Failed step 2 CS, help!!

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vbgal41

vbgal41

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Looking for some advice here. Failed the CIS portion of Step 2 CS. I've talked things over with the deans of my school, advisor, etc. and I'm confident I can pass the second time.

Scheduled my test for late December so I will take the test in time to have a pass for the rank list submission. BUT:

1) Will programs actually ask for it? Some say on their websites that they need it for ranking. My step 2 CK is solid (250) and is already in.

2) if I decide to release it, looks like it will be all or nothing, can't just decide to release it to some schools but not others. So should I just stay silent? Or will this impact how programs rank me if they see a fail?

Would appreciate any advice of people who have had this same scenario. I've calmed down a bit but I'm still pretty stressed out and now a little worried about matching! I'm trying to match into an average specialty, nothing too competitive (not psych or fam med- I know they care about CS more).
 
I wouldn't release it. Obviously, if anyone asks don't lie about the situation, but it's not required for you to do so at this time and many people take it in December for the first time. I think most programs who require it for matching, this would be a check by a secretary prior to their rank list submission, so release it after you have a pass.
 
vbgal41 said:
Looking for some advice here. Failed the CIS portion of Step 2 CS. I've talked things over with the deans of my school, advisor, etc. and I'm confident I can pass the second time.

Scheduled my test for late December so I will take the test in time to have a pass for the rank list submission. BUT:

1) Will programs actually ask for it? Some say on their websites that they need it for ranking. My step 2 CK is solid (250) and is already in.

2) if I decide to release it, looks like it will be all or nothing, can't just decide to release it to some schools but not others. So should I just stay silent? Or will this impact how programs rank me if they see a fail?

Would appreciate any advice of people who have had this same scenario. I've calmed down a bit but I'm still pretty stressed out and now a little worried about matching! I'm trying to match into an average specialty, nothing too competitive (not psych or fam med- I know they care about CS more).
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What specialties don't care about a failure on CS? I would imagine all of them do. You should not have failed CS (it is their fault, not yours). You should have received feedback about how to improve and then worked with your school to remedy any deficiencies.
 
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Wow. Reality is I failed it, I won't again, but was looking for any advice on how to approach it. Saying "you shouldn't have failed" does little but chastise. I've spent years doing OSCEs and passed with nothing but positive feedback on my schools practice exam. I feel I may not done enough counseling, summarizing, or explaining, but that's neither here nor there on this particular thread.
 
Donald Juan said:
I wouldn't release it. Obviously, if anyone asks don't lie about the situation, but it's not required for you to do so at this time and many people take it in December for the first time. I think most programs who require it for matching, this would be a check by a secretary prior to their rank list submission, so release it after you have a pass.
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So I am taking it in December in time to release for ranking, my question is should I not release it at all so they don't see the fail? I believe that would have an impact even if they see the pass.
 
You are not obligated to release your scores, but as you mentioned, some programs do require it for ranking (particularly those on the West coast). Unfortunately, it is an 'all or nothing' process and whether you choose to release it should depend on how many schools on your rank list will require it, and how badly you want to have a shot at those programs.

Personally, I would not release this before rank lists are due even if it is accompanied with a subsequent "pass". Program directors on here have mentioned that those who failed CS were more likely to struggle in residency and it's something they watch out for.
 
vbgal41 said:
So I am taking it in December in time to release for ranking, my question is should I not release it at all so they don't see the fail? I believe that would have an impact even if they see the pass.
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So your choices are to either release the F now, or wait and release the P before rank lists are due. What possible upside does releasing an F now have? I can't think of any.

The whole point of taking CS late enough to receive the first result after Sep 15th is so that you can keep taking the damn thing until you pass and then release the results. That way a program never sees a worrisome F unless it is also accompanied by a reassuring P.
 
I wouldn't release it. I think it would hurt you more. Also, if I could give you advise for CIS, make sure you ask the patient how they feel about the plan, and how their symptoms affect their life... I almost failed my school OSCE bc I didn't do this, luckily it was before my CS. Good luck!
 
sliceofbread136 said:
They increased the fail rate when they became afraid of losing their cash cow test. Corruption at its fin
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RooibosTea said:
Aint it scary? Guess they are trying to make it harder. They cant justify this exam if 100% of med students are passing.
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They can risk it going too far the other way too. I would rather just pay them the fee with no risk of failure. If they think you should remediate, then they can charge you another $1,500 to take their "remediation course" to make sure you are up to "standards". They could make so much more money and no one's life would be ruined. I've always wondered how a CS failure affects someone who dominated Step 1/2 - 240s-250s and has gotten Honors on most clinical grades. Also if that student has gotten comments from clerkship directors "Excellent clinical skills and amazing interpersonal skills", then there must be something that the test is not capturing. We need a new process if good students are falling through the cracks.
 
