IMG - 99 on both step exams, just found out I failed CS...

[asclepiusIMG]

Hey guys, I'm a long time follower, but just registered 'cause I really need your input on my case...

I'm an IMG that just finished med school. I graduated in the top 10% of my class (of 200) and scored 99/250 on step I and 99/259 on step II CK.

I just found out I failed my CS exam (CIS eval). And plan to reschedule/retake it ASAP.

I aspire to enter a university based peds program.
Being an IMG, I am definitely not too picky on entering a top tier program. However, I would like to enter a program that is good enough to allow me to enter the subspecialty of my choice (currently torn between cardiology and GI).

My question is the following: Assuming I try really hard on my next attempt and finally pass the f-ing exam. Do you think this will lower my chances on entering a decent residency program. And if so, what would your advice be regarding mentioning this on my personal statement, interviews, dean's letter, etc.

Thanks a lot for your help!

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[sendwich]

Hey guys, I'm a long time follower, but just registered 'cause I really need your input on my case...

I'm an IMG that just finished med school. I graduated in the top 10% of my class (of 200) and scored 99/250 on step I and 99/259 on step II CK.

I just found out I failed my CS exam (CIS eval). And plan to reschedule/retake it ASAP.

I aspire to enter a university based peds program.
Being an IMG, I am definitely not too picky on entering a top tier program. However, I would like to enter a program that is good enough to allow me to enter the subspecialty of my choice (currently torn between cardiology and GI).

My question is the following: Assuming I try really hard on my next attempt and finally pass the f-ing exam. Do you think this will lower my chances on entering a decent residency program. And if so, what would your advice be regarding mentioning this on my personal statement, interviews, dean's letter, etc.

Thanks a lot for your help!

do you have any idea why you didnt pass? as you were interviewing the SP's, were you fumbling?

 

[34140]

with your scores, i dont think it would be impossible to get a university peds program. you can always tell them you were ill or something for a reason why you failed. Just make sure you pass it asap.

 

[kemper6036]

i dont think your situation is impossible by any means, but failing a step exam might get your app tossed at some places. i'm sure your dual 99s will help you though

try to figure out what you need to improve on for the next time. good luck

 

[asclepiusIMG]

do you have any idea why you didnt pass? as you were interviewing the SP's, were you fumbling?

Don't get me wrong, I'm not socially impaired or anything. It was basically bad time management. I guess I needed a little bit more practice on that, since I ran out of time in 2-3 cases and didn't get to give a proper closure.

The only part I failed was "Information Sharing" in the CIS section of the exam. Other sections were in the High Pass zone.

I'll be sure to practice more cases for my next attempt.

 

[sendwich]

Don't get me wrong, I'm not socially impaired or anything. It was basically bad time management. I guess I needed a little bit more practice on that, since I ran out of time in 2-3 cases and didn't get to give a proper closure.

The only part I failed was "Information Sharing" in the CIS section of the exam. Other sections were in the High Pass zone.

I'll be sure to practice more cases for my next attempt.

this is what happened to me too (ran out of time and didnt get to close 2-3 cases), which worries me. what's "information sharing"??? is that the part where you tell the SP your DDx/tx plan?

 

[Proverbs31]

this is what happened to me too (ran out of time and didnt get to close 2-3 cases), which worries me. what's "information sharing"??? is that the part where you tell the SP your DDx/tx plan?

Answers to what all the scoring sections entail and mean are found on the website here: http://www.usmle.org/Examinations/step2/cs/content/scoring.html


Information Sharing, specifically, is
Information-sharing skills - examples include:

• acknowledging patient issues/concerns and clearly responding with information
• avoidance of medical terms/jargon unless immediately defined
• clearly providing
  • counseling when appropriate
  • closure, including statements about what happens next

 

[vicinihil]

You're lucky that CS is what you chose to fail. It's valued the least out of all standardized tests. Pass this time around and I think you're still golden. Good luck.

 

[asclepiusIMG]

Thanks a lot for your input...

Has anybody heard of anyone getting lucky with their Step 2 CS Re-checks?

Is it even worthwhile to ask for it?

 

[radiodoc99]

Humanism is imp component of scoring the exam

 

[Golding]

Thanks a lot for your input...

Has anybody heard of anyone getting lucky with their Step 2 CS Re-checks?

Is it even worthwhile to ask for it?

It doesn't hurt to try, but I've never heard of anyone passing a failed test from the rechecks, personally. They don't review your interactions and re-score, as far as I understand it. They just look to see that the scores were counted correctly. More often than not, they were.

I'm not sure what advice to give based on your situation. Your written scores are great, but failing a step (even the CS) is not a good thing. I've met people who did the same thing -- albeit with inferior Step I and 2CK scores -- get denied interviews solely on the basis of not passing CS on the first try. But those people did end up matching in the end, and not being picky about peds programs will probably work out fine for you.

