Clinical Skills Exam-Part II Boards

[twocavusfeet]

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Fellow Colleagues,

I am writing this in regards to the Part II oral clinical boards that is supposedly a go for the Class of 2015. As a third year student getting ready for finals and externships, I think it is unacceptable that we have not been given the logistics of this exam. As a medical licensing exam I think it is laughable we have not been given a date, time, cost, or rubric within a six month time frame from the “provided month”. I am wondering if any other students feel the same way. If you or your classmates also believe we deserve to know the information regarding our board exam and our future, please feel free to voice your opinions on here, as this is an anonymous forum and open to all. I feel like NBPME needs added pressure from the student body nation wide to realize the importance of the students' concern. If you have ideas on how to go about this, please voice them for all to hear.

 

[MaxillofacialMN]

In case you weren't aware, there is an APMSA Liaison to the NBPME. I'm sure you are always welcome to email him or have your class's APMSA delegate get in touch with him to voice any concerns you have. SDN is usually a good place to vent, but not a great place for decisive action.

 

[twocavusfeet]

I am fully aware of the positions of APMSA liaison to the NBPME and class delegate. I have contacted multiple people in the House. To my knowledge NBPME is not releasing any information regarding this exam at this time (date, time, grading criteria, final location, final price). I am not asking for definitive action to be taken over SDN, but I am testing the climate. I think it is time the students spoke up and voiced our opinion on this important, pressing manner.

 

[PeaJay]

I find it a little upsetting that the NBPME has provided little to no information, but I cannot say that I am surprised. They have a captive audience so does it really matter if they provide sufficient customer satisfaction?

This whole finding out less than a year in advance that I will have an additional board exam is an insult. What makes is even more hilarious is we MAY be able to get additional loans to cover the expenses of an additional trip and board fee. It is going to be fun pinching pennies to make an unfunded last minute trip. It is a shame that there is little that can be done on our end. My dean has made it clear that this is happening with or without our approval.

 

[that1guyfromFL]

To my knowledge NBPME is not releasing any information regarding this exam at this time (date, time, grading criteria, final location, final price).

The most up to date information I've heard is this: the exam is taking place during the month of August, the exact date yet to be determined. The location is Philadelphia, PA. The cost will be $1,230. For those who do not pass, there will be a second opportunity to take the exam some time later in the fall.

I am assuming by grading criteria you mean content areas, this is from the APMLE website:

What competencies are to be covered in this exam?
All CSPE exam forms will include stations that test an examinee’s ability to:

• perform a complete history & physical
• perform a problem-focused history & physical
• demonstrate elements of a biomechanical exam
• communicate and gather information
• demonstrate interpersonal skills
• share information with patients and colleagues
• demonstrate behavioral counseling/patient education
• demonstrate clinical decision making
• appropriately document information
• synthesize a differential diagnosis
• design an appropriate management plan

I have contacted multiple people in the House.

You are talking to the wrong people if they did not know this information to pass along.

 

[that1guyfromFL]

What makes is even more hilarious is we MAY be able to get additional loans to cover the expenses of an additional trip and board fee. It is going to be fun pinching pennies to make an unfunded last minute trip. It is a shame that there is little that can be done on our end. My dean has made it clear that this is happening with or without our approval.

For clarification, your school administration and financial aid office is responsible for securing additional financial aid for you in the form of a cost of attendance increase. It has been done at multiple schools already.

 

[podstudent11]

The most up to date information I've heard is this: the exam is taking place during the month of August, the exact date yet to be determined. The location is Philadelphia, PA. The cost will be $1,230. For those who do not pass, there will be a second opportunity to take the exam some time later in the fall.

I am assuming by grading criteria you mean content areas, this is from the APMLE website:

What competencies are to be covered in this exam?
All CSPE exam forms will include stations that test an examinee’s ability to:

• perform a complete history & physical
• perform a problem-focused history & physical
• demonstrate elements of a biomechanical exam
• communicate and gather information
• demonstrate interpersonal skills
• share information with patients and colleagues
• demonstrate behavioral counseling/patient education
• demonstrate clinical decision making
• appropriately document information
• synthesize a differential diagnosis
• design an appropriate management plan

You are talking to the wrong people if they did not know this information to pass along.

The content areas represented on the APMLE website are, at best, vague. How will any of those competencies be evaluated? For this test to be fair, it has to be objective. Those competencies, as stated, are subjective. One grader may think that simply palpating pulses constitutes an adequate vascular exam. Another may require capillary fill times, comparison of temperatures between tibia and forefoot, and mention of hair growth. A standard needs to be defined by the AMPLE so the students know what is expected of them. This is even more true when considering this exam is placed under a time constraint. I could do a full and perfect history and physical, but not leave time to write my note, and still fail (potentially, who knows?!)

Also remember that practice questions, albeit a limited set, were provided by the NBPME for Boards Part 1 so students could familiarize themselves with the format. It was stated that the test was 205 questions, and was to be completed in a time period of 4 hours. We don't even know how many patients we will be expected to see (rumors range from 1 - 12). If the whole purpose of this clinical skills exam is the achieve parity with our MD counterparts, who get multiple practice scenarios provided to them by their testing board, as well as a thorough description of what to expect, how can we not be livid about being denied the same?

