Failed COMLEX Level 2 PE - want OBGYN

[trugrit19]

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Im a 3rd year at ACOM and failed level 2 PE. I’m set to retake it this June. If I pass in June, do I even have to report the failure for PE?

 

[Dr. Death]

It'll be on your transcript. You don't have an option of what you do and don't report. It's all together

 

[Ozilcr7]

Im a 3rd year at ACOM and failed level 2 PE. I’m set to retake it this June. If I pass in June, do I even have to report the failure for PE?

I hope for your sake that you scored well on your Step 1.

 

[Oh_Gee]

Im a 3rd year at ACOM and failed level 2 PE. I’m set to retake it this June. If I pass in June, do I even have to report the failure for PE?

on ERAS, you will have to submit all your COMLEX scores, pass or fail.

i highly recommend reading the First Aid for the USMLE Step 2 CS book and practicing all the cases with a friend

 

[trugrit19]

I hope for your sake that you scored well on your Step 1.

thanks for nothing...

 

[trugrit19]

on ERAS, you will have to submit all your COMLEX scores, pass or fail.

i highly recommend reading the First Aid for the USMLE Step 2 CS book and practicing all the cases with a friend

you have to submit 2 COMLEX scores pass and fail in my case?
thanks for the help. not sure wth i did to fail...

 

[Oh_Gee]

you have to submit 2 COMLEX scores pass and fail in my case?
thanks for the help. not sure wth i did to fail...

when doing ERAS, you pay some fee to NBOME and they will submit all your comlex scores. you can't pick and choose which ones they send

which part did you fail?

 

[trugrit19]

when doing ERAS, you pay some fee to NBOME and they will submit all your comlex scores. you can't pick and choose which ones they send

which part did you fail?

Ahh that makes sense.
OMT and Data gathering..
I did TART changes on specific spine segments every single patient. I did MFR and Muscle energy as treatments.
as far as data gathering...SMASH FM FEDTACOS ROS every single time like I've always done flawlessly. My SOAP notes were excellent.
I referred two of my patients..could that be a reason I failed

 

[samac]

thanks for nothing...

I don't think they were trying to be disparaging, it's just the OB can be hard in the DO world and a good step score could get them to overlook the PE failure.
As others have said your entire transcript gets released as one, you can't choose to not release the fail.

 

[Oh_Gee]

Ahh that makes sense.
OMT and Data gathering..
I did TART changes on specific spine segments every single patient. I did MFR and Muscle energy as treatments.
as far as data gathering...SMASH FM FEDTACOS ROS every single time like I've always done flawlessly. My SOAP notes were excellent.
I referred two of my patients..could that be a reason I failed

not really sure from what you said.

that's how i did my data gathering.

Sounds like you went above and beyond on OMT. i didn't do TART or MFR.

i think i only requested a consult once but can't imagine them failing you for that

 

[samac]

Ahh that makes sense.
OMT and Data gathering..
I did TART changes on specific spine segments every single patient. I did MFR and Muscle energy as treatments.
as far as data gathering...SMASH FM FEDTACOS ROS every single time like I've always done flawlessly. My SOAP notes were excellent.
I referred two of my patients..could that be a reason I failed

Are you sure your SOAP notes were excellent? Did you document something you didn't actually do? Get the entire history in there? You might have gotten a full past history, but how did you do for your HPI? Did you do the same kinds of OMT for different patients? Somehow miss the one patient that asked, "is there something you can do today doc?" Were your techniques solid?
You're going to have to be super critical of yourself to try and pinpoint what happened, sometimes it seems super nitpicky.

 

[Spectreman]

Ahh that makes sense.
OMT and Data gathering..
I did TART changes on specific spine segments every single patient. I did MFR and Muscle energy as treatments.
as far as data gathering...SMASH FM FEDTACOS ROS every single time like I've always done flawlessly. My SOAP notes were excellent.
I referred two of my patients..could that be a reason I failed

Did you maybe over blast OMT? I’ve heard doing it on everyone will lead to a fail. Is there a chance you didn’t recheck anyone? Did you watch the Kaufmann videos? I barely reviewed OMT the night before, didn’t practice with a single person, and still passed. All I did was watch the Kaufmann videos and wrote a mock soap for each one before watching the explanation. I also sadly feel like there truly is an element to of bad luck with this. They basically have to fail 1-2 people per group and it seems like it’s almost drawing the short straw. Timing was okay too? Didn’t rush out with 4+ minutes left in your time anything like that right? OMT and data gathering, but doing focused TART and all of fedtacos SMASHFM on everyone seems like there must have been some other major issue because that’s basically a golden ticket. Very tough situation, sorry to hear this.

Like they said above, if your step/level 1 are 240+/600+ I’d still go for it. If not I’d dual apply FM and go OB that route because it’s way competitive and that red flag is gonna get you screened like crazy.

