advance.

---

Members don't see this ad.

 

[EpiIV]

For the NRMP the rank order deadline is Feb 25. My program director (a decent but mid level program) told me that I needed to schedule my scores so that I would have a pass by the match deadline. She refused to rank people who hadn't passed before the deadline because she wanted that guarantee they were going to graduate . But with that being said, she just cared that they passed.

So you'll have your score in time for the NRMP.

Also, you haven't failed yet. Even if you have, there's nothing you can do about this today. You have 10 programs that are intrigued by you, and want to meet you face to face. Breathe.

You just have to let this year unfold one step at a time and react accordingly as things come up. You're going to become a good psychiatrist someday. It will happen.

 

[NickNaylor]

I did some research on this earlier in the process as I was initially unable to schedule my CS exam in time to get scores before the rank deadline. I wasn't able to find specific lists of programs - this might be something you need to look up program-by-program - but I did find that about a quarter of programs require a passing CS score prior to the rank list deadline. I'm not sure how applicable that is to the COMLEX exams, but I'm guessing that the policies are somewhat similar.

If you're really concerned about this (and I agree with @EpiIV that this seems a bit premature), get in touch with individual programs and see what their policies are.

 

[psychattending]

A more important variable is what the medical school requires for graduation. If the medical school does not require a pass on the exam in order for you to get your MD/DO, thenI am less concerned as a PD whether you have passed it or not. Once I have decided to offer you an interview, then one of my key issues on putting you on my rank list is whether you will be able to function as a MD/DO on July 1 or not.

 

[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

 

[hoodwinkd]

So sorry to hear the bad news, especially during an interview. How did you know it was bottom 1%? I thought NBOME only reported pass or no pass.
For help with the biomed domain, I think the Kauffman book is more pertinent for the COMLEX than First Aid USMLE CS, although if you need help with coming up with DDx list I would skim through First Aid as well. Definitely doable in a few days! As for the humanistic domain, no one knows how they determine what is acceptable cuttoff for being "humanist" so I don't have any tips for you other than be a confident barbie (or ken) version of yourself. Even if you have to out-fake our lovely standardized patients, it's probably safer to go overboard with the empathy than not do anything at all. And always wash hands/ask "do you have any questions."
Sorry don't have enough experience in this field to help with the rest of your inquiries so I'll leave that up to those higher up on the totem.
Better luck on the next go round.

 

[hamstergang]

it was in the middle of one of my interviews that I found out through e-mail.

My only advice is to not check emails during interviews!! While you are there, you should be there. If you have to be pulling out your phone, that will come across as disinterest or disrespect. And if you're only checking in the privacy of the bathroom, why? No email could be that time-sensitive that you can't just keep your head focused on your current interview and deal with the emails once you're done.

 

[microshar88]

I'm putting my quote from the other thread here. For the biomedical domain, I would highly suggest the minid ddx section from First Aid Step 2CS for a quick refresher. GOOD to know that a lot of programs will not need the score to rank, but really, whats more important, one day in PA, or 2 years worth of OSCE's and consistent preceptor feedback regarding our clinical/patient skills?

can you imagine flying from California, forking over $800 in travel expenses on your OWN (no help from dearest school), blowing $1500 on this damn test, and finding out you failed so you have to do it 2XX?!?!?! THIS IS TORTURE!

the most awful part of my tragic story, is that now a lot of programs don't even have interview slots to offer me, I would have been fine even if I didn't have a PE result, the FAIL just disqualified me. but now I'm ok to be interviewed, but their no slots this late in the season. I can't take off of my rotation for interviews either

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 $2000 travelling 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.

 

[brownsoul]

seems like a paradox. a failed PE will disqualify you from interview... but a passed PE is not required for ranking??? for psychiatry -- are you sure about that?

 

[microshar88]

seems like a paradox. a failed PE will disqualify you from interview... but a passed PE is not required for ranking??? for psychiatry -- are you sure about that?

This is entirely program dependent. A failed PE is a negative which will automatically put a red flag on your app and will put you in the "ignore or come back later pile". Unfortunately, having a passing PE so late in the season means your chances of getting an interview are diminished since most of the slots have been taken.