Furthermore, while Boards grading protocol has always been secretive, this exam is a complete mystery. Do I have to meet 85% of the competency standards for every patient, or do I have to meet 100% of the standards on only 85% of patients? In other words, assuming 12 patient encounters, could I still pass if I perfectly preformed the clinical skills on 11, and completely bombed 1 patient? Or does every patient deserve a level of basic competency? For testing situations, the former should apply; ethically, the latter. Just what kind of doctor are you asking us to be?

Maybe we are just asking the wrong people. If anyone can definitively answer these questions, please do so.

 

[that1guyfromFL]

Also remember that practice questions, albeit a limited set, were provided by the NBPME for Boards Part 1 so students could familiarize themselves with the format. It was stated that the test was 205 questions, and was to be completed in a time period of 4 hours. We don't even know how many patients we will be expected to see (rumors range from 1 - 12). If the whole purpose of this clinical skills exam is the achieve parity with our MD counterparts, who get multiple practice scenarios provided to them by their testing board, as well as a thorough description of what to expect, how can we not be livid about being denied the same?

You aren't being denied anything, there will be an official candidate bulletin with more information forthcoming.
It's pretty pointless to rage about something you haven't even been fully educated about yet. (Cue: someone yelling about how the candidate bulletin should have been released way before now. I agree 110% about that.)

Furthermore, while Boards grading protocol has always been secretive, this exam is a complete mystery.

Parts 1 and 2 written are scored using the Angoff method, nothing secret there. Concerning the clinical skills exam, if it's not explained by the official documentation (like Parts 1 and 2 written both are) I would be surprised.

Do I have to meet 85% of the competency standards for every patient, or do I have to meet 100% of the standards on only 85% of patients? In other words, assuming 12 patient encounters, could I still pass if I perfectly preformed the clinical skills on 11, and completely bombed 1 patient? Or does every patient deserve a level of basic competency?

Fair questions that only the NBPME can answer. Seriously, wait until you have the candidate bulletin and see if you still have questions. Your time right now would be much better spent studying to crush externships.

Maybe we are just asking the wrong people. If anyone can definitively answer these questions, please do so.

The only people with more detailed answers have not published the final word yet. If questions remain after the official documentation comes out, I'd encourage you to utilize your class APMSA representatives to seek out more information or clarification from the appropriate sources.

 

[Marathoner15]

‪All this information is great and I am sure the bulletin will be helpful once it is released, but the golden question is, when is the bulletin going to be made available for students? Is there a deadline NBPME has set for the bulletin to be released?

Or can any of the previous students who took the dry run of the exam give us any tips or pointers to prepare? What was it like when they took it? How many patients they saw, how long they had to see each patient, was it lower extremity specific or more general medicine, were you expected to do a complete physical or just lower extremity focused?

 

[ldsrmdude]

I can give you what I remember from the practice test when I took it two years ago. If I recall correctly, it was about 5-6 hours with a break in the middle for lunch. We had a total of 10-12 patient interactions, all lower-extremity I think. I can't remember for sure but I want to say there was a total of 15 minutes or so per patient, including the time to write the notes. I didn't do anything to study and I felt prepared. If you know how to work up a patient and have a differential diagnosis and know what steps you would take to come to your diagnosis, you should end up fine. Of course, my test was never scored (at least no score was given to me) so I had no pressure during the test, and they may very well have changed the format since then. On top of all that, I've had a busy month and am sort of sleep deprived and am trying to remember a day from 2 years ago that I didn't find particularly important, so take what I say with grain of salt 🙂

 

[podstudent11]

Fair questions that only the NBPME can answer. Seriously, wait until you have the candidate bulletin and see if you still have questions. Your time right now would be much better spent studying to crush externships.

This is the exact source of my frustration. And you are very right, "crushing externships" is much more important to me, especially in the face of a residency shortage. Mine start in 2 short months. There is no guarantee that the candidate bulletin will be out by that time. Preparation and planning take time, even if it is just arranging to get to the testing center. It is stressful and unfair to ask me to take that time away from my externships when it should have been done months in advance. I had paid, registered, and picked an exam location for Boards Part 1 six months early. We are six months out from this exam and we don't even have a final test date. UNACCEPTABLE.

 

[Marathoner15]

I can give you what I remember from the practice test when I took it two years ago. If I recall correctly, it was about 5-6 hours with a break in the middle for lunch. We had a total of 10-12 patient interactions, all lower-extremity I think. I can't remember for sure but I want to say there was a total of 15 minutes or so per patient, including the time to write the notes. I didn't do anything to study and I felt prepared. If you know how to work up a patient and have a differential diagnosis and know what steps you would take to come to your diagnosis, you should end up fine. Of course, my test was never scored (at least no score was given to me) so I had no pressure during the test, and they may very well have changed the format since then. On top of all that, I've had a busy month and am sort of sleep deprived and am trying to remember a day from 2 years ago that I didn't find particularly important, so take what I say with grain of salt 🙂

Thank you for your input! It is helpful and greatly appreciated!

 

[twocavusfeet]

Thank you to those who have provided input and information! Hopefully we will get a better idea of what is to come very soon!