 

[Spectreman]

Ahh that makes sense.
OMT and Data gathering..
I did TART changes on specific spine segments every single patient. I did MFR and Muscle energy as treatments.
as far as data gathering...SMASH FM FEDTACOS ROS every single time like I've always done flawlessly. My SOAP notes were excellent.
I referred two of my patients..could that be a reason I failed

Also, referring is supposed to be bread and butter on these SOAPs. We were taught to always throw in a referral, an education, and ideally some OMT (although after going through Kaufmann I did not always put an OMT in my plan). Also any chance you didn’t type out your vitals on all the objectives? You said your SOAPs were flawless, but that’s where “data gathering” is going to be majorly assessed.
Just spit balling to help you for the next round, again, so sorry this happened. Majorly sucks.

 

[mathnerd88]

Ahh that makes sense.
OMT and Data gathering..
I did TART changes on specific spine segments every single patient. I did MFR and Muscle energy as treatments.
as far as data gathering...SMASH FM FEDTACOS ROS every single time like I've always done flawlessly. My SOAP notes were excellent.
I referred two of my patients..could that be a reason I failed

I'm not sure OMT was indicated in all your patients. If you performed OMT while it was contraindicated it would most likely net you a failure. I did not have time to perform OMT on every patient, and only did OMT for those patients that hinted and asked for it.

Also, as for data gathering, did you do CLODIERS or OPQRST for every patient? You didn't mention any of that. I would say having CLODIERS or OPQRST is the most important part of data gathering.

Another common reason why people fail the PE is that they document something they absolutely did not do. Did you write things in your notes that you didn't do or even ask? For example, write heart sounds/ bowel sounds when you did not use your stethoscope at all?

 

[Spectreman]

I'm not sure OMT was indicated in all your patients. If you performed OMT while it was contraindicated it would most likely net you a failure. I did not have time to perform OMT on every patient, and only did OMT for those patients that hinted and asked for it.

Also, as for data gathering, did you do CLODIERS or OPQRST for every patient? You didn't mention any of that. I would say having CLODIERS or OPQRST is the most important part of data gathering.

Another common reason why people fail the PE is that they document something they absolutely did not do. Did you write things in your notes that you didn't do or even ask? For example, write heart sounds/ bowel sounds when you did not use your stethoscope at all?

Oh man, this is a big one as well... Had an upperclassman with a 250+ fail because he was so berserk about the PE that he had memorized a billion scenarios and typed them out from memory. Completely typed a bunch of false crap without realizing it.

 

[trugrit19]

Did you maybe over blast OMT? I’ve heard doing it on everyone will lead to a fail. Is there a chance you didn’t recheck anyone? Did you watch the Kaufmann videos? I barely reviewed OMT the night before, didn’t practice with a single person, and still passed. All I did was watch the Kaufmann videos and wrote a mock soap for each one before watching the explanation. I also sadly feel like there truly is an element to of bad luck with this. They basically have to fail 1-2 people per group and it seems like it’s almost drawing the short straw. Timing was okay too? Didn’t rush out with 4+ minutes left in your time anything like that right? OMT and data gathering, but doing focused TART and all of fedtacos SMASHFM on everyone seems like there must have been some other major issue because that’s basically a golden ticket. Very tough situation, sorry to hear this.

Like they said above, if your step/level 1 are 240+/600+ I’d still go for it. If not I’d dual apply FM and go OB that route because it’s way competitive and that red flag is gonna get you screened like crazy.

seriously....I’m gonna have to go FM because of this one test....

 

[trident_gum]

You can always aim for FM-OB, no?

 

[allin1211]

I'm not sure OMT was indicated in all your patients. If you performed OMT while it was contraindicated it would most likely net you a failure. I did not have time to perform OMT on every patient, and only did OMT for those patients that hinted and asked for it.

Another common reason why people fail the PE is that they document something they absolutely did not do. Did you write things in your notes that you didn't do or even ask? For example, write heart sounds/ bowel sounds when you did not use your stethoscope at all?

This to the T. Do NOT do OMT for EVERY pt! According to the NBOME orientation guide, "Candidates are expected to incorporate osteopathic principles and practices into encounters with SPs where indicated and appropriate. This includes palpatory diagnosis, osteopathically-oriented history taking, OMT, and documentation of osteopathic findings and treatment." For instance, if a pt comes bc she think she has a certain disease or diagnosis, you have to think to yourself: is it REALLY necessary to do any OMT assessment? The ONLY time you should be even considering OMT is if they are very explicit about it. Also, "The total duration of the treatment should not be longer than three to five minutes for any given patient, but long enough for a trained physician observer to note the effectiveness and quality of the technique." If youre doing TART changes and all that assessment, you maybe be going over 5 minutes. I'd recommend watching the Kauffman videos to see when he actually considers using OMT.