I think what you were missing was timing practice, because if you're running out of time in the middle of your routine, you're probably sacrificing your counseling time. You have to practice with a friend acting as a patient who is very strict on you when it comes to points and when it comes to time. Becoming comfortable with the 15 minutes is essential. The books tell you that the history should take 7 minutes, the physical should take 5 minutes, and the counseling should take 3 minutes. And after you've done it a few times, it tends to naturally work out that way.

Reading your patient's facial expressions is sometimes a nice thing to do, too. I don't know where you're from, but I've seen that many IMG's will mess up on the "don't use medical jargon" points. Whenever I've slipped up on it personally, I'd notice the patient put on a confused look where they furrow their brow. Then I'd be like "Do you know what that is?" and they'd be like "No" and I'd be like "Well let me explain..."

 

[Captopril]

Hey bud...I'm in the same boat as you. I'm an IMG who failed my CS once (passed on the retake). My step I score isn't nearly as great as yours, but decent...so in fact I might be in a worse spot than you. I'm really hoping that the second attempt for CS doesn't completely kill my app. I've heard different things from different people. Some say as long as you pass the thing before you apply, it shouldn't be a big deal since it's a pass/fail and you could likely just be having a bad day. Not sure how many PD's subscribe to this philosophy. Others have said that it may lower the # of invites you get. I'm hoping it's the former.

As for taking the test again, just study and practice from First Aid. Practice is really really key. Try to find someone to play the patient if you can. I found that even when I had memorized the crap out of a case, I didn't know it until I had practiced it 2-3 times.

Hey guys, I'm a long time follower, but just registered 'cause I really need your input on my case...

I'm an IMG that just finished med school. I graduated in the top 10% of my class (of 200) and scored 99/250 on step I and 99/259 on step II CK.

I just found out I failed my CS exam (CIS eval). And plan to reschedule/retake it ASAP.

I aspire to enter a university based peds program.
Being an IMG, I am definitely not too picky on entering a top tier program. However, I would like to enter a program that is good enough to allow me to enter the subspecialty of my choice (currently torn between cardiology and GI).

My question is the following: Assuming I try really hard on my next attempt and finally pass the f-ing exam. Do you think this will lower my chances on entering a decent residency program. And if so, what would your advice be regarding mentioning this on my personal statement, interviews, dean's letter, etc.

Thanks a lot for your help!

 

[radiodoc99]

Setup a rotation where you want to go and show your clinical skills.

 

[asclepiusIMG]

Thanks a lot everyone for all your help!

I've requested a re-check form, I'll hope for the best and prepare for the worst...

 

[DoctorDisturbed]

I am a little concerned.. I also had a similar experience.. I was not able to close 3 encounters because of difficult/talkative patients.. What if I was able to counsel and close all other encounters well.. Can this jeopardize CIS Score??

 

[hot sauce]

I know this a somewhat old thread so have you retaken the exam? Unfortunately, I think failing CS as a FMG is going to be a red flag. Your step I and CK scores show you are smart enough but if I'm a program director I'm going to be worried that you may not be able to communicate with patients well (this may be unfair but I think it will be concern). I don't think you are out of the running so good luck.

Retake, pass, and be prepared to talk about the failure on interviews.

 

[km11]

Why do FMGs focus on the two digit score and not the three digit score?

 

[Gute]

Why do FMGs focus on the two digit score and not the three digit score?

its a defense mechanism

 

[docbill]

Why do FMGs focus on the two digit score and not the three digit score?

Maybe because some don't want to tell you exactly what score they got.
Maybe because if you go to the USMLE thread, you will see many AMG argue that the two digit score is a good indicator of comparing between different test takers. Also that once you have a 99 two digit score... you considered to be pretty much on top.

Did you get 99?
PS. AMG also can fail the CS exam!!! YES it can happen. Do a search. Some people just don't prepare properly for the exam. CS is really a dance show/act. Got to play the game to pass.

 

[docbill]

its a defense mechanism

I don't believe that fits in to any of the different groups of defense mechanisms. Scratch that maybe the OP is using intellectualizing?

Oh I wonder which defense mechanism you are using? Did you do psych rotation yet?

 

[Docsammd]

I have searched far and wide about the importance of CS and its seems the overwhelming majority of programs do not give a damn about the attempts. All they want is certification before the ROL. Plus if god forbid u failed 3+ times in multiple states u will not be able to practice.. Just check out FSMB when u start applying for Step 3.