Now, in your case, they will most likely assume you'll pass the PE since they have no clue you failed "assuming you did not retransmit your scores." So a lot of places, could rank you without the passing PE since they never knew you failed to begin with. This is program dependent however.

 

[TexasPhysician]

I would not release the failed score or future scores prior to match day. I'm not sure if others agree, but regardless of future passing, a failed score could drop you down further than not releasing them.

 

[brownsoul]

are you sure about that?

 

[TexasPhysician]

are you sure about that?

No. I know very few people who failed step 2 cs. The person I know well had excellent other step scores and blew off cs. He already had interview at top programs like Stanford, UCLA, NYU, etc for emergency medicine. He released his failed score with a later passing cs. He ended up matching dead last of 14 programs - our home program. If it wasn't for the home program, one of our top academic students would have gone unmatched due to that cs grade. That is just an n-1 but after seeing that, I'd keep the failed score well hidden. Just my thoughts. Others may disagree.

 

[OldPsychDoc]

I feel a heck of a lot better about ranking an applicant with both 2 CS and CK (or their osteo equivalents) passed, than one with a score "pending"--whether waiting for a pass after a known fail, or having not yet taken it. So intentionally withhold information at your peril. A blank spot on your transcript where 2CS or COMLEX-PE should be is not going to help you one bit.

 

[TexasPhysician]

I feel a heck of a lot better about ranking an applicant with both 2 CS and CK (or their osteo equivalents) passed, than one with a score "pending"--whether waiting for a pass after a known fail, or having not yet taken it. So intentionally withhold information at your peril. A blank spot on your transcript where 2CS or COMLEX-PE should be is not going to help you one bit.

Step 2 cs pass rates for US MD's was >97% the last time I looked. Granted I think you are at a well known program that can eliminate anybody with a small reason, but you think the average psych program believes a US grad can't have cs ready to go by residency, especially with other decent scores?

 

[OldPsychDoc]

Been burned before...

 

[TexasPhysician]

Been burned before...

Always exceptions. Does your program filter out applicants with a step failure? Mine does.

 

[OldPsychDoc]

Always exceptions. Does your program filter out applicants with a step failure? Mine does.

Not automatically. A subsequent pass and other factors can outweigh a failure (up to a point, of course--our state won't grant a license after the 3rd failure on a single step). Keeping us guessing is a bad idea, though.

 

[microshar88]

Always exceptions. Does your program filter out applicants with a step failure? Mine does.

If your program gives more importance to a COMLEX PE subjective failure as opposed to 2+ years of passing osces, then I think you need to reevaluate. You mean to tell me u won't even look for the passing score and give the poor sap a chance? What if the actors were subjective in their assessment Bc they didn't like the fact that the student doctor was wearing a turban for religious reasons? Or that he had a darker skin Complexion? Not making accusations but we live in a cruel world and I think you really need to assess these subjective exams before you make such huge decisions

 

[OldPsychDoc]

Yes it is a cruel world--and the other 1200+ applications we have looked through have also passed 2+ years of OSCEs, the difference being that they also passed the ONE exam that shows up on their USMLE or COMLEX transcript. I'm more than willing to "give a poor sap a chance", but you seem to be asking me to rank you ignoring the 3% chance that you will screw that exam up again and not be able to start the program in June. Sorry, but there are 1199 poor saps in line ahead of you, and I am averse to uncertainty. I didn't design this system, but I can't toss it aside.

 

[TexasPhysician]

If your program gives more importance to a COMLEX PE subjective failure as opposed to 2+ years of passing osces, then I think you need to reevaluate. You mean to tell me u won't even look for the passing score and give the poor sap a chance? What if the actors were subjective in their assessment Bc they didn't like the fact that the student doctor was wearing a turban for religious reasons? Or that he had a darker skin Complexion? Not making accusations but we live in a cruel world and I think you really need to assess these subjective exams before you make such huge decisions

I don't make the rules, but please don't assume that comlex pe is the only place that could be subjective in medical school training. If so, we have to eliminate ms3-4 grades as well.

