Took this bad boy today. Thoughts...
- This was a classic COMLEX exam in most ways - short stems with seemingly inadequate info, weird/obscure qs, multiple correct answers, way too much OMM, poor quality imaging, the works. Everything you love to hate about the COMLEX was there, although these things do seem to be improving somewhat (more on that below).
- The heaviest subject was definitely peds (perhaps 40% of the exam), followed by OBGYN, with OMM and medicine splitting most of the rest. There was a smattering of psych and barely any biostats (perhaps 3 total qs). Ethics, as always, had its 3-5 qs per block. Surprisingly, optho (of all things) had a larger than usual presence on my exam; it probably had 3qs per block, and they were not easy by any means. Medicine qs: GI>>ID>>cards>heme/onc. There wasn't much renal or pulm, and just a touch of endo and rheum qs.
- There were definitely some dominant 'themes' on my exam:
- Medicine: GI bleeds (up/down/all around; people had blood pouring from every orifice), IBS, WPW, B12 deficiency (know ALL about it), GI imaging
- OBGYN: STDs, infertility, contraception, primary and secondary amenorrhea
- Peds: child abuse, rashes, failure to thrive, exanthems. Surprisingly ZERO qs on pediatric milestones.
- OMM: almost entirely viscerosomatics, cranial and Chapman's points. (I wasn't expecting so much cranial and thus there was definitely some guesswork going on in that department.)
- Optho: glaucoma, AMD
- The quality of the questions has improved marginally. I didn't find any misspellings, grammatical errors, missing phrases, or other editorial gaffes this time around (this is a step up from previous experiences). The writing style and clarity of the questions seemed to be somewhat better overall. The early blocks actually had a lot of USMLE-esque multistep questions that seemed very well written, but the later blocks reverted to the classic 'murky' COMLEX style with short stems, inadequate info etc. Maybe the early blocks were the experimental ones?
- There's still plenty of WTF qs. These almost always involved topics that were well-covered in review books; they just took everything a step farther than what you had likely learned or forced you to apply your knowledge to novel situations. Maybe 30-40% of the test were qs I narrowed down to two good options and went with whatever option seemed more reasonable.
- Ethics qs were either very obvious or very obtuse, the latter featuring bizarre scenarios where there probably was no objective 'best answer'.
- Medicolegal qs were never obvious and featured laws I'd mostly never heard of (why do these questions even exist? Are they trying to get us to learn about this stuff by googling it after the test?)
- The 'video exhibits' were generally pointless. Why do I need to burn 18 seconds watching a pt say 'ow' to palpation in the RLQ when you can just say that in the stem? Furthermore, there was one video where a pt let out a totally blood-curdling scream to palpation that seemed just a bit excessive (or maybe I should be thankful for it - it did wake me up a bit).
- There were no CCS cases on my exam.
All in all: Like most COMLEX exams, I felt like complete garbage by the end of the exam but knew I had probably answered enough questions to at least pass. I 'studied' for a month but since most of that month was spent on an ICU service with overnight call, most studying really happened within the last week. Finished 90% of COMBANK with 74.6% avg. Used primarily Boards and Wards (which was actually really clutch; it's underrated, shame so much of it is outdated now) with Crush Step 3 and FA for step 3 to fill in. Given that I'm ACGME IM, passing is all I care about (nobody in IM fellowships cares about step 3 scores). I'd be happy with a 351. Knowing this, however, the COMLEX roulette wheel will probably give me an 893 or something totally ridiculous (or worse, a 194). We'll see what happens.