COMLEX COMLEX Level II PE 2017

[RockDoc28]

Hi everyone!

I couldn't find a thread about the 2017 COMLEX Level II PE so I thought I'd start one-- please comment a link to an official thread if one exists already.

I am starting to study for it and wanted to hear more about how the day went, what you used to study, etc. For confidentiality/ not getting kicked out of future COMLEX test reasons, some topics I'm looking for include:

• Did you feel rushed during the testing, or did you have enough time?
• What resources did you use to prepare and did you feel like they did a good job?
• Any tips on writing notes you picked up along the way that you feel helped you save time?
• Any technical difficulties on test day?
• Where did you stay/ travel tips.

A list of topics to AVOID include:

• Any detail about a patient case you saw on test day
• Any detail about a patient case your friend saw on test day
• OMT techniques you used on test day

Just to give a little more warning (even though I know you're all very good at not revealing improper info), here's the statement from the NBOME.

Alright, let's get this thing started!

---

Members don't see this ad.

 

[ortnakas]

Resources: the Kauffman PE book (just google/amazon it) was most representative, but it's worth going through some cases in the First Aid USMLE CS book too.

 

[Dannyboy676]

My only concern is the nine minute soap note


Sent from my iPhone using Tapatalk

 

[jandm]

Passed. Sorry guys, original post in wrong forum.

Best advice is just practice, and you can't be too sympathetic.

 

[SpartanWolverine]

• Did you feel rushed during the testing, or did you have enough time?

I was usually one of the first people out of the exam rooms, actually, so I wrote detailed notes. My exams were very focused but always did CV/resp/pertinent systems. If anything I could have been more thorough with exam, but felt like the time was sufficient overall. Only felt rushed on a couple of stations (usually OMM).

• What resources did you use to prepare and did you feel like they did a good job?

The major thing I did to prepare was to practice writing notes a few times to make sure I had a good format/timing. I also brushed up on OMM for common things using some old course slides.

• Any tips on writing notes you picked up along the way that you feel helped you save time?

I usually wrote down some of my assessments (at least three) and plans first before going on to the subjective/objective. This way I knew I could spend most of my time filling in all of the random S/O information that I picked up. I would add further assessments and plans as they came to me while writing out the S/O.

• Any technical difficulties on test day?

Yeah, our overhead system stopped working. The test staff were great at figuring out a remedy. They're very good.

• Where did you stay/ travel tips.

I did an afternoon session at the Chicago site. Stayed at the Marriott just down the street and walked to the testing center (though apparently they do have parking). Absolutely zero complaints. I ended up staying the night before the exam but I might recommend staying the night after as well if you're driving any distance. I drove four hours home after the exam and was basically delirious by the time I got home (~4am?). It's a mentally taxing exam.

Outcome: Passed. Wish there was a bit more detailed information provided.

 

[1lifeleft28]

Does anyone know if it's an absolute must to sit while delivering assessment and plan? I stood within normal distance of patient, made eye contact and was very sympathetic while explaining everything and I'm worried about something so stupid as body position will screw me...

 

[jrlob91]

Does anyone know if it's an absolute must to sit while delivering assessment and plan? I stood within normal distance of patient, made eye contact and was very sympathetic while explaining everything and I'm worried about something so stupid as body position will screw me...

....you won't fail just for standing up at the end of your encounter.

 

[ortnakas]

Does anyone know if it's an absolute must to sit while delivering assessment and plan? I stood within normal distance of patient, made eye contact and was very sympathetic while explaining everything and I'm worried about something so stupid as body position will screw me...

Didn't know this was a "thing," so I don't recall if I was sitting or standing for this part of most of my encounters, and I passed. Of all the things you can stress about this would be pretty low on my list.

 

[1lifeleft28]

Didn't know this was a "thing," so I don't recall if I was sitting or standing for this part of most of my encounters, and I passed. Of all the things you can stress about this would be pretty low on my list.

It probably is not... but I'm a bit of a nutjob.

 

[Postictal Raiden]

Hi, i passed all of my USMLE steps on my first attempt and currently a United States resident physician. If you need help or need to find a study partner for the Clinical Skills (CS), feel free to contact me. Please let me know know where you are located (country and/or state/city) and your contact number.

lol, explain to us how to perform the Spencer's technique in less than three minutes.

 

[CajunMedic]

Flying out tomorrow for a Thursday AM session in PA. Trying not to freak out. I'll let y'all know how it goes.