Currently my residency program is competitive enough that the program director has to narrow down the AMG's to interview/rank. An easy way to do that is eliminate those with any step/comlex failures, course failures, and other red flags. Right now there are just so many applications that you have to find reasons to drop some people. I'm sure if the program becomes less competitive in the future then the criteria would change. My program does rank applicants that haven't taken step 2's, but their rank may drop a little if all else is relatively equal. A local med school puts little emphasis on step 2's, and we do not want to bias against them as it is a good school.

The fellowship programs do interview those with step/comlex failures. Every program is different.

It seems that there may not be a 100% answer to the OP. Without polling a good number of programs/program directors, I'm not sure what percentage would punish your application for a failure vs not releasing/taking it.

With that said, I would bet that there are many many programs that are not competitive enough to narrow AMG applicants by either criteria. I know AMG applicants that have matched at less competitive well-known academic centers with multiple large red flags.

 

[vistaril]

In terms of being penalized for not having a passing score on either step 2 back yet, to me it would really all depend on the history. If someone has already failed steps for example, and doesn't have a step 2 ck back.....that's a LOT different than someone who passed step 1 and just hasn't bothered to take step 2 yet. A program shouldn't be worried that a person is going to fail step 2 MULTIPLE times if they passed step 1. Penalizing someone in that situation would be dumb and you really have to wonder about any program that would do that. but penalizing someone who is at a higher risk(statistically) of failing step 2 who doesn't have it back in time....sure, that's reasonable.

 

[microshar88]

Yes it is a cruel world--and the other 1200+ applications we have looked through have also passed 2+ years of OSCEs, the difference being that they also passed the ONE exam that shows up on their USMLE or COMLEX transcript. I'm more than willing to "give a poor sap a chance", but you seem to be asking me to rank you ignoring the 3% chance that you will screw that exam up again and not be able to start the program in June. Sorry, but there are 1199 poor saps in line ahead of you, and I am averse to uncertainty. I didn't design this system, but I can't toss it aside.

I'm trying to board a plane right now but will reply with a thorough response once I get a chance.

I got my passing result on dec 1.interview slots were filled by that time.

Also, you should know that not everyone who passed COMLEX PE passed all the osces.

I truly feel like issuing a lawsuit against the NBOME for not providing any feedback on the humanistic fail.

Tbc...

 

[hamstergang]

Also, you should know that not everyone who passed COMLEX PE passed all the osces.

You really think you know something about this process that he doesn't? The fact is, without a passing Step 2, you aren't allowed to start residency, but the same isn't true for the OSCEs. So there's quite a difference to a PD which one you are failing/at risk for not passing.

 

[vistaril]

You really think you know something about this process that he doesn't? The fact is, without a passing Step 2, you aren't allowed to start residency, but the same isn't true for the OSCEs. So there's quite a difference to a PD which one you are failing/at risk for not passing.

really......who gives a crap about osces. Osces are a joke.

 

[OldPsychDoc]

In terms of being penalized for not having a passing score on either step 2 back yet, to me it would really all depend on the history. If someone has already failed steps for example, and doesn't have a step 2 ck back.....that's a LOT different than someone who passed step 1 and just hasn't bothered to take step 2 yet. A program shouldn't be worried that a person is going to fail step 2 MULTIPLE times if they passed step 1. Penalizing someone in that situation would be dumb and you really have to wonder about any program that would do that. but penalizing someone who is at a higher risk(statistically) of failing step 2 who doesn't have it back in time....sure, that's reasonable.

Nope--I'm just worrying about them failing Step 2 after I've blown an interview slot on them, and ranked them, and potentially matched them to a position that they can't start, especially when there were dozens of perfectly good candidates who DID schedule and pass their Step 2s in a timely manner. Now that's what's "dumb". I'm not the one "penalizing" them--they put themselves at the disadvantage on an extremely non-leveled playing field. You're free to run your program in the way that you wish--and live with the ramifications of your decisions.