Otherwise fix the problem and take the exam ASAP

The reason why FMGs/Non American always quote the 2 digit score is its they only way they are able to communicate their score to the outside world. Imagine when calling your parents (even in the states) and telling them oh gee mom i made a 240. Who the hell know what that really means anyway?

 

[km11]

Maybe because some don't want to tell you exactly what score they got.
Maybe because if you go to the USMLE thread, you will see many AMG argue that the two digit score is a good indicator of comparing between different test takers. Also that once you have a 99 two digit score... you considered to be pretty much on top.

Did you get 99?
PS. AMG also can fail the CS exam!!! YES it can happen. Do a search. Some people just don't prepare properly for the exam. CS is really a dance show/act. Got to play the game to pass.

Seems kind of odd since the 99 basically equates to a mid 230 right? Anything above that is just 99. That's a huge portion of scores that are simply lumped into the 99 pile. Seem weird to mention the double digit score when the triple digit is more informative

 

[Golding]

The reason why FMGs/Non American always quote the 2 digit score is its they only way they are able to communicate their score to the outside world. Imagine when calling your parents (even in the states) and telling them oh gee mom i made a 240. Who the hell know what that really means anyway?

Not really true. Being an FMG, it seems that we stress over the 2-digit score because word-of-mouth dictates that program directors put it into consideration. Whether or not it's actually true is irrelevant - the concept is pervasive enough that it's what people are inclined to believe. Being an FMG is enough of a handicap without putting on that you're at least scoring high on your exams.

I told my parents my three-digit score. They asked what the maximum score is, and I told them the average and standard deviation. I doubt I'm that uncommon in that.

 

[Gute]

Also that once you have a 99 two digit score... you considered to be pretty much on top.

not really, a 240 and a 260 are both 99s, but are approximately 1 std deviation apart from each other. The NBME makes it clear that the 2 digit score is meant to be a peg against 75, which is the passing mark. The 3 digit score matters more as well because it is the score that is valid to compare over time (i.e. a 220 this year means the "same" as a 220 in 2000)

 

[jackets5]

The 2 digit score is what standardizes the test from year to year from form to form. I have heard this from 2 residency directors.

 

[Scottish Chap]

Hey guys, I'm a long time follower, but just registered 'cause I really need your input on my case...

I'm an IMG that just finished med school. I graduated in the top 10% of my class (of 200) and scored 99/250 on step I and 99/259 on step II CK.

I just found out I failed my CS exam (CIS eval). And plan to reschedule/retake it ASAP.

I aspire to enter a university based peds program.
Being an IMG, I am definitely not too picky on entering a top tier program. However, I would like to enter a program that is good enough to allow me to enter the subspecialty of my choice (currently torn between cardiology and GI).

My question is the following: Assuming I try really hard on my next attempt and finally pass the f-ing exam. Do you think this will lower my chances on entering a decent residency program. And if so, what would your advice be regarding mentioning this on my personal statement, interviews, dean's letter, etc.

Thanks a lot for your help!

Sorry you didn't pass. It's a ding in your application. Best advice I can offer is to sit with a 4th year U.S. medical student who has taken the exam and let them see what you are doing. An IMG friend of mine failed CS twice. I sat with him and saw that he was flawless in his differential, but he did a lot of things we just never do in the U.S. (towered over the patient, acted in a non-empathic way, forgot to wash his hands). His manner sucked (at least during the exam). I basically showed him a few things we always do in the U.S. He passed next time. Good luck!

 

[Scottish Chap]

not really, a 240 and a 260 are both 99s, but are approximately 1 std deviation apart from each other. The NBME makes it clear that the 2 digit score is meant to be a peg against 75, which is the passing mark. The 3 digit score matters more as well because it is the score that is valid to compare over time (i.e. a 220 this year means the "same" as a 220 in 2000)

I think it's the other way around. 10 years ago a 99 was a 2-digit score of around 220 - now you need about 240 for a 99.

 

[EM2011]

The 2 digit score is what standardizes the test from year to year from form to form. I have heard this from 2 residency directors.

Gute and Scottish Chap are correct. Once and for all, straight from the nbme website:

Under current procedures, the scores for each administration of a USMLE Step are equated so that a given three-digit score represents essentially the same level of examinee performance for that Step, and this holds true across years. In other words, a score of 200 on one administration of a Step indicates a comparable level of examinee performance as a score of 200 on any other administration of the same Step. This equivalence holds even if the pass-fail standard is changed, which permits comparing performance across time.

It is important also to remember that the two-digit score, also reported for USMLE, is not a percentile and is not fully equated like the three-digit score. The two-digit score is a total test score that is designed to meet the requirements of some state licensing authorities. The two-digit score scale is one on which a 75 is always the minimum passing score. A given two-digit score may represent a different level of performance if the two administrations were subject to different pass/fail standards.