Also, like the above person said, do NOT lie on your SOAP note. If they catch one inaccuracy they investigate all your other SOAP notes. If you forgot to do something, put it in your plan. If youre unable to complete a specific part of the exam bc the pt was having pain or something, document that! Do not imply anything in the subjective/objective section.

 

[trugrit19]

This to the T. Do NOT do OMT for EVERY pt! According to the NBOME orientation guide, "Candidates are expected to incorporate osteopathic principles and practices into encounters with SPs where indicated and appropriate. This includes palpatory diagnosis, osteopathically-oriented history taking, OMT, and documentation of osteopathic findings and treatment." For instance, if a pt comes bc she think she has a certain disease or diagnosis, you have to think to yourself: is it REALLY necessary to do any OMT assessment? The ONLY time you should be even considering OMT is if they are very explicit about it. Also, "The total duration of the treatment should not be longer than three to five minutes for any given patient, but long enough for a trained physician observer to note the effectiveness and quality of the technique." If youre doing TART changes and all that assessment, you maybe be going over 5 minutes. I'd recommend watching the Kauffman videos to see when he actually considers using OMT.

Also, like the above person said, do NOT lie on your SOAP note. If they catch one inaccuracy they investigate all your other SOAP notes. If you forgot to do something, put it in your plan. If youre unable to complete a specific part of the exam bc the pt was having pain or something, document that! Do not imply anything in the subjective/objective section.

I DIDNT DO OMT ON EVERY PATIENT. I ONLY DID OMT ON PTS THAT MENTIONED/ASKED. I did TART changes for every patient to cover the OMM component. The most I can think of I did wrong is I ran out of time in one room to do a full cranial nerve exam and then the rest of the rooms I was out early. I NEVER have ever put something down I didn’t do in the room. If I didn’t say it, I would put in the plan literally “did not mention but will do blah blah blah next visit”.

 

[trugrit19]

You can always aim for FM-OB, no?

I do not, do NOT want to do FM

 

[trugrit19]

Also, referring is supposed to be bread and butter on these SOAPs. We were taught to always throw in a referral, an education, and ideally some OMT (although after going through Kaufmann I did not always put an OMT in my plan). Also any chance you didn’t type out your vitals on all the objectives? You said your SOAPs were flawless, but that’s where “data gathering” is going to be majorly assessed.
Just spit balling to help you for the next round, again, so sorry this happened. Majorly sucks.

typed out vitals for every single patient.

 

[Dr. Death]

I do not, do NOT want to do FM

I'm a 4th year that matched ob/gyn. PM me if you have questions/need advice.

 

[Dr.Bruh]

I DIDNT DO OMT ON EVERY PATIENT. I ONLY DID OMT ON PTS THAT MENTIONED/ASKED. I did TART changes for every patient to cover the OMM component. The most I can think of I did wrong is I ran out of time in one room to do a full cranial nerve exam and then the rest of the rooms I was out early. I NEVER have ever put something down I didn’t do in the room. If I didn’t say it, I would put in the plan literally “did not mention but will do blah blah blah next visit”.

Help us out and tell us your Step1/Comlex score. If its decent and you get a chance to do aways you can still be a viable OB candidate! Some programs may screen you out witha PE fail but there are many programs that as long as you pass it eventually you'll be good. But very dependent on your step1/Comlex score.

 

[sharpstickie]

Ahh that makes sense.
OMT and Data gathering..
I did TART changes on specific spine segments every single patient. I did MFR and Muscle energy as treatments.
as far as data gathering...SMASH FM FEDTACOS ROS every single time like I've always done flawlessly. My SOAP notes were excellent.
I referred two of my patients..could that be a reason I failed

Perhaps, now consider this for a second, that you may not be as good at it as you think you are. The only way you're going to be able to turn it around and pass is if you take a look at every aspect of what you are doing and not assume you failed based on a technicality.

 

[Spectreman]

I'm a 4th year that matched ob/gyn. PM me if you have questions/need advice.

Ayyyyy congrats my friend!!

 

[popopopop]

I did osteopathic screening on every patient and actually illicit responses even in non-omm cases. I passed. For data gathering, did you ask relevant f/u questions and able to ask 2-3 questions to rule out some red flags and differentials?

 

[trugrit19]

Perhaps, now consider this for a second, that you may not be as good at it as you think you are. The only way you're going to be able to turn it around and pass is if you take a look at every aspect of what you are doing and not assume you failed based on a technicality.

I've very much considered that. I am extremely hard on myself usually. But getting honors on all of my rotation evals and always making an A for SP encounter...this confuses me. I do the same thing every single time. I have a country accent....do you think having a country accent makes me come off as dumb?

