Failed COMLEX PE Twice and Really Re-considering Medicine as a Career

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NYKFanatic7

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Hello all,

I'm wondering if anyone has any advice for preparing for this exam, as I have now failed TWICE and my school has a policy that we are dismissed with 3 failures of any COMLEX exam. I feel I have exhausted myself preparing for this exam, going above and beyond figuring out what they want for the Humanistic domain, which I passed on my second attempt. I am still baffled that I failed the Biomedical portion of the exam as I thought this was the most straightforward part. I felt I asked every question possible, maybe only missed a few things on my physical exams the whole day, and wrote thorough complete notes with many differentials/problems on problem list and detailed plans, yet I received a low performance on "data gathering" and "SOAP note" sections. I really have not had any problems in school until this point.

Also, this is not exactly related, but I'm wondering what you think someone could do at this stage if they wanted to leave medicine. I am a current OMS-IV, I studied Molecular Biology and did lab research, but was not very good at it and definitely did not enjoy it before coming to medical school. Just open to hearing serious suggestions on this matter. I feel I am stuck, being out of the work force for nearly 4 years and 6-figures in debt. I am not particularly tech-savvy or don't have any other special skills, apart from being able to work hard, memorize a lot of information, and knowing a lot about science and medicine. I am fortunate enough to have the support of my family as I can live with my parents, but I feel my life and career prospects are now severely limited, all because I decided to take a risk to go to medical school. People always said "not to worry about the money" when I was trying to decide if I really wanted this career, and now I feel stuck and hopeless, not to be overly dramatic.

Maybe this is more of a PM type of conversation, I'd be open to taking all serious advice. Thank you!
 
You need to practice with someone who is able to give you feedback and that you trust and is an intelligent and competent person. I believe that you may not be doing the best job of evaluating yourself, otherwise I don't see how you could have failed it twice. You shouldn't just be writing down differentials just to have a long list; they need to be differentials that make sense in the context of the patient presentation. Without feedback, you're not going to improve. Go through Kauffman with a classmate and have them help you figure out what your deficiencies are.
 
JoTheGirl said:
You need to practice with someone who is able to give you feedback and that you trust and is an intelligent and competent person. I believe that you may not be doing the best job of evaluating yourself, otherwise I don't see how you could have failed it twice. You shouldn't just be writing down differentials just to have a long list; they need to be differentials that make sense in the context of the patient presentation. Without feedback, you're not going to improve. Go through Kauffman with a classmate and have them help you figure out what your deficiencies are.
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I genuinely appreciate this feedback. I also may have poorly worded my original post, though it may not change much of your answer:
I didn't just list out a bunch of differentials, what I meant to say, is I thought I had written many appropriate differentials for each case. Not only that, I thought I got the diagnosis correct in each case. I'm not sure how I could have asked the wrong questions or done the wrong physical exam maneuvers (which is what the Data Gathering section measures) if my diagnoses made sense given the facts of the case.

As for practicing and getting competent feedback, after my first exam failure, I practiced at my school several times in front of faculty who watched both in real time and recorded videos, as well as our standardized patients, who also offered their feedback on each case. I will be going back to my school faculty to come up with a plan, as well as looking at a prep course. Thanks for the replies!
 
I’m so sorry. That’s a crappy thing to have to go through.
A formal prep course is probably a good idea.
If you failed data gathering I’ve got to ask are you using a mnemonic and sticking to it?
On the SOAP note are you focusing on getting a large differential and letting other things suffer?
You can do this. That test is dumb and doesn’t define a good doctor. Good luck.
 
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You should take Pacific Northwest University prep course. I found it to be very helpful. If your school is from Cali, you cannot get license if fail a board exam 3 times. Need to go all in on this. PM me if any question
 
feeling-dizzy said:
You should take Pacific Northwest University prep course. I found it to be very helpful. If your school is from Cali, you cannot get license if fail a board exam 3 times. Need to go all in on this. PM me if any question
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Are you sure about this? I thought that only applied to level 3
 
OP, the NBOME gives you 6 chances for each licensing exam. Just keep taking it until you pass. It's frustrating to fail, but it's ludicrous to give up and have hundreds of thousands of debt over the PE. It's not even like having to study for the other licensing exams
 
AlbinoHawk DO said:
OP, the NBOME gives you 6 chances for each licensing exam. Just keep taking it until you pass. It's frustrating to fail, but it's ludicrous to give up and have hundreds of thousands of debt over the PE. It's not even like having to study for the other licensing exams
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My school's policy is three fails, for any COMLEX exam. No one has ever failed PE 3 times at my school. Really don't want to be the first. I am otherwise a pretty strong candidate, i.e. above average rank in class, above average COMLEX Level 1 and 2 scores each on one attempt. So I am not sure to what degree they will actually come down hard on me and enforce this policy and what prospects I have to appeal. If anyone has experience or knowledge with that sort of process, I'd be curious if they could weigh in. Again, hoping it doesn't happen, but if it comes down to it would be good to know. Thanks!
 
NYKFanatic7 said:
My school's policy is three fails, for any COMLEX exam. No one has ever failed PE 3 times at my school. Really don't want to be the first. I am otherwise a pretty strong candidate, i.e. above average rank in class, above average COMLEX Level 1 and 2 scores each on one attempt. So I am not sure to what degree they will actually come down hard on me and enforce this policy and what prospects I have to appeal. If anyone has experience or knowledge with that sort of process, I'd be curious if they could weigh in. Again, hoping it doesn't happen, but if it comes down to it would be good to know. Thanks!
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I don't know about your school in specific, but at Western they had the same 3 fails policy and we have 2 people on their 4th try for the CE. I would hope no school dismisses a student over PE. I know you're nervous, but I got a sense that you'll pass this next time. You passed biomedical once. You passed Humanism once. This makes me believe that you can pass both on a 3rd try
 
Passed my exam on the 3rd attempt. Just found out today! I'm going to graduate next month. I'm super relieved. I found the WV SOM prep course I took to be very helpful. Feel free to ask me anything if you're struggling with this exam, or curious about the course. Thanks again to anyone who reached out and responded to my post.
 