 

[vistaril]

Nope--I'm just worrying about them failing Step 2 after I've blown an interview slot on them, and ranked them, and potentially matched them to a position that they can't start, especially when there were dozens of perfectly good candidates who DID schedule and pass their Step 2s in a timely manner. Now that's what's "dumb". I'm not the one "penalizing" them--they put themselves at the disadvantage on an extremely non-leveled playing field. You're free to run your program in the way that you wish--and live with the ramifications of your decisions.

my point OPD was that the # of American grads who fail step 2 who were not at risk to fail step 2(previous failing or *barely* passing step 1 score and no huge red flags) is very very very low. The number is so insignificant that I wouldn't worry about it happening. That's why I made the distinction between the two groups. If it has happened to your program before(a failure of an applicant without previous major struggles on step1 and they couldn't start) that's unfortunate but it doesn't change the fact that it is extremely unlikely to happen for any given applicant. Given the state of the psych applicant pool past the top 150 or so people in any given match year, I wouldn't want to miss out on any potentially solid applicants for something that is very unlikely to happen. I'd certainly rather have a shot at the excellent candidate who has a < 1% chance to fail an exam he gets a score back March 12th or whatever than the 'perfectly good' candidate who took it a couple months early and already passed. Note that I don't understand anything about DO exams and their version of things and the numbers, so this probably doesn't apply in the OPs case.

Many of the best students in our class(talking step scores above 250, AOA, top notch in everything) didn't take step 2 until late January/early February just because it was irrelevant. They certainly weren't put at a disadvantage because it's well understood that it's not an issue for them. A 'timely' time to take step 2 for them was anytime before they graduated. Now a less academically inclined person like myself, otoh, would be more suited to make sure all their stuff is in because they are less a sure thing...

 

[microshar88]

Nope--I'm just worrying about them failing Step 2 after I've blown an interview slot on them, and ranked them, and potentially matched them to a position that they can't start, especially when there were dozens of perfectly good candidates who DID schedule and pass their Step 2s in a timely manner. Now that's what's "dumb". I'm not the one "penalizing" them--they put themselves at the disadvantage on an extremely non-leveled playing field. You're free to run your program in the way that you wish--and live with the ramifications of your decisions.

What about an applicant who passed his retake? Do you still hold that fail against them when you rank? I sincerely hope that somebody exposes and publicizes how ridiculous the COMLEX PE humanistic portion is

Lastly, i agree that osces are ridiculous but our school makes it seem that they totally predict if u pass COMLEX PE which is a false lie

What I'm getting at is, this test just came into being 10 years ago. You have competent DO's who never took this BS exam. I strongly feel that a passed retake should not put someone out of the running especially when they have shown a genuine interest in your program.

I also did not claim to know more about the match process. I'm just pleading the case for anyone that has had to bare this injustice of a failure. At least the written exams are objective and as such should be given far more weighting. Also, preceptor evals are also subjective but at least they tell u why u got the eval u did.

 

[OldPsychDoc]

What about an applicant who passed his retake? Do you still hold that fail against them when you rank? I sincerely hope that somebody exposes and publicizes how ridiculous the COMLEX PE humanistic portion is

Lastly, i agree that osces are ridiculous but our school makes it seem that they totally predict if u pass COMLEX PE which is a false lie

What I'm getting at is, this test just came into being 10 years ago. You have competent DO's who never took this BS exam. I strongly feel that a passed retake should not put someone out of the running especially when they have shown a genuine interest in your program.

I also did not claim to know more about the match process. I'm just pleading the case for anyone that has had to bare this injustice of a failure. At least the written exams are objective and as such should be given far more weighting. Also, preceptor evals are also subjective but at least they tell u why u got the eval u did.

No, I said above (Post #18) that I'd happily accept a subsequent pass. And what I've been trying to emphasize is that even a pass after a fail would outweigh a blank transcript, because some were advocating to not release scores until after the Match. Someone following that advice should not be surprised if selection committees balk a bit at that. (And vistaril, gee whiz, good for you that you were only hanging out with AOAs and 250s. As you well know, that doesn't represent the majority of the psych pool by any means. And frankly, I think it's a mark of hubris to assume that a 245 ensures equivalent performance on the next step. I think that schools that encourage their students to postpone Step 2, or withhold their scores, are simply giving terrible, outdated advice--and I have seen students, including those from good US schools, get bad news in March because of that.)