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[noods]

Hey guys,

Need some advice here. I'm a 3rd year med student. Trying to schedule my level 2 PE and of course all the dates that would work well for me filled up within 5 hours. I ended up scheduling my exam for the Monday directly after my Family med COMAT. I am wondering if you guys think it would be wiser to take the PE the Monday AFTER or the FRIDAY prior to the Friday of my FM COMAT? I don't have a lot of insight to how hard that comat is and how much of my time it will take. What advice do you have to offer?

Thank you

 

[jw3600]

Hey guys,

Need some advice here. I'm a 3rd year med student. Trying to schedule my level 2 PE and of course all the dates that would work well for me filled up within 5 hours. I ended up scheduling my exam for the Monday directly after my Family med COMAT. I am wondering if you guys think it would be wiser to take the PE the Monday AFTER or the FRIDAY prior to the Friday of my FM COMAT? I don't have a lot of insight to how hard that comat is and how much of my time it will take. What advice do you have to offer?

Thank you

As long as you have had a few rotations and some OSCE prep from your school, the PE is fairly straightforward. I did practically zero prep except for school sponsored standardized patient practice. Reading the intro chapters the to CS book is helpful just to understand the format of the test. You would have no issue with preparing over that weekend only for your PE on Monday.

 

[CajunMedic]

So, I just finished PE about 45 minutes ago:
Did you feel rushed during the testing, or did you have enough time?
Yes and No, plenty of time to see the pt. and OMT, but not enough for the note.
What resources did you use to prepare and did you feel like they did a good job?
I watched the COMBANK videos and read the Dr. Kauffman's PE guide. They definitely did a good job and probably helped me pick up some humanistic domain "style points"
Any tips on writing notes you picked up along the way that you feel helped you save time?
Practice with the eSOAP and typing will help. try to get used to the official abbreviations and your personal format and statements
Any technical difficulties on test day?
None
Where did you stay/ travel tips.
Residence Inn by Marriott. No food in hotel other than breakfast. It's actually within walking distance (I can see the NBOME parking lot from my room.

I realized being in the ER on auditions the last 2 months have not been helpful, I'm so used to being in and out of a room in 6-8 minutes, and I had to force myself to slow down and try to stretch it to 12-14 minutes.

 

[ortnakas]

Travel/packing tip: you can't use your locker during the day, but you can have access to some of your own snacks/drinks/meds/etc if you like. Not notes, obviously-- but they'll let you leave a few things on the table for your breaks. The lunch provided isn't exactly the greatest, and I felt even worse for the vegetarians, so it's not a terrible idea to bring a Cliff bar or something like that. You could also bring little things like Tylenol, chapstick/lipstick, tampons if you're going to need them, etc. (If you have meds you could urgently need like an inhaler, the proctors will hold them for you).

 

[PK128]

What time did scores come out?

 

[DoctorofDelight]

Actual time of day? 3:40pm EST for me.

Which day in the range? First day? Or later?

 

[SpartanWolverine]

Which day in the range? First day? Or later?

Oh sorry, the time I mentioned for was my 2-CE (released late in the afternoon on the last day of the range).

2-PE was released at 8:48am on the first day of the date range. Not sure how helpful this information will be for you, but there ya go!

 

[DoctorofDelight]

Oh sorry, the time I mentioned for was my 2-CE (released late in the afternoon on the last day of the range).

2-PE was released at 8:48am on the first day of the date range. Not sure how helpful this information will be for you, but there ya go!

What month did you take the exam?

 

[SpartanWolverine]

What month did you take the exam?

PE was end of June. CE was mid/late August.

 

[DoctorofDelight]

PE was end of June. CE was mid/late August.

Thanks! Man this is nerve wracking. I'm pretty convinced I failed it.

 

[SpartanWolverine]

Thanks! Man this is nerve wracking. I'm pretty convinced I failed it.

Try not to worry too much! It's an awfully stressful, draining exam and they give you plenty of time to ruminate over potential shortcomings before scores are released. Be assured that it is a test of minimal competence and they are really quite lenient with anything you may have done wrong. Hope you get some good news soon.

 

[Postictal Raiden]

Scores are up

I passed!!!

I'm officially done with all medical school exams.

 

[DoctorofDelight]

Scores are up

I passed!!!

I'm officially done with all medical school exams.

Same here!

