Step II Just took Comlex II PE and I'm very concerned...

[retro]

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Hello everyone, I just took my Comlex PE 5 days ago and I am very concerned about my performance.
Honestly, I didn't feel so bad immediately after the exam...but 1-2 days after, I started remembering all these dumb mistakes and red flags.

My major concern is that I totally messed up on draping the patients. There were a good 5 patients who needed the abdominal exam. I lay them supine and used the draping sheet to cover waist down. Instead of pulling the gown under the sheet from down-up, I pulled the gown from up-down and exposed patient's anterior chest and the abdomen. This just goes against common sense, but I just can't figure out what made me do that on the test day. Has anyone heard of people making this mistake? Would this be an automatic failure for humanistic portion?

I also forgot to repeat BP measurements for 1-2 patients who clearly had high BP, could not figure out a clear diagnosis for a good number of patients and ended up listing possibilities and respective work-up in no particular order in assessment & plan. It sucks that I'll be thinking about these mistakes for the next 8 weeks...just wanted to hear what you guys think of my situation. Thanks in advance.

 

[Erek94]

I feel ya. I took it about 2 weeks ago and also felt good afterwards but then realized I made some dumb mistakes as well, for example (Didnt get a pregnancy test for someone I put on birth control, I probably missed some other vital diagnostic workups, also my physical exam was scant for a couple pts bc I felt confident in the diagnosis but didnt realize this was a problem till after, i didnt do a HEENT exam for someone with likely pneumonia) Not to mention the computer crapped out 2 min into my first note and i had to finish it on paper, which eneded up being a sloppy mess. I feel like if you consistently introduced yourself, asked how they wanted to be adressed, washed your hands, did heart/lungs on everyone and at least attempted draping when indicated and at least made a half ass attempt at counceling on substance abuse and offered empathy when indicated it would be hard to fail someone for not being humanistic. Its too late at this point thought just gotta sit back and deal with the anxiety till we know. One thing that definitey doesnt help is looking at all the threads of people who did fail though, make me crazy.

 

[Duon89]

I am a 3rd year and took it in mid December, 2014. And I passed.

here are my mistakes.

1. Called female patient as Mr. xxx. Had to quickly correct myself. Pt got really mad.
2. did not ask allergies on at least 2-3 cases.
3. Ran out of time on one of the cases before doing PE.
4. Did not speak clearly many times. English is my second language.
5. forgot to ask medication dose on several cases.
6. ok differentials, but for many cases, my top differential was off.

I mean the list goes on and on. But, I still passed. Things that I made sure I did was showing compassion, and giving A/P to all pt and explaining what can be happening to them (except for one case, for which I ran out of time. It was just a check up case without any chief of complaint)

Unless you did not show compassion, like during FHx, you heard pt's father died few years ago and you did not ask how the pt is coping with it, I think you should be fine.

I get the sense that they are more lenient on biomechanical part when compared to humanistic part.
After all, people failed because of the humanistic score not the other.

So, worry not and just wait. Well, I mean it is hard. I did worry for few days. But after awhile, I decided to tell myself that I have failed and I should just take it again during 4th year as late as possible and prepare well, like work on things I did not do right.
So.....maybe.. I should just recommend thinking about what you can do to not fail next time, instead of worrying about what has already been done. It helped me. At least, you can learn from mistakes and improve. Just think that you have learned a lesson by paying 1K. It helped me. And I pretty much told everyone I met, that I will probably have to take it again.

When I learned that I passed, it was unexpected. And I was unexpectedly happy.
But, if I have failed it, then I would have at least expected it and do as I planned (take it again).

 

[matt1221]

Just wondering how detrimental it is if you forgot to discuss assessment and plan with the patient but did everything else pretty good?

 

[Erek94]

Id think youd be ok. These things are likely a check off the check list the standard patients fill out while we're writting our notes.

 

[retro]

I appreciate the input, everyone. Duon89 makes really good points. My mentality right now is to be prepared for the worst so that I won't be surprised when **** actually hits the fan. Honestly, all the hassles of paying 1000 bucks and retaking are the least of my worries...I'm mostly concerned about having a record of 1st attept failure on my ERAS and how it can affect my chances in residency. I'm a 3rd year considering EM, and I heard EM residency programs actually put a lot of weight on Comlex PE. I'm not 100% sure about this, but it's what I've heard from N=1.

 

[Erek94]

Just found out I passed this morning so I thought I write a follow up as to all things I did wronf that drove me crazy while waiting for my pass.
-didnt get carotid U/S for an obvious embolic stroke / TIA case
-Didnt do an HEENT exam for a peumonia or bronchitis case
- Didnt get a preganncy test for a pt before giving birthcontrol
- Performed most of my OMM wrong (I suck at it)
- Didnt follow up on allergies like asking what the reaction was
- took a pretty half ass history overall and for the most part a pretty half ass physical exam as well
- Finished each encounter before the 2 min warning ( im a slow typer and i needed the extra time to organize my thoughts)

**Things I did always do
-Introduced my self as Student Dr. so and so and asked how they wanted to be adressed then washed my hands before cshaking hands
- Listened to heart and lungs on everyone on skin and always tied the gown back up for them
- did an half ass OMM spinal exam on everyone
- alawys drapped for abdomen exam and asked if it was ok to look at abdomen before proceeding
- always summarized with the pt my assesment and plan before ending
- when indicated always talked about smoking cesstion or alcohol counceling

Good luck to everyone taking this exam. Youll most liekly pass, but I know the feeling of waiting for this stupid exam score report is disabling. Happy to move on.
Cheers!

 

[retro]

Hello everyone, thought I'd keep you all posted with the result as well. I passed. Like the other posters here, it's been the most painful, dreadful waiting ever (actually took 5 weeks to get my score so I was pleasantly surprised). Anyway, my only piece of advice is to keep your chin up, have faith, and try to distract your thoughts from this exam after it's done. I pulled the gown from top to bottom, exposing whole anterior chest of the patient and still managed to passed. I hope that gives some comfort to others that might be in a similar boat that I was in.

 

[pk1989]

I just took pe..feel like complete idiot... i literally forgot to introduce myself as dr so and so for each case...but i still did the rest i.e. sanitized before shakin hands said mr or ms so and so when i came in asked what we can do for u draped each pt helped change positions each time asked permission to touch was empathetic when need be addressed concerns also asked if affecting their life etc etc...sometimes forgot to counsel but due to time issue more so than anything else, im not sure how much effect forgetting to introduce to each pt has on humanistic portion but im scared atm and furious at myself....any advice how bad it is or can be?