The rest of your post, the rant vs. the COMLEX PE, I can't do anything about. I get it...you're p.o.'d. I'm just trying to offer the perspective of a mid-range PD about such things. This is the system we are stuck with, and I'm sorry that your school didn't advise you explicitly that you are ALWAYS at risk in these testing situations. (Heck--I know that even I'm at risk as MOC time rolls around next year, high pass rates or no. The computer could get f-d up, I could have episodic dyslexia or something...I'm not taking anything for granted.)

 

[vistaril]

The fact that there are a limited number of American allo grads with solid scores, solid grades, and no red flags(and by limited number I mean a couple hundred or so) makes it all the more important to not let any get away for trivial and/or irrelevant reasons.

Nevermind the fact that if one gets a failing score back in early march(after programs submit), it would still be very possible to get a passing score back by July 1.

 

[Doctor Bagel]

seems like a paradox. a failed PE will disqualify you from interview... but a passed PE is not required for ranking??? for psychiatry -- are you sure about that?

In a way, it makes sense. With a test that 97% of applicants pass, you'll assume people will pass it. A fail is a red flag, while no score is just no score. I've met applicants at my program with failures on CS, and it makes me wonder what happened. No score just makes me assume they couldn't schedule it yet. The big rule is that you shouldn't release your scores automatically so no one will see the fail unless that's no longer allowed -- I'm admittedly pretty out of touch with this stuff these days.

About what programs want, I don't think there's a universal rule. My residency program didn't seem to care that much about having Step 2 scores -- not having them wouldn't delay either interviews or affect rankings that much. Of course this is assuming you're at least an average student with an OK step 1 score and a US grad. If you have other issues, Step 2 might be more important. My medical school wouldn't rank anyone without both Step 2 scores, though, so yeah, it varies. IMO, I think it's a good idea for everyone to schedule CS early enough to get your scores back before the rank list. CK beforehand makes sense for psych applicants, too -- if you're applying in a competitive specialty and have a solid step 1 score, I can see the point in delaying because you might have a score drop, which might be a bad thing. For psych applicants, no one really cares as long as you've passed.

 

[microshar88]

No, I said above (Post #18) that I'd happily accept a subsequent pass. And what I've been trying to emphasize is that even a pass after a fail would outweigh a blank transcript, because some were advocating to not release scores until after the Match. Someone following that advice should not be surprised if selection committees balk a bit at that. (And vistaril, gee whiz, good for you that you were only hanging out with AOAs and 250s. As you well know, that doesn't represent the majority of the psych pool by any means. And frankly, I think it's a mark of hubris to assume that a 245 ensures equivalent performance on the next step. I think that schools that encourage their students to postpone Step 2, or withhold their scores, are simply giving terrible, outdated advice--and I have seen students, including those from good US schools, get bad news in March because of that.)

The rest of your post, the rant vs. the COMLEX PE, I can't do anything about. I get it...you're p.o.'d. I'm just trying to offer the perspective of a mid-range PD about such things. This is the system we are stuck with, and I'm sorry that your school didn't advise you explicitly that you are ALWAYS at risk in these testing situations. (Heck--I know that even I'm at risk as MOC time rolls around next year, high pass rates or no. The computer could get f-d up, I could have episodic dyslexia or something...I'm not taking anything for granted.)

I see what you're saying. Apologies for the confusion.

I'm glad that you would at least give someone the benefit of the doubt, especially after seeing a passing retake.

Also, I know for a fact that assessments such as the OSCE can never guarantee a passing score. But just for hypothetical purposes, wouldn't you be suspicious if you were getting feedback about how grade your humanistic skills are and what a wonderful interpersonal you have with patients, that you would be failing the humanistic domain on the real deal? Again, it's just a random twist of fate sometimes as you alluded to in your post. I'm just grateful that their are some PD's like you who are willing to give applicants like me the benefit of the doubt especially when it comes to at least granting an interview. Thank you for that.

I guess the heart of my frustration, with my own experience this match cycle, is that now that I have my passing score interview invitations are pretty much gone and I'm scrambling to take spots in geographically preferable regions. This is, as a said earlier, just sheer misfortune.