Neuropsych testing for failed shelf exams?

[criticalmass]

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My school wants me to undergo neuropsychological testing because I scored 59-61 on 3 consecutive shelf exams. In all three instances the score was 1-2 points below the cut off. The problem is I don't see how this is an appropriate indication for a neuropsychological test, as I think I just need to work on my study strategy and time management-both in studying and during a test. I have retaken and passed the first exam after completing a question set most student report completing on their attempt. I also took step I twice-Scoring 74 on first attempt (75 needed to pass)-doing about 2/3 U-World wrt questions. Upper 80s on 2nd attempt-after completing UWorld 1X.

Is this a customary practice for medical schools? Does anyone think these consistently borderline scores necessarily reflect a neuropsychiatric problem vs test-taking strategy?

 

[Rendar5]

you had this problem not once, not twice, not three times, but four times already (3 shelves and step I). most of those are tests of minimal competency and this is both worrisome, and is putting you in danger of not matching into a residency after med school. Go get the testing done and see if it's dyslexia or something, because without a medical reason for poor performance, you're going to run into career trouble very early on.

 

[45408]

I would go along with what they want you to do.

 

[myhandsarecold]

Psych will help you gain some insight. And take your meds.

 

[criticalmass]

Thanks for your responses. Not matching after graduating is scaring indeed.

By biggest apprehension about the neuropsych testing, is that I'm not sure how any ADHD or similar diagnosis would appear on my record-I'm afraid of being labeled. Also I worry about the limitations of the test in specificity etc-i.e. what are my chances of getting a false positive label that will follow me the rest of my life-especially since this type of test seems to be used mostly for people with significant neuropathology e.g. following the progress of kids who had neurosurgery for tuberous sclerosis!

I'm a non-traditional student, and always had excellent grades before medical school (well everyone did