NYKFanatic7 said:
Passed my exam on the 3rd attempt. Just found out today! I'm going to graduate next month. I'm super relieved. I found the WV SOM prep course I took to be very helpful. Feel free to ask me anything if you're struggling with this exam, or curious about the course. Thanks again to anyone who reached out and responded to my post.
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That WVSOM PE Review class is golden. I have no idea why all DO schools cannot adequately prepare their students for the PE exam, so I always recommend this review class to any students which ask me for advice. Congratulations on your upcoming graduation!
 
NYKFanatic7 said:
Passed my exam on the 3rd attempt. Just found out today! I'm going to graduate next month. I'm super relieved. I found the WV SOM prep course I took to be very helpful. Feel free to ask me anything if you're struggling with this exam, or curious about the course. Thanks again to anyone who reached out and responded to my post.
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Asking for those who might find it helpful in the future (and a bit curious myself), what do you think went wrong with the preparation in the prior attempts? What did you do differently? Anything?

Honestly, there's certainly a bit of randomness to this exam, but at the same time, I got the impression that they placed a lot of emphasis on the way something is done or said. It felt like there are very specific checkboxes they have. So even though things might be technically correct/appropriate, they don't always check the box they're looking for. Not sure if you felt the same way.

Congratulations, you can finally put this test behind you. Now focus on GME. 1 year could get you licensed in 30+ states, and 3 yrs will be all 50.
 
"Honestly, there's certainly a bit of randomness to this exam, but at the same time, I got the impression that they placed a lot of emphasis on the way something is done or said. It felt like there are very specific checkboxes they have. So even though things might be technically correct/appropriate, they don't always check the box they're looking for. Not sure if you felt the same way. "

I felt this to be very true. Definitely helps to include a broader differential in the Assessment, and in the Plan section provide more things you may do.

Examples:
Always, always, always- diet and exercise if they are overweight, if they tell you they eat a poor diet
smoking/alcohol cessation
Rest, ice, compression, elevation, NSAIDs, OMT if musculoskeletal injury
Return plan, work note, ask how this will impact their home life, if they need you to discuss with a family member or make any other special arrangements, etc
I was taught to write more tests you would order as opposed to less, as you don't lose points for wrong stuff, you just aren't awarded any. Same with differentials.

Kaufmann's mnemonics CODIERS SMASH FM will get you the appropriate history details.
For the Objective portion, write something like "vitals within normal limits", or "febrile, vitals otherwise normal" in addition to writing vitals. Do include a "General" or "constitutional" section

That is my advice for SOAP note.

For OMT, the only thing I would add is to briefly screen 1-2 other body regions aside from the area of complaint for TART changes (ROM, tenderness) Even more if you are an OMT wiz and the case is pretty straightforward otherwise. But make sure you have plenty of time to complete the treatment and explain the plan, that is more important than screening additional body regions.

Humanistic: start with open ended questions, involve the patient in the plan, ask if they have questions, provide clear transitions between sections of the History and Examination. See how complaint is impacting their life, what concerns them most.
 
AlbinoHawk DO said:
OP, the NBOME gives you 6 chances for each licensing exam. Just keep taking it until you pass. It's frustrating to fail, but it's ludicrous to give up and have hundreds of thousands of debt over the PE. It's not even like having to study for the other licensing exams
Click to expand...
You're not wrong, just PSA since this post the NBOME has reduced the attempts to 4 per exam.
 
NYKFanatic7 said:
Passed my exam on the 3rd attempt. Just found out today! I'm going to graduate next month. I'm super relieved. I found the WV SOM prep course I took to be very helpful. Feel free to ask me anything if you're struggling with this exam, or curious about the course. Thanks again to anyone who reached out and responded to my post.
Click to expand...

Congratulations! Have a drink of something very expensive!
 
Just to update on this thread, I was able to match into Psychiatry this 2020 Match cycle after completing a TRI and passing COMLEX Level 3 on my first attempt. Hopefully that provides motivation to anyone who has struggled with similar things over the course of their career.
 
NYKFanatic7 said:
Just to update on this thread, I was able to match into Psychiatry this 2020 Match cycle after completing a TRI and passing COMLEX Level 3 on my first attempt. Hopefully that provides motivation to anyone who has struggled with similar things over the course of their career.
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congrats!!!!
 
Some info I shared with someone personally abut doing a TRI: The purpose of most TRI programs is to gain exposure to everything, so most TRI program directors are supportive and their programs are set up to facilitate you matching (i.e. days off for interviews and board exams). Obviously, doing a TRI was not my first choice, but I passed COMLEX PE in April and had to scramble for whatever spots were available.

I don't recommend doing a TRI unless your specialty requires it, or it's more of like a backup if you don't match into your chosen specialty. Having said that, I would recommend applying to a backup specialty like IM or FM, even though you would need other LORs. As for new letters for the TRI, I got one from the program director whose rotation I performed well on.

As for showing interest in psychiatry, I was lucky enough to be at a program that allowed me to do child and adult psychiatry during my elective months. However, my TRI program did not have a psychiatry residency, which did suck because if we did have psych I could try to match there instead of having to go elsewhere.

Overall, I believe it was a good experience that got me better and broader exposure to medicine and I feel more confident as an incoming psychiatry intern. Let me know if that helps. The experience can vary based on the site, but I was at a place with a great culture, wellness for the residents, etc.
 
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