 

[Postictal Raiden]

Ok just a quick write up:

I only used the Kaufman videos to prep for this tests. I did not practice a single case.

Felt awful walking out of the test. Although I didn't think I missed any major domain or made big mistakes, I thought that I missed little things here and there on every single encounter. All my SOAPs were horrible, but I made sure to have something in every box.

OK my advise:

1. Make sure you hit every single category. Don't get too hung on trying to do perfect on some at the cost of skipping others. For example, don't try to do a perfect physical exam if you think you won't have time to close properly.

2. Try to smile when it's appropriate. Pretend to sympathize with them. Use their preferred name frequently.

3. Always do heart, lungs, and check TARTs on the spine for the corresponding regions. Do pertinent exams. If you need to do breast/genitalia, make sure to let them know that you'd be performing that with a chaperone.

4. When they call 2 mins, make sure you stop everything you are doing and start the patient education/counseling part

5. Don't dwell too much on the HPI section of your SOAP. Instead, make sure you have something in every box. I'd do the HPI as quickly as possible and move on. If time allows, come back to it and add more stuff.

 

[Mdincorporated]

What's your advice on counseling? And OMM?

Ok just a quick write up:

I only used the Kaufman videos to prep for this tests. I did not practice a single case.

Felt awful walking out of the test. Although I didn't think I missed any major domain or made big mistakes, I thought that I missed little things here and there on every single encounter. All my SOAPs were horrible, but I made sure to have something in every box.

OK my advise:

1. Make sure you hit every single category. Don't get too hung on trying to do perfect on some at the cost of skipping others. For example, don't try to do a perfect physical exam if you think you won't have time to close properly.

2. Try to smile when it's appropriate. Pretend to sympathize with them. Use their preferred name frequently.

3. Always do heart, lungs, and check TARTs on the spine for the corresponding regions. Do pertinent exams. If you need to do breast/genitalia, make sure to let them know that you'd be performing that with a chaperone.

4. When they call 2 mins, make sure you stop everything you are doing and start the patient education/counseling part

5. Don't dwell too much on the HPI section of your SOAP. Instead, make sure you have something in every box. I'd do the HPI as quickly as possible and move on. If time allows, come back to it and add more stuff.

 

[Postictal Raiden]

What's your advice on counseling? And OMM?

Counseling:

Start by explaining the diagnosis and prognosis/plan. Don't waste too much time on that. Couple sentences in layman language is sufficient. Then address lifestyle modifications (smoking cessation, healthier diet, hydration, exercise, stretching, work ergonomics, etc...). If patient leads a healthy lifestyle (eats home made meals, doesn't drink/smoke/do drugs, and exercises), then you can encourage them to continue doing that.

OMM:

Stick to simple stuff. Lymphatics, MFR, and soft tissue. CS's and ME take too long. Articulatory depends (obviously Spencer's take forever). Learn a trick or two for every major region (Head, cervical, thoracic, lumbar, sacral/pelvic, UE's, and LE's). Test before and after treatment. No need for a full structural examination; just inspect and palpate, maybe check PROM/AROM. Ask how they felt afterwards.

No magic formula, use common sense.

 

[Mdincorporated]

Thank you man, and lastly for patients where we might have to break bad news or give them test results for example - how do we go ahead and tackle that? I know that we have to get a general hx and Pmhx info for every patient along with PE however for these patients do we just go to "Lets talk about your hx first" then proceed to come back to the test results in the end when we are done with that and PE - in the counseling aspect?

Counseling:

Start by explaining the diagnosis and prognosis/plan. Don't waste too much time on that. Couple sentences in layman language is sufficient. Then address lifestyle modifications (smoking cessation, healthier diet, hydration, exercise, stretching, work ergonomics, etc...). If patient leads a healthy lifestyle (eats home made meals, doesn't drink/smoke/do drugs, and exercises), then you can encourage them to continue doing that.

OMM:

Stick to simple stuff. Lymphatics, MFR, and soft tissue. CS's and ME take too long. Articulatory depends (obviously Spencer's take forever). Learn a trick or two for every major region (Head, cervical, thoracic, lumbar, sacral/pelvic, UE's, and LE's). Test before and after treatment. No need for a full structural examination; just inspect and palpate, maybe check PROM/AROM. Ask how they felt afterwards.

No magic formula, use common sense.

