I've been a longtime lurker/sometimes poster, I created this new profile to protect my identity. First a quick introduction...
I'm an AMG who goes to a top 10% MD school on the east coast. I've done well on all my exams throughout med school, decent Step 1 and 2CK scores, and did very well on all my rotations; I'm applying to IM. I'm considered a very friendly guy, and have been complimented numerous times by patients and physician evaluators for my pleasant and empathetic manner with patients. I did have a bit of a hard time with SP's in my first practice sessions set up by my school (I think I had a hard time pretending they were real patients at first) but this improved greatly as the year progressed.
I had to take CS pretty late due to some scheduling issues, and had a very hard time finding available dates by the time I went to sign up, ended up taking it towards the end of Dec. I went into it with a pretty lax attitude, as I considered myself to be very good with patients and was under the impression that it was extremely rare for an AMG to fail. My prep consisted of going through FA for CS a few weeks before my exam, and I was't real serious about it even then.... One thing I was worried about going in is that I'm a very slow typer, I've been complimented on my notes in real life but I have a hard time banging it out in minutes, and given the increased focus on the PN I was afraid I wouldn't be able to finish my notes on time. One piece of advice I got from a friend was to go straight to the Differential and the Workup and then work back to the History and Physical, that way even if there are some things missing from the H&P you have already listed them in the supporting findings section and the doctor evaluating it will see you got that info in somewhere. Overall I felt pretty confident going in...Big mistake I guess.
I also felt very confident about the actual exam. I took it in Philly, got there early, and tried to be as thorough and personable as I could with every SP, even the "difficult" ones. I had a few cases where I felt I wasn't getting a lot from the patient and had a hard time figuring out what the actual problem was, definitely missed some big PE stuff I should have done, and didn't get to wrap up with quite a few of the cases. I even had to cut short one encounter very early in the PE (a neuro case where the guy was being extra difficult and the history took forever), and many of my notes were missing a lot of information from the history and especially the PE (I just couldn't type any faster). But overall I felt like I had done well and figured the bar is pretty low to pass. I mean, the people grading you know you're under pressure and are being timed so you're bound to make a few mistakes and run out of time on a few encounters and notes, right??
Anyway, when I got the results I was devastated. I had failed the ICE portion, and was borderline on the CIS portion as well. Apparently I speak fluent English (gee thanks). I'm not sure why exactly I failed as these score reports are incomprehensible, but I assume it's because I ran out of time before finishing a few encounters and PN's properly. I suppose they don't grade them as leniently as I thought they would...
After a very brief grieving period, I rescheduled for late Feb, as this was the earliest date I could get so quickly. The main point was to pass before May so I can begin my residency. I didn't release my score to programs, and wherever I (hopefully) match won't know I failed until it's way too late anyway and probably won't care as long as I do end up passing. I redoubled my efforts on FA, went through it 3X in depth, I watched a bunch of PE videos online to strengthen my skills, practiced encounters with a friend, practiced writing PN's, and read a bunch more random stuff I found online. I obviously went in much more nervous the second time around, as failing was now a real possibility, as opposed to the first time when I hadn't even considered it.
I took it in Philly again, (although it was the other building this time) even though I had read in a few places that more people fail there. I saw in other places that wasn't necessarily the case and i didn't feel it was worth traveling across the country on a mistakenly perceived difference in sites. Unfortunately, I don't really feel like I did much better this second time around. Even though I tried to be much faster with the patients (without sacrificing PEARLS and thoroughness) I still ran out of time a few times, and while I tried to speed up the PN as well, I began each note from the beginning this time and instead of leaving the H&P sections bare this time I found myself running out of time again, and ended up missing a lot at the end. One of my notes didn't even have a single thing ordered in the workup. I honestly feel like I may have failed again.
What gets me the most is how subjective and useless this exam is. It's $1400 down the drain twice for an exam that doesn't in any way reflect or indicate anything about my skills as a competent physician. If I do end up passing, I will NEVER have to write a note like they require for the rest of my life. In this era of EMRs, I'll either be checking boxes for the ROS and PE's to indicate my findings or I'll at least have more time to be complete and thorough in my notes. Why do they put people who have spent many years and untold thousands working toward a goal through this subjective crapshoot? I'm pretty down right now and the next 6 weeks or so will be a brutal wait.
Sorry for the lengthy post but I really needed to get this off my chest, and I was too embarrassed to admit it to any of my friends. Appreciate all your feedback.