vbgal41 said:
Wow. Reality is I failed it, I won't again, but was looking for any advice on how to approach it. Saying "you shouldn't have failed" does little but chastise. I've spent years doing OSCEs and passed with nothing but positive feedback on my schools practice exam. I feel I may not done enough counseling, summarizing, or explaining, but that's neither here nor there on this particular thread.
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I was saying you shouldn't have failed because the process is unfair, not because you did not do well. I don't feel like you should risk not matching because they felt like you did not summarize enough.
 
postbacpremed87 said:
I was saying you shouldn't have failed because the process is unfair, not because you did not do well. I don't feel like you should risk not matching because they felt like you did not summarize enough.
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Wow your post came across as being a total a-hole, but now that I reread it with your explanation above I see what you meant. Thanks for the clarification. I actually agree with you now.
 
sliceofbread136 said:
They increased the fail rate when they became afraid of losing their cash cow test. Corruption at its finest
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Got my score today and passed. But - They listed me as "borderline" in the CIS section. I dont know what that means, but seems like total horse ****. I suppose I didnt hand someone a tissue when they said their cat died. The exam is a complete and total scam.

Sent from my SM-N910P using SDN mobile
 
cbrons said:
Got my score today and passed. But - They listed me as "borderline" in the CIS section. I dont know what that means, but seems like total horse ****. I suppose I didnt hand someone a tissue when they said their cat died. The exam is a complete and total scam.

Sent from my SM-N910P using SDN mobile
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Keep whining. They'll arbitrarily increase the failure rate from 5% to 9% as retribution.
 
I have seen people fail, retake within one week and pass with high marks without doing anything particularly different. The test is a money-making program for the NBME. OP should re-take, then release passing grades thereafter. The OP's match should be unaffected with a passing report.

Some tips for CIS: look the patient in the eye as much as possible (tell the patient you will take some notes and will look down at your paper on occasion), smile appropriately, be gentle (a warm touch on the shoulder or the back of the hand can earn you points, if indicated, for a depressed or teary patient), make small talk (I know, can be hard to do if nervous, but fake it), ask how the condition or problem is affecting the patient's quality of life.

And other routine/standard stuff which you already know--when you come in greet the patient with a smile and warm handshake, act appropriately concerned (yes, act, it's a show), counsel if smoking or using drugs or drinking excessively, wash your hands or use the hand sanitizer, ask for permission before the physical exam, pull out the leg rest and ensure patient comfort, close, discuss next steps in general terms, ask if the patient has questions or other concerns. If you wait to counsel a smoker, drug user or alcohol abuser, you might forget, so just do it (if indicated) when getting the social history.

People generally do these things in real life encounters, but in such an artificial setting and with the possible anxiety, one may mess up. Most re-takers pass it, so give these crooks the additional $1500 and pass the exam. Hopefully the "test" will be abolished soon.
 
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It's so unrealistic that we're supposed to do alcohol/tobacco counseling during a 15 minute acute visit with a patient we've never met before. Who would do that in the real world?
 
Levo said:
It's so unrealistic that we're supposed to do alcohol/tobacco counseling during a 15 minute acute visit with a patient we've never met before. Who would do that in the real world?
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In the real world:

"You should stop smoking, it's really making your COPD, asthma, whatever worse and increases your risk for lung cancer. Here is a brochure from the State Quitline which provides free resources for people to help quit smoking."

There's your counseling for you.
 
Cyal said:
I have seen people fail, retake within one week and pass with high marks without doing anything particularly different. The test is a money-making program for the NBME. OP should re-take, then release passing grades thereafter. The OP's match should be unaffected with a passing report.

Some tips for CIS: look the patient in the eye as much as possible (tell the patient you will take some notes and will look down at your paper on occasion), smile appropriately, be gentle (a warm touch on the shoulder or the back of the hand can earn you points, if indicated, for a depressed or teary patient), make small talk (I know, can be hard to do if nervous, but fake it), ask how the condition or problem is affecting the patient's quality of life.

And other routine/standard stuff which you already know--when you come in greet the patient with a smile and warm handshake, act appropriately concerned (yes, act, it's a show), counsel if smoking or using drugs or drinking excessively, wash your hands or use the hand sanitizer, ask for permission before the physical exam, pull out the leg rest and ensure patient comfort, close, discuss next steps in general terms, ask if the patient has questions or other concerns. If you wait to counsel a smoker, drug user or alcohol abuser, you might forget, so just do it (if indicated) when getting the social history.