 

[Postictal Raiden]

Thank you man, and lastly for patients where we might have to break bad news or give them test results for example - how do we go ahead and tackle that? I know that we have to get a general hx and Pmhx info for every patient along with PE however for these patients do we just go to "Lets talk about your hx first" then proceed to come back to the test results in the end when we are done with that and PE - in the counseling aspect?

I don't think there is one unique way to approach this. Do what you are comfortable with. I'd probably start by asking the patient if they want to hear the news and proceed from there. I'd deliver the news in as humanistic and quick as possible, and quickly move on to the rest of the H&P. Remember, you still need to finish every component of the encounter and have a solid two minute period at the end to counsel them. Therefore, I wouldn't dwell too much on the history taking part because you'll get some opportunity to address these shortcomings at the end during your counseling.

It's apparent to me that you are stressing over this, and I totally get that because I was in your shoes few months ago. However, having gone through it, I can confidently say that if you do your best and use "common sense", you'll pass. They understand that you are pressured on time and will not be able to do everything perfectly, so they cut you a slack.

 

[PEthrowaway]

Looking for a bit of reassurance. Took the exam last week, and have been ruminating on this for a few days now. In one encounter, through some awkwardness that I won't divulge exactly at risk of giving up too much information, I shook a patient's hand before using hand sanitizer. I think the rest of the encounter was ok (felt like I made a good connection with the patient, washed my hands before the physical exam, draped the pt, helped them up/down from the table, counseled and arranged speedy follow up) but I'm a bit paranoid that not "washing in" is some kind of auto-failure. Anyone forget to wash their hands and still pass?

Also, I would say for about half the encounters, I ran out of time during my last sentence. I finished the sentence, shook hands, and left. Anyone else run into a similar scenario and still pass? During the orientation video, it made it sound like this was ok.

Of course, this is assuming I'm as normal a human being as I feel like I am and I didn't screw up the humanism or SOAP notes too much otherwise. There were a few patients I was iffy about the exact diagnosis, but I think my differentials and plans were appropriate given the info. There was one patient that was a sensitive topic so I'm not sure how humanistic I came across in discussing it (I know this sounds so cryptic, I'm trying not to divulge too much) and one patient where I had to repeat the HPI back to them several times to make sure I had gotten all the information correct. Other than that, and some physical exam stuff that I wish I had done more of here and there, I think it was ok... other than the fact that it went by REALLY fast and I left not knowing exactly what to feel (like any other COMLEX exam I guess.) I always get good feedback from patients in clinic that I'm going to be a good doctor and I usually get along well with patients, but everything about the PE was so forced and awkward I'm really not sure how I feel about it. Anyway... haaaalp!

 

[SpartanWolverine]

There's actually some debate whether or not you should wash/sanitize hands before shaking or just before exam. I certainly don't think you'll be dinged for it as long as you washed/sanitized at some point before exam.

Absolutely no need to worry about cutting off your sentence at the end.

Specific dx is no big deal (the exam is purposefully somewhat vague). As long as your ddx was reasonable you're fine.

Your concerns are all very common things, but unlikely to significantly affect your grade. You'll be fine.

 

[ortnakas]

In one encounter, through some awkwardness that I won't divulge exactly at risk of giving up too much information, I shook a patient's hand before using hand sanitizer. I think the rest of the encounter was ok (felt like I made a good connection with the patient, washed my hands before the physical exam, draped the pt, helped them up/down from the table, counseled and arranged speedy follow up) but I'm a bit paranoid that not "washing in" is some kind of auto-failure. Anyone forget to wash their hands and still pass?

I know people who said they forgot to sanitize and passed. Even if it is an auto-fail for that particular case, it's not for the whole day, and you're probably fine.

 

[PEthrowaway]

@SpartanWolverine and @ortnakas thank you both for the reassurance! I'll keep this thread posted on whether or not I passed when that time comes. It's difficult finding answers to these things when people who post freaking out don't follow up with whether or not they passed... I'm just hoping that means the majority of them did pass!

 

[MelMcT2009]

Finished yesterday. Que insane paranoia for the next 8 weeks.