I'm an AMG who goes to a top 10% MD school on the east coast. I've done well on all my exams throughout med school, decent Step 1 and 2CK scores, and did very well on all my rotations; I'm applying to IM. I'm considered a very friendly guy, and have been complimented numerous times by patients and physician evaluators for my pleasant and empathetic manner with patients. I did have a bit of a hard time with SP's in my first practice sessions set up by my school (I think I had a hard time pretending they were real patients at first) but this improved greatly as the year progressed.
I had to take CS pretty late due to some scheduling issues, and had a very hard time finding available dates by the time I went to sign up, ended up taking it towards the end of Dec. I went into it with a pretty lax attitude, as I considered myself to be very good with patients and was under the impression that it was extremely rare for an AMG to fail. My prep consisted of going through FA for CS a few weeks before my exam, and I was't real serious about it even then.... One thing I was worried about going in is that I'm a very slow typer, I've been complimented on my notes in real life but I have a hard time banging it out in minutes, and given the increased focus on the PN I was afraid I wouldn't be able to finish my notes on time. One piece of advice I got from a friend was to go straight to the Differential and the Workup and then work back to the History and Physical, that way even if there are some things missing from the H&P you have already listed them in the supporting findings section and the doctor evaluating it will see you got that info in somewhere. Overall I felt pretty confident going in...Big mistake I guess.
I also felt very confident about the actual exam. I took it in Philly, got there early, and tried to be as thorough and personable as I could with every SP, even the "difficult" ones. I had a few cases where I felt I wasn't getting a lot from the patient and had a hard time figuring out what the actual problem was, definitely missed some big PE stuff I should have done, and didn't get to wrap up with quite a few of the cases. I even had to cut short one encounter very early in the PE (a neuro case where the guy was being extra difficult and the history took forever), and many of my notes were missing a lot of information from the history and especially the PE (I just couldn't type any faster). But overall I felt like I had done well and figured the bar is pretty low to pass. I mean, the people grading you know you're under pressure and are being timed so you're bound to make a few mistakes and run out of time on a few encounters and notes, right??
Anyway, when I got the results I was devastated. I had failed the ICE portion, and was borderline on the CIS portion as well. Apparently I speak fluent English (gee thanks). I'm not sure why exactly I failed as these score reports are incomprehensible, but I assume it's because I ran out of time before finishing a few encounters and PN's properly. I suppose they don't grade them as leniently as I thought they would...
After a very brief grieving period, I rescheduled for late Feb, as this was the earliest date I could get so quickly. The main point was to pass before May so I can begin my residency. I didn't release my score to programs, and wherever I (hopefully) match won't know I failed until it's way too late anyway and probably won't care as long as I do end up passing. I redoubled my efforts on FA, went through it 3X in depth, I watched a bunch of PE videos online to strengthen my skills, practiced encounters with a friend, practiced writing PN's, and read a bunch more random stuff I found online. I obviously went in much more nervous the second time around, as failing was now a real possibility, as opposed to the first time when I hadn't even considered it.
I took it in Philly again, (although it was the other building this time) even though I had read in a few places that more people fail there. I saw in other places that wasn't necessarily the case and i didn't feel it was worth traveling across the country on a mistakenly perceived difference in sites. Unfortunately, I don't really feel like I did much better this second time around. Even though I tried to be much faster with the patients (without sacrificing PEARLS and thoroughness) I still ran out of time a few times, and while I tried to speed up the PN as well, I began each note from the beginning this time and instead of leaving the H&P sections bare this time I found myself running out of time again, and ended up missing a lot at the end. One of my notes didn't even have a single thing ordered in the workup. I honestly feel like I may have failed again.
What gets me the most is how subjective and useless this exam is. It's $1400 down the drain twice for an exam that doesn't in any way reflect or indicate anything about my skills as a competent physician. If I do end up passing, I will NEVER have to write a note like they require for the rest of my life. In this era of EMRs, I'll either be checking boxes for the ROS and PE's to indicate my findings or I'll at least have more time to be complete and thorough in my notes. Why do they put people who have spent many years and untold thousands working toward a goal through this subjective crapshoot? I'm pretty down right now and the next 6 weeks or so will be a brutal wait.
Sorry for the lengthy post but I really needed to get this off my chest, and I was too embarrassed to admit it to any of my friends. Appreciate all your feedback.