People generally do these things in real life encounters, but in such an artificial setting and with the possible anxiety, one may mess up. Most re-takers pass it, so give these crooks the additional $1500 and pass the exam. Hopefully the "test" will be abolished soon.
Click to expand...

Thanks for the tips! Any particular reason why you think that a fail accompanied by a pass wouldn't make a difference?
 
postbacpremed87 said:
I was saying you shouldn't have failed because the process is unfair, not because you did not do well. I don't feel like you should risk not matching because they felt like you did not summarize enough.
Click to expand...

Thanks for clarifying, it's much appreciated 🙂
 
Levo said:
It's so unrealistic that we're supposed to do alcohol/tobacco counseling during a 15 minute acute visit with a patient we've never met before. Who would do that in the real world?
Click to expand...

Step 2 CS is the opposite of the real world, but regardless. It's certainly possible to do cessation counseling in the period allotted. "Do you smoke?" Yes "Are you interested in assistance in quitting?" Yes - Here's some resources. No - I recommend you do and we will be available for you with assistance when you are ready to quit. Boom, done. The test is a checklist. Get the points for that aspect of the exam, pass the f-er, and move on with your life.
 
vbgal41 said:
Thanks for the tips! Any particular reason why you think that a fail accompanied by a pass wouldn't make a difference?
Click to expand...

Because people who passed on re-take matched without problems, at least from what I have seen. The cost to you will be time, money, and the nuisance of the entire process.

A general consciousness that the test is worthless is also starting to grow in the medical community.
 
Levo said:
It's so unrealistic that we're supposed to do alcohol/tobacco counseling during a 15 minute acute visit with a patient we've never met before. Who would do that in the real world?
Click to expand...
You don't have to counsel during that appointment. If they want to quit, just say we'll make an appointment to fully address it, pick a quit date, and make a plan.
 
Cyal said:
Because people who passed on re-take matched without problems, at least from what I have seen. The cost to you will be time, money, and the nuisance of the entire process.

A general consciousness that the test is worthless is also starting to grow in the medical community.
Click to expand...

Thanks, anyone have experience with people passing on retake, releasing and having trouble matching?
 
As someone anxiously awaiting his own results for this BS exam, I wanted to wish you the best of luck, OP. This process is awful!
 
So, lot of discussion here about the test in general.

OP - no benefit of releasing the failure. Re-take CS and you'll likely pass it this time. Most programs only care about CS to be available at time of rank lists. I think if you pass at some point it's not going to significantly knock you down a rank list. I don't think PDs are scrutinizing Step 2 CKs or Step 2 CS's of anyone that they're ranking - if you didn't take CK either and did poorly on it, it wouldn't drop you in the rank list.

However, a failure (on CK or CS) may be worse, but there is absolutely no benefit to you of releasing your CS scores now, before you have a passing grade in hand.
 
Does anyone have any insight on the repercussions if the retake score is not available by ROL submission?

I found out I failed 2 weeks ago (took it in September) and was not able to retake it by December because of fewer dates available due to the holidays. I'm now retaking the exam in January, and the score will not be released until March, which should be in time for match but not by ROL.
 
sunyourbuns said:
Does anyone have any insight on the repercussions if the retake score is not available by ROL submission?

I found out I failed 2 weeks ago (took it in September) and was not able to retake it by December because of fewer dates available due to the holidays. I'm now retaking the exam in January, and the score will not be released until March, which should be in time for match but not by ROL.
Click to expand...

I had a friend last year who had a failed CS attempt (which was released because he had to release his CK score which he got after) and pending retake when ROL were due. He still matched into Family Med but fell down his rank list about halfway.
 
PCIRISH52 said:
I had a friend last year who had a failed CS attempt (which was released because he had to release his CK score which he got after) and pending retake when ROL were due. He still matched into Family Med but fell down his rank list about halfway.
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Do you happen to know how many programs he ranked? I know someone who did not match into FM last year because he failed CS and I believe he ranked ~14 programs.
 
W19 said:
Do you happen to know how many programs he ranked? I know someone who did not match into FM last year because he failed CS and I believe he ranked ~14 programs.
Click to expand...

It was something like 10-12 programs.
 
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Wow that's super rough and really sad to hear. At the very least I already submitted CK so programs don't know about my CS score.