Are you supposed to have labs and EKGs to interpret on this thing? Completely forgot to even look since none of the book cases even mention this

 

[runthiscity]

The more time I have to ruminate on this thing, the worse I feel about it. I forgot plenty of physical exam things (like I listened only to 6 listening posts for the lungs unless they had some type of lung problem- anyone have experience with something similar?) However, I am stuck on what (I'm my mind) are humanism screw ups. Like one pt I could not keep the HPI straight in my head and asked her to clarify multiple times. Also asked her a stupid question basically about where she was living (Chicago... Duh.) She seemed to be a bit annoyed after a bit. Another case was a rather sensitive topic and the whole thing I didn't know if I was handling it correctly or not. Stuff like that.

Hopefully I am concentrating primarily on the bad stuff and not remembering the good stuff as much but hot dang the waiting is torturous and it's only been 2 weeks.

 

[CajunMedic]

Got my score at straight up 1200. PASSED!!!!

 

[AOAmed]

+

 

[Brach Zaff JD]

Hey guys, very nervous waiting for my results, im worried about humanistic as i feel i hit most checkboxes but forgot to tell patients my assessment 3 times and jumped straight to plan, saying we’ll do these labs and imaging to rule out other causes but yet i actually never told them my diagnosis; anyone have some reassuring tales of classmates doing that and passing.

 

[Ron1x]

Passed

Took the exam late october, found out the first day of score release date range.

I wanted to talk a little bit about my experience, and give some advice but the more I wanted to discuss how I did, the more I worried it would disclose too much information.

Basically to prepare I read the Kauffman book, then made flashcards from any topic I came across in the book step up to medicine that I thought might be a case. Things like MI got a flashcard, but things like PSVT did not. The flashcards had the following on the back side

1) Diagnosis explained in lay terms and how it might have been caused
2) Diagnostic tests to perform or other pertinent tests to have done
3) Differentials (it can be hard on the spot to think of all the different chest pain differentials when nerves are running high, but writing three or four on a flashcard helped)
4) Meds (what meds should I remember for a COPD exacerbation or if I'm suspecting an MI)

I feel like as a fourth year we should know all the above, but again my fear was that I would get too nervous due to the high stakes of the exam and forget. Having the flashcards to review throughout the week before and the time on the plane was very helpful

For the exam itself, I literally was the last person to go into the room. Every single time. I was also done about 2 or sometimes 3 minutes before the final 2 minute warning with the encounter. This actually worried me with grading and I felt like my exams may have been too focused. On my blank paper I wrote all my mnemonics. Again, worried that nerves would make me blank, I had them to always fall back on. I did OLDCARTS, FEDTACOS, MASHFM on one side of the paper. On the right side of the paper I wrote vitals (prompting myself to check again and mention if the patient had normal vitals which was reassuring or if they had fever or high blood pressure), Diff (writing out at least 2 or 3 differentials before going into the room) and then MOTHER.

For every patient I introduced myself, asked what brought them in, and if the conversation was close ended I went with my mnemonics. I did very focused exams and was thorough with what I did check like Kauffman suggested with how many listening posts to do etc... I asked if I could untie the gown to ausculate, retied it myself, offered to help with position changes etc... I think a majority of my time, besides taking the history, was spent doing MOTHER and explaining the diagnosis, the plan, what meds to start and any tests to order which is why the flashcards were helpful. I asked everyone if they had insurance and family for support. Some patients I asked if they wanted me to call their family to let them know what was going on. Then I asked if they had any final questions, thanked them and left.

The test experience was great overall, the proctors were fantastic and it truly felt like another day in clinic. There were two I didn't know and I flat out told them I thought it might be this or possibly that, but I would work with them to figure out what was going on. I'm so relieved that now I have all my scores I can enjoy the rest of interview season.


If anyone believes that the above is revealing any information that violates NBOME standards please let me know. That is not my intent at all and I will correct it immediately if so. I don't believe I have disclosed anything exam related. Hope this helps some people, I turned to sdn for a lot of reasons to try to research this exam since so little in terms of grading is provided elsewhere. Ultimately I think it was writing the mnemonics that helped me save time and use it to get a lot of humanism with my plan.

 

[chasm-e-baddoor]

Passed

Took the exam in novemeber, in PA, and got the results today (first day of score release date range) at around noon.

I had already taken the test once before and failed, so today's news was especially sweet.

I would like to tell everyone this might concern to not take this test lightly. It's a crapshoot imo. I failed the humanistic domain the first time (while passing the biomedical domain) but passed this time, despite the fact that I didnt change my demeanor much. And I usually get top grades in the patient interaction categories on my rotations...I'm seen as a nice guy who goes the extra mile for patients and is willing to listen on the wards. Hell, I even ran out of time before I could get to counselling the patient at the end for a couple of cases and was unable to do OMM in a blatant OMM cases but I still passed the humanistic domain, which I am extremely thankful for.