Somebody just tell me what they did for patients with no complaints and just there for a physical. Did you make sure they were up to date on colonoscopies, paps, mammograms? Because I left off pap and mammogram for 2 patients I think.

 

[mathnerd88]

I DIDNT DO OMT ON EVERY PATIENT. I ONLY DID OMT ON PTS THAT MENTIONED/ASKED. I did TART changes for every patient to cover the OMM component. The most I can think of I did wrong is I ran out of time in one room to do a full cranial nerve exam and then the rest of the rooms I was out early. I NEVER have ever put something down I didn’t do in the room. If I didn’t say it, I would put in the plan literally “did not mention but will do blah blah blah next visit”.

I'm sorry, but doing TART changes for every patient means you're doing OMT for every patient. TART changes is part of the OMT umbrella.

Again, you would have to fail more than half the stations to actually fail the PE. Therefore, you are doing something repeatedly wrong in more than half your stations that would cause you to fail. Failing one or two stations would not net you a fail on the PE. Did you do a full CLODIERS or OPQRST?

 

[Dr.Bruh]

I did osteopathic screening on every patient and actually illicit responses even in non-omm cases. I passed. For data gathering, did you ask relevant f/u questions and able to ask 2-3 questions to rule out some red flags and differentials?

I only did OMM screen on 4 patients and treated 3 and passed. You def don't have to screen everyone.

 

[mathnerd88]

I also have to mention OP, if your report said you failed on the OMT component, then it definitely means you did something OMT related that was wrong. If you stated that you attempted to OMT screen everyone, then that is probably most likely it.

If you're trying to perform an OMT screen on a patient with that you suspect has tension pneumothorax or ascending thoracic dissection or some other emergency that requires immediate intervention, then that is definitely wrong and constitutes a failure.

 

[popopopop]

I only did OMM screen on 4 patients and treated 3 and passed. You def don't have to screen everyone.

For sure, just giving an example of over omm-ing and still passing.

 

[Dr.Bruh]

I also have to mention OP, if your report said you failed on the OMT component, then it definitely means you did something OMT related that was wrong. If you stated that you attempted to OMT screen everyone, then that is probably most likely it.

If you're trying to perform an OMT screen on a patient with that you suspect has tension pneumothorax or ascending thoracic dissection or some other emergency that requires immediate intervention, then that is definitely wrong and constitutes a failure.

This. I had like 2-3 ER cases, 1 that was a surgical emergency. OMM screen def would have been inapropriate to do in those cases.

 

[deleted610572]

If OB is out and you don’t want to do FM what’s a back up specialty. You can still apply OB. Just apply to your back up as well

 

[samac]

I've very much considered that. I am extremely hard on myself usually. But getting honors on all of my rotation evals and always making an A for SP encounter...this confuses me. I do the same thing every single time. I have a country accent....do you think having a country accent makes me come off as dumb?

Somebody just tell me what they did for patients with no complaints and just there for a physical. Did you make sure they were up to date on colonoscopies, paps, mammograms? Because I left off pap and mammogram for 2 patients I think.

I also have a southern accent and passed.

For someone with no complaints I asked the screening stuff, colonoscopies, paps, mammograms, checking screening labs.
I’m sorry this happened to you and it must be very hard to pinpoint.

 

[JibsGuy52]

Sorry you failed this miserable test. What is your step 1 score?

 

[risus_sardonicus]

Im a 3rd year at ACOM and failed level 2 PE. I’m set to retake it this June. If I pass in June, do I even have to report the failure for PE?

You don’t get to choose if you report it or not, NBOME will send all your available scores at once.


Sent from my iPhone using SDN

 

[Ho0v-man]

I've very much considered that. I am extremely hard on myself usually. But getting honors on all of my rotation evals and always making an A for SP encounter...this confuses me. I do the same thing every single time. I have a country accent....do you think having a country accent makes me come off as dumb?

Somebody just tell me what they did for patients with no complaints and just there for a physical. Did you make sure they were up to date on colonoscopies, paps, mammograms? Because I left off pap and mammogram for 2 patients I think.

Reading through the thread, it sounds like you did everything right. It’s a garbage test and I’m sorry this happened to you. For what it’s worth, I’ve heard of multiple people doa TART screen of the thoracic spine while simultaneously auscultating and passed.

For patients with no complaints I talked about that stuff in the quote, as well diet/exercise, prostate ca screening, low-dose ct chest for those who meet criteria, one time abdominal US in smokers >65 yo, etc. The Kauffman videos are gold, but I got a lot of mileage out of memorizing the USPTF guidelines in the Dorian anki deck. I even had one encounter that basically needed screened for everything but was on a fixed income. The game there became empathizing with the situation while still explaining why you thought that stuff was important. God I’m glad that’s over...

As far as data gathering, did you stack questions? I caught myself doing this a couple times and had to re-ask the questions I stacked.