I just feel really backed into a corner now because I took the exam 3 months ago but only just found out about failing and am left with no option but to retake the exam when it's too late for a passing score to get back before ROL are due. I've actually had some good interviews so far and am sad to hear that this could ruin everything.
 
sunyourbuns said:
Wow that's super rough and really sad to hear. At the very least I already submitted CK so programs don't know about my CS score.

I just feel really backed into a corner now because I took the exam 3 months ago but only just found out about failing and am left with no option but to retake the exam when it's too late for a passing score to get back before ROL are due. I've actually had some good interviews so far and am sad to hear that this could ruin everything.
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There's a few people here and on reddit who failed after the deadline to retake for ROL time and still matched without issue. My own school had someone fail last year and still match to a top ortho program. Your career isn't over. If a program explicitly requires it, then it will probably come up. Otherwise, many programs are less concerned about it. Until recently, pretty much everyone passed anyway. CK seems to be more of an issue.

Regarding the stories of people who fell down their rank list, you don't know why that happened. Maybe they did release their scores so programs saw the failure. Maybe they applied to programs that have had past difficulties with residents starting on time so they're extra careful about making sure everyone has scores in before ranking. Maybe they would have fallen far on their rank lists regardless due to their interviews/applications. You'll be fine.
 
If we students can't eliminate Step 2 CS, we should petition to get it moved to a requirement to enter medical school.

This whole model of "we are going to secretly and arbitrarily eliminate 8-10 students from a class of 200 for no particular reason" is the sort of behavior we expect from med school admissions, not when a med student already has $250,000 in the game.
 
prok said:
There's a few people here and on reddit who failed after the deadline to retake for ROL time and still matched without issue. My own school had someone fail last year and still match to a top ortho program. Your career isn't over. If a program explicitly requires it, then it will probably come up. Otherwise, many programs are less concerned about it. Until recently, pretty much everyone passed anyway. CK seems to be more of an issue.

Regarding the stories of people who fell down their rank list, you don't know why that happened. Maybe they did release their scores so programs saw the failure. Maybe they applied to programs that have had past difficulties with residents starting on time so they're extra careful about making sure everyone has scores in before ranking. Maybe they would have fallen far on their rank lists regardless due to their interviews/applications. You'll be fine.
Click to expand...

Thanks for the reassurance. I indeed have heard of some success stories despite a failed CS attempt but didn't know if those circumstances were different from mine (i.e. regarding having a passing score by ROL submission). I guess we'll see...

sazerac said:
If we students can't eliminate Step 2 CS, we should petition to get it moved to a requirement to enter medical school.

This whole model of "we are going to secretly and arbitrarily eliminate 8-10 students from a class of 200 for no particular reason" is the sort of behavior we expect from med school admissions, not when a med student already has $250,000 in the game.
Click to expand...

I agree with this sentiment--med school hasn't been completely painless but I don't have any major issues with grades, clerkship performance, step 1 or 2 CK scores, or even the OSCE. At the very least it should be moved to be taken at an earlier point so that it wouldn't interfere with applications and the match. I guess this varies depending on how each school does things, though.

It disappoints me to no end that I failed the dumbest portion of the boards at the 11th hour and that this could now even remotely affect my match after I've spent thousands already on interviews on top of 4 years of tuition. What's even worse is that I failed the CIS portion, which is arguably the most subjective portion as it's graded by SPs on our behavior and interactions (read: acting skills), the grades aren't validated by video recording, and no further feedback is provided aside from some crummy asterisks. The SPs are supposed to be treated as "real" but they also aren't supposed to be forthcoming with providing information or their emotions, which makes it that much harder to have a "genuine" interaction with them. Terrible exam. I just hope I can pass it next time, move on, and cross my fingers that none of my top ranked programs will care about a missing CS score when it comes time to rank. :drowning:
 
Agree completely however in real life some patients are not forthcoming with data unless you question them specifically. In any case, CS is the most ridiculous and also the most expensive "exam" I have ever taken.

sunyourbuns said:
The SPs are supposed to be treated as "real" but they also aren't supposed to be forthcoming with providing information or their emotions, which makes it that much harder to have a "genuine" interaction with them. Terrible exam.
Click to expand...
 
sunyourbuns said:
Thanks for the reassurance. I indeed have heard of some success stories despite a failed CS attempt but didn't know if those circumstances were different from mine (i.e. regarding having a passing score by ROL submission). I guess we'll see...



I agree with this sentiment--med school hasn't been completely painless but I don't have any major issues with grades, clerkship performance, step 1 or 2 CK scores, or even the OSCE. At the very least it should be moved to be taken at an earlier point so that it wouldn't interfere with applications and the match. I guess this varies depending on how each school does things, though.

