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If you're like me, before and after your COMLEX PE you helped simultaneously feed and soothe your neuroses by googling various internet strangers' experiences. So I guess as a personal debrief and in order to impart whatever (little) wisdom I have, here's mine:
I absolutely hated this exam. Hated, hated, hated it. It was a money sink--$1400 to register 8mos in advance as well as money to get there and money to stay in a hotel nearby and money to get Lyfts etc. On top of that, knowing that most people pass yet still ALSO knowing that failing would be a large, unnecessary red flag on my app stressed me out for months. I will say that despite my huge anxiety for the exam, I do feel like being forced to practice for it DID help shift my mind from "I'm just a student" to "Dang, I'm going into M4 and need to think like an actual diagnostician." Do I think that was worth the cost and the stress? No, I'd rather be pimped by my IM attending any day. But I do think it helped me "put it all together" in the long run.
The testing staff themselves were very nice and aware of how stressful the whole situation was and did everything they could to make the experience organized and predictable. The NBOME of course talked up how amazing the patient actors were, but actual experience showed them to be rather wooden/robotic in their interactions. However, the patients DID attempt to help me out toward the end of my patient encounters. Just by asking "Is there anything else you think I missed?" toward the end triggered a particularly helpful patient to give me a clue that basically saved my differential. Props to you, guy!
Here are my aforementioned nuggets of wisdom (rants):
1. The Truelearn COMBANK PE videos with Dr. Kauffmann were very helpful (even if they tell you to prepare for a standard way higher than reality). Some of the example SOAP notes and patient interactions, while not perfect, are useful and I would even recommend you watch them throughout 3rd year if you have a COMBANK subscription. Kauffmann also writes a COMLEX PE book and I assume that's basically the same thing as the videos. Either seems to work relatively well. Do NOT use Step 2 CS books to prepare for this. They are entirely different tests with different grading systems/requirements. Just don't. I know the cool thing to do is to crap on COMLEX while worshipping USMLE, but not having to retake PE in order to graduate is even cooler so suck it up and deal with it.
2. The post-test anxiety is absolutely real. I walked out totally fatigued and/or concussed so I didn't have many immediate concerns. But over the next two weeks my "retrospectoscope" worries peaked and I was repeatedly struck with moments of panic and doubt even though I knew I had adequately prepared for an exam that boasts a 93-95% national pass rate. Even though the actual exam didn't seem (objectively) that hard, the worrying in the 7-8weeks afterwards was definitely the most miserable thing I've had to deal with this year.
3. Overall you DO need to prepare for this exam. As much as you'll want to write it off and study for Step 2/Level 2, putting time in will prepare you for it and put your mind (at least a little) at ease leading up to it and afterward. Personally, I would much rather feel like I had over-studied for PE rather than be absolutely sure I failed while trying to study for my written boards afterward.
4. On that note, this test is NOT seeking perfection. This will not be like your OB/Gen Surg rotations where even the slightest mistake at 3am on a Friday morning will bomb your eval. They are looking for ADEQUATE, MINIMUM competency to let you progress toward M4/residency. The reason that every COMLEX PE thread is filled with "I failed to do ____ but I still passed" comments is because that stuff is absolutely true. You may bomb one patient interaction, but then make up for it elsewhere. Your score is averaged over all of your encounters so the goal is to bomb as little as possible while accepting the fact that you will make stupid errors here and there given the time constraints and nervousness. So long as you have reasonable data gathering, physical exam, and note writing skills you will likely pass. Meanwhile, being a jerk, not preparing, making REPEATED/SYSTEMIC errors on every encounter, or lying about your data collection are the fastest ways to actually fail.
5. Communication and "empathy" for the patient and all the little tips and tricks they say to use DO pay off. If you are nice/sympathetic to your patient and you can speak plain English to them you've already won half the battle. The acting staff sit in those rooms for 8hr shifts and by the end of the day it starts to show. I have no doubt aside from the checkboxes they are required to check, being a likable/normal person probably goes a long way toward them rounding up your score vs. looking for reasons to bomb you. Even if you have no idea what the diagnosis is, explaining your A/P with (somewhat) confidence and treating them like a human being is all you really need.
