Step II Failed PE 3 times. Please help.

[PCOM13]

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I somehow failed the COMLEX PE three times. Always in biomedical domain. Can't do anymore to prepare. Have studied more every time and score is actually going down. I already passed the CE and have no idea how I'm failing a test with a 95% pass rate. I've reviewed all the links on here. ANY constructive input and/or tips would be awesome. No idea what else I can do. What am I missing??? Thanks. 🙂

 

[shaymeg]

Hey PCOM13,
Sorry for what you are going through. What is your background? I mean, were you born outside the States/do you have a detectable accent? the reason I am saying this is that the two people i know that have failed the Comlex PE multiple times had detectable accent. The only difference from your situation was that they failed the humanistic domain. The COMLEX PE may have 95% pass rate ( 95% of test takers might not have an accent) but there might be other underlining factors that can make people fail the exam that a lot of people do not know about. The so called " just show up, dont be rude to the patient, and you will pass" is not necessarily true. So if you can get help from a mentor/faculty member/resident/colleague, let them 'help you analyze what you are doing wrong. Keeping trying, don't despair and good luck to you.

 

[PCOM13]

Thank you for your response. I don't have any accent except maybe a southern one. Lived in the US my whole life. Nothing I can do except take it again and hope I get a lot of the same cases I suppose. Thanks for your encouragement 🙂

 

[ASAPRocky]

like can u elaborate more? I believe in flukes, but 3 x = not a fluke. Do u struggle with differential? Do u not do a good exam? Like its biomedical so something must be up with ur exam/diagnosis

 

[PCOM13]

I always fail the biomedical domain. The best score I ever got was ...
Data Gathering: Needs Improvement
OMM: Needs Improvement
SOAP Note: Proficient

I feel I can bring up the OMM grade by watching the clock better and making sure it's not contraindicated. The main problem is data gathering. Before I walk in the room, I jot down 5 dx from the CC on the chart. Then I go in and ask questions to rule those dx in or out. I ask enough questions to get to the correct diagnosis. Maybe they are docking me on not asking every single letter of OLD CARTS. I think my physical exam is fine.

There are always 2-3 cases that I'm not sure of the exact diagnosis. Instead of stretching it to an accurate dx, maybe I should just generalize to a more basic dx. Or maybe I'm just thinking too hard. I think a more general differential that's SOLID would fare better than vague guesses.

 

[thepoopologist]

Maybe they are docking me on not asking every single letter of OLD CARTS.

That's most likely what it is.

 

[PCOM13]

I should have known it was something that simple.

 

[thepoopologist]

I should have known it was something that simple.

Yes, be more complete if that's the case. I went straight down the line with every patient OLDCARTS +PMHX, PSHX, Medications, Allergies, Tobacco, Alcohol, Drugs with everyone. You must've left the room quite early doing it your way. Do you have the COMLEX PE book? Download it.

 

[ASAPRocky]

I always fail the biomedical domain. The best score I ever got was ...
Data Gathering: Needs Improvement
OMM: Needs Improvement
SOAP Note: Proficient

I feel I can bring up the OMM grade by watching the clock better and making sure it's not contraindicated. The main problem is data gathering. Before I walk in the room, I jot down 5 dx from the CC on the chart. Then I go in and ask questions to rule those dx in or out. I ask enough questions to get to the correct diagnosis. Maybe they are docking me on not asking every single letter of OLD CARTS. I think my physical exam is fine.

There are always 2-3 cases that I'm not sure of the exact diagnosis. Instead of stretching it to an accurate dx, maybe I should just generalize to a more basic dx. Or maybe I'm just thinking too hard. I think a more general differential that's SOLID would fare better than vague guesses.

OLDCARTS is key. Be complete on everyone. Idk how you take a hx without doing OLDCARTS, even IRL I ask a modified version of it. Do the PMHx, PShx, Mesds, All, everything poop said. Its mandatory. If you don't know diagnosis, who cares. Get the differential and work up. If someone comes in with chest pain, and looks like a PE, smells like a PE, You still get a EKG and a CXR for the most part. Differential is huge man.

OMM....well I can't help you with that unless I really break some rules. BUt since you took it 3 times, you should be fine with it.

 

[PCOM13]

Thank you everyone for all the help. The COMLEX book is very helpful. I will hit every letter in OLDCARTS even if I know the dx. I am confident I can pass this thing now. I don't know where my head was at. Anyone else who reads this in the future and needs encouragement, just PM me. I should be a PE master by now.