you are right in saying as a doctor I will face people from all walks of life educated uneducated but they will not assess my clinical skills and my knowledge they do not come with that attitude and above all they are actors fake people.
You are right in terms of percentages only 1% fail twice or are upset like I am what do u think I should do sit, don't say anything????????
and it just my opinion.
and because I failed ICE I shouldn't practice in this country is not fair to say
that is the point I am trying to make. There are people like me even a small percentage that suffers.
It is false that your patient won't assess your clinical skills (i.e. attitude) and clinical knowledge. I have met some very savy patients who have read up everything about their condition on the internet AND some will want to know very specifics things about their illness, it will be painfully clear if you try to tell them what you know and you don't really know what you are talking about.
In terms of clinical skills, if you look down on people for lack of education or a job at McDonalds (which is a real job, but not a "proper" job) then patients pick up on this even without an education THUS making you a less effective physician. If this is what your standardized patients picked up during your encounter then I am glad then they had a good reason and were doing their job. The exam is standardized as much as possible as it is recorded and reviewed for failure cases to make sure.
Then again, you must have done something wrong as you failed the examination twice in TWO different areas. You may have gotten the wrong differential diagnosis or not asked the right questions. All of my examinations were very straight forward and the diagnosis was simple. I did not use any PAMHUGGSFOSSY or whatever pheumonic as you have to ask the important questions. While a program director may look at one failure as a one time event, two failures on Step 2 CS looks bad.
Because you did fail Step 2 CS twice then many states say that you can never get a license there as an FMG. That is why Step 2 CS exists to try to weed out the really bad FMGs who can't relate to patients. Everybody knows that this is why this exam exists. I would say that the "actors" who are proctoring this examination do a good job as far as I can tell, i.e. they answer the HPI questions quickly. They ARE trained properly to do their job, i.e. basically just list what you did right and wrong and there are standards as everything is VIDEO TAPED.
If you really feel that you shouldn't have been graded so harshly they go protest it, but you know what? They have the video tape which shows you messing up, which you probably know you did.
Saying that the people doing the examination are not "properly" educated is just your excuse for not doing well twice and not taking responsibility for bad performances. It is a myth that the examination is all based on your reviewers. Let me guess, you had two different sites or group of patients and they failed you at both places? Doesn't sound like a subjective problem at all.