And that's my rant. Moving on.
I absolutely hated this exam. Hated, hated, hated it. It was a money sink--$1400 to register 8mos in advance as well as money to get there and money to stay in a hotel nearby and money to get Lyfts etc. On top of that, knowing that most people pass yet still ALSO knowing that failing would be a large, unnecessary red flag on my app stressed me out for months. I will say that despite my huge anxiety for the exam, I do feel like being forced to practice for it DID help shift my mind from "I'm just a student" to "Dang, I'm going into M4 and need to think like an actual diagnostician." Do I think that was worth the cost and the stress? No, I'd rather be pimped by my IM attending any day. But I do think it helped me "put it all together" in the long run.
The testing staff themselves were very nice and aware of how stressful the whole situation was and did everything they could to make the experience organized and predictable. The NBOME of course talked up how amazing the patient actors were, but actual experience showed them to be rather wooden/robotic in their interactions. However, the patients DID attempt to help me out toward the end of my patient encounters. Just by asking "Is there anything else you think I missed?" toward the end triggered a particularly helpful patient to give me a clue that basically saved my differential. Props to you, guy!
Here are my aforementioned nuggets of wisdom (rants):
1. The Truelearn COMBANK PE videos with Dr. Kauffmann were very helpful (even if they tell you to prepare for a standard way higher than reality). Some of the example SOAP notes and patient interactions, while not perfect, are useful and I would even recommend you watch them throughout 3rd year if you have a COMBANK subscription. Kauffmann also writes a COMLEX PE book and I assume that's basically the same thing as the videos. Either seems to work relatively well. Do NOT use Step 2 CS books to prepare for this. They are entirely different tests with different grading systems/requirements. Just don't. I know the cool thing to do is to crap on COMLEX while worshipping USMLE, but not having to retake PE in order to graduate is even cooler so suck it up and deal with it.
2. The post-test anxiety is absolutely real. I walked out totally fatigued and/or concussed so I didn't have many immediate concerns. But over the next two weeks my "retrospectoscope" worries peaked and I was repeatedly struck with moments of panic and doubt even though I knew I had adequately prepared for an exam that boasts a 93-95% national pass rate. Even though the actual exam didn't seem (objectively) that hard, the worrying in the 7-8weeks afterwards was definitely the most miserable thing I've had to deal with this year.
3. Overall you DO need to prepare for this exam. As much as you'll want to write it off and study for Step 2/Level 2, putting time in will prepare you for it and put your mind (at least a little) at ease leading up to it and afterward. Personally, I would much rather feel like I had over-studied for PE rather than be absolutely sure I failed while trying to study for my written boards afterward.
4. On that note, this test is NOT seeking perfection. This will not be like your OB/Gen Surg rotations where even the slightest mistake at 3am on a Friday morning will bomb your eval. They are looking for ADEQUATE, MINIMUM competency to let you progress toward M4/residency. The reason that every COMLEX PE thread is filled with "I failed to do ____ but I still passed" comments is because that stuff is absolutely true. You may bomb one patient interaction, but then make up for it elsewhere. Your score is averaged over all of your encounters so the goal is to bomb as little as possible while accepting the fact that you will make stupid errors here and there given the time constraints and nervousness. So long as you have reasonable data gathering, physical exam, and note writing skills you will likely pass. Meanwhile, being a jerk, not preparing, making REPEATED/SYSTEMIC errors on every encounter, or lying about your data collection are the fastest ways to actually fail.
5. Communication and "empathy" for the patient and all the little tips and tricks they say to use DO pay off. If you are nice/sympathetic to your patient and you can speak plain English to them you've already won half the battle. The acting staff sit in those rooms for 8hr shifts and by the end of the day it starts to show. I have no doubt aside from the checkboxes they are required to check, being a likable/normal person probably goes a long way toward them rounding up your score vs. looking for reasons to bomb you. Even if you have no idea what the diagnosis is, explaining your A/P with (somewhat) confidence and treating them like a human being is all you really need.
And that's my rant. Moving on.
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