It disappoints me to no end that I failed the dumbest portion of the boards at the 11th hour and that this could now even remotely affect my match after I've spent thousands already on interviews on top of 4 years of tuition. What's even worse is that I failed the CIS portion, which is arguably the most subjective portion as it's graded by SPs on our behavior and interactions (read: acting skills), the grades aren't validated by video recording, and no further feedback is provided aside from some crummy asterisks. The SPs are supposed to be treated as "real" but they also aren't supposed to be forthcoming with providing information or their emotions, which makes it that much harder to have a "genuine" interaction with them. Terrible exam. I just hope I can pass it next time, move on, and cross my fingers that none of my top ranked programs will care about a missing CS score when it comes time to rank. :drowning:
Click to expand...

How did things work out for you OP?
 
postbacpremed87 said:
They can risk it going too far the other way too. I would rather just pay them the fee with no risk of failure. If they think you should remediate, then they can charge you another $1,500 to take their "remediation course" to make sure you are up to "standards". They could make so much more money and no one's life would be ruined. I've always wondered how a CS failure affects someone who dominated Step 1/2 - 240s-250s and has gotten Honors on most clinical grades. Also if that student has gotten comments from clerkship directors "Excellent clinical skills and amazing interpersonal skills", then there must be something that the test is not capturing. We need a new process if good students are falling through the cracks.
Click to expand...

It's measuring exactly what it is supposed to - your acting abilities while auditioning for the role of a doctor on TV.
 
sazerac said:
If we students can't eliminate Step 2 CS, we should petition to get it moved to a requirement to enter medical school.

This whole model of "we are going to secretly and arbitrarily eliminate 8-10 students from a class of 200 for no particular reason" is the sort of behavior we expect from med school admissions, not when a med student already has $250,000 in the game.
Click to expand...

I am of the opinion that Step 2 CS is a waste of money for US Allopathic students and should not be required (as there are in-house clinical exams required by the LCME). My in-house exam was far more difficult than Step 2 CS, with a higher failure rate (could retake 2 weeks later).


Remember when AMA and AMSA and medical students were vocal about CS? I believe it backfired. Previously, approximately 2-4% of US allopathic students failed first time. Because concerns were raised by the organizations, the USMLE changed the format slightly as well as how they score "to better reflect" clinical experience. Since the re-do, the failure rate is higher now, thinking 5-8% of allopathic students fail first time.
 
terrence_110 said:
I am of the opinion that Step 2 CS is a waste of money for US Allopathic students and should not be required (as there are in-house clinical exams required by the LCME). My in-house exam was far more difficult than Step 2 CS, with a higher failure rate (could retake 2 weeks later).


Remember when AMA and AMSA and medical students were vocal about CS? I believe it backfired. Previously, approximately 2-4% of US allopathic students failed first time. Because concerns were raised by the organizations, the USMLE changed the format slightly as well as how they score "to better reflect" clinical experience. Since the re-do, the failure rate is higher now, thinking 5-8% of allopathic students fail first time.
Click to expand...

yep, the test wasn't catching enough "deficiencies" the first time around to justify its existence as a "quality control." We never lower the bar or remove it in medicine. We only raise it. The bar was too low before. Raise it and identify more physicians who could "improve." Because total commitment to improvement. Which this harder test to fail people in a money making scheme does.
 
The test is basically a list of checklists. Follow the format to the letter. Fill out every single section available even if there was absolutely nothing to really fill out. Have an idea of everything you want to ask or say before you even walk into each patient's room. I personally failed this test the first time too. Once I got notified of my failure, I immediately looked for the next opening date. Fortunately, a date opened up for a time at 3 days from when I was notified of my failure. I signed up for it, bought a plane ticket as soon as possible, flew out to the same testing site that I used the first time, took the test again. I quickly reviewed the First Aid for Step 2 CS book a day before I did the retake. This time I wrote as much as I could on every document. Found out I passed it 1 month later. Either I phenomenally improved within a 48 hour period from spending a couple hours reviewing a book or the test itself has very poor reliability. An extra $1500 down the drain, not including transportation and hotel costs. Talk about flying out of state and back just for a weekend.
 
Almost everyone thinks that test is useless and yet can't do anything about it even if poor med students are sinking over 1.5k for it. You gotta love AAMC, AMA, LCME etc...
 
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W19 said:
Almost everyone thinks that test is useless and yet can't do any about it even if poor med students are sinking over 1.5k for it. You gotta love AAMC, AMA, LCME etc...
Click to expand...
yeah..no kidding
 
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