I'm not saying to absolutely have 2 weeks of dedicated study for this test, but be confident in your differential diagnoses for the major presentations so that you will not only be more time efficient, but also seem more confident in the face of your patient. If you know the biomedical portion like the back of your hand, you can devote more thought and time to humanistic portions.Know how to rule out the life threatening conditions (ie what to write in the plan to r/o )

Biomedical portion - I forgot to do OMT on an obvious OMT case, and I wasnt able to finish a couple of notes, and still got through.

Do NOT put something in your note that you did not address/do in the actual encounter. If you are unsure of whether or not you did it, refer to the next piece of advice.

If you forget to do something, lik epart of a physical exam, OMT, counselling, asking part of the HPI, you can write it in the plan to get partial credit i believe. For example, when I forgot to do OMT i wrote it in my plan.

Say, "I'm sorry to hear that" even if the patient's loved one died 25 years ago

Be supportive and express genuine enthusiasm when patients report that they are trying to improve an aspect of their lifestyle or are seeking improvement. Say that you are glad they are improving/looking for improvement and that you want to help. Congratulate them on their improvement even.

Do not put the earpieces of your stethoscope in your ears too deep. You might miss the patient saying something or the 2 minute warning. I missed the 2 minute warning because I did not hear it and I got screwed on that case - did not have time for closing discussion with the patient.

Always ask if the patient has any questions. Let them know that they are free to interject at any point if they have questions, concerns, discomfort, whatever.

Know an OMT technique for each area of the body cold. look at the green book, watch videos, and/or practice them so you can do them as accurately and confidently as possible. Also make sure you know the indications so the OMT youre administering is actually warranted. Give them a brief explanation about what OMT is and how it can help. Always help the patient into proper positions and try to make them do as little work as possible - ideally no work. I also verbalized what I was doing at every step - wasnt sure if it's required but it didnt hurt imo. Always reassess, like we were drilled to do during the practicals back in pre-clinical years.

I was not able to do the wrap up discussion on case - what I did is say call the office if you have any questions/we will contact you/we will schedule another visit to further address. Maybe it helped maybe it didnt but I felt that it at least left some closure and addressed solving the problem. For me, since I failed the humanistic part the first time, I made it a point to jump straight to the concluding statements at the 2 minute warning regardless of whether or not i was finished with the PE or OM, since the biomedical portion can always get partial credit by putting it in the plan of the note.


I'll write more when I get home

To be continued...

 

[Mad Jack]

Passed. Yet another "I swore I failed" story, did fine.

 

[Bobcat18]

Passed- such BS you get no other feedback other than 'passed'. No further evaluation of our performance, no suggestions on improvement. Just...you are within the >92% of those who passed the exam. What exactly is my $1300 going towards?

 

[ortnakas]

Passed. Yet another "I swore I failed" story, did fine.

Congrats! The story really does apply to everyone.

Passed- such BS you get no other feedback other than 'passed'. No further evaluation of our performance, no suggestions on improvement. Just...you are within the >92% of those who passed the exam. What exactly is my $1300 going towards?

The worst turkey sandwich and best chocolate chip cookie ever. Obviously. /s

 

[em20178]

guys this is for all of those who have previously failed one attempt before... I've just passed yesterday. I had multiple panic like attacks days before the score was done. I couldn't sleep well days before. I had a lot of crazy nightmares.

My advice guys: If you have failed before go to your osce dept. Make sure you do a few rehearsals with the osce professors. I found that, even though I was using the Kaufmann format, I could have still structured my notes better. Always do the assessment and plans first. Then the HPI. For the vital signs that you have to waste precious seconds listing, just list them as opposed to writing BP, Pulse, RR, Temp...etc if you don't have time. (Just my guess as I ran out of time and was forced to do this). If you can't spend a lot of time retaking the BP just write it in the assessment that I will come back and recheck. Don't waste precious time during encounter. Also for washing hands, I made sure to do it twice and verbalized each time (you never know if the patient forgot that you washed hands and you don't know if this might cause an auto-fail for the case). Make sure you do essentially the same physical exam with Heart and Lungs + pertinent system(s). Stick to CODIERS SMASH FM for the history. Spend time with the assessment and plan with patient. I do think the exact diagnosis doesn't matter as much as conveying it in an easy to understand manner and having a plan to support it. I really think Kaufmann's strategy is done correctly, he is spot on. I regret not being adept with his methodology the first time. Stick to his strategy and get faster with it.

Show emotion with the voice. For example: "I really like how you are exercising X times a day, keep it up!" Also don't forget to show empathy. Perfect time to do this is when they share their own past medical history or family history as you can probably have a situation to say "That must be difficult" Obviously there are countless other situations. For the OMM, forget about complex techniques. Stick to basics: myofascial, rib raising. Go through the Kaufmann video for OMM 3 or 4 times. I think that is all you need to know. I think verbalizing what you are doing is key here. The camera might not show the grader the best angle so if you verbalized you might get points here. I do think the humanistic domain needs to be done continuously throughout the encounter. It's not just enough to throw it in once or twice during the encounter as the patient might forget your humanism. Always end with something along the lines of "We will get started with the treatment immediately," if its a ER case. Obviously a thank you as well.

I know I probably left something out so feel free to ask.

 

[OverOnChestnut]

Hi everyone,

I'm hoping for some down-to-earth insight, so please give honest opinions as I'm not trying to get any false hope. On my PE, I failed to put any OMT assessment in the objective portion, I did all the techniques for the cases and then solely put in the plan the OMT that I chose. In hindsight, I can't believe I did this, and it has me rather worried...thoughts? I feel like other aspects were decent; except my plans were scant but I made sure to have at least 4 things in the plan for every case.

I keep reading that everyone feels terrible about this exam, but I never thought I would feel this paranoid. There are so many other things that I keep playing over in my head that have me concerned but I think the OMT issue is the biggest thing...thoughts?

 

[KarmaIsTruth]

Can I withdraw my test from scoring after I took it? I can just retake it and not get the "F".

I feel like I failed. I really do.

I used medical jargon, which I could tell annoyed patients. I also failed to properly relate to patients who were pretending to be in pain - like in the ED setting. I failed to see them as real patients. Also often skipped a lot of stuff in the history - like asking the surgical history or parts of the social history which I felt were less relevant. Sometimes skipped the heart and lung exam due to lack of time.

I really might have failed. I am also a minority and I felt that some of the patients didn't really like that. It was an uphill battle everytime to get the patients to like me. = /

 

[ortnakas]

Can I withdraw my test from scoring after I took it? I can just retake it and not get the "F".

I feel like I failed. I really do.

I used medical jargon, which I could tell annoyed patients. I also failed to properly relate to patients who were pretending to be in pain - like in the ED setting. I failed to see them as real patients. Also often skipped a lot of stuff in the history - like asking the surgical history or parts of the social history which I felt were less relevant. Sometimes skipped the heart and lung exam due to lack of time.

I really might have failed. I am also a minority and I felt that some of the patients didn't really like that. It was an uphill battle everytime to get the patients to like me. = /

Unfortunately no-- no withdrawals.

Actually, that probably is fortunate-- most of us left the building thinking we failed, and most of us passed. I'm glad I didn't have the option to give the NBOME an extra $1300, thinking about it.

You probably did fine. And if not, you know what not to do next time (ie don't skip things! For future test-takers-- don't skip any history and do heart & lungs at the minimum).

 

[KarmaIsTruth]

Unfortunately no-- no withdrawals.

Actually, that probably is fortunate-- most of us left the building thinking we failed, and most of us passed. I'm glad I didn't have the option to give the NBOME an extra $1300, thinking about it.

You probably did fine. And if not, you know what not to do next time (ie don't skip things! For future test-takers-- don't skip any history and do heart & lungs at the minimum).

How do you know this?

Did you call and ask them if you could withdraw?

 

[KarmaIsTruth]

Unfortunately no-- no withdrawals.

Actually, that probably is fortunate-- most of us left the building thinking we failed, and most of us passed. I'm glad I didn't have the option to give the NBOME an extra $1300, thinking about it.

You probably did fine. And if not, you know what not to do next time (ie don't skip things! For future test-takers-- don't skip any history and do heart & lungs at the minimum).

Thanks for replying by the way.

 

[ortnakas]

How do you know this?

Did you call and ask them if you could withdraw?

I just remember that (unlike the MCAT) once you start taking a COMLEX or USMLE exam, barring a medical emergency or act of God, you can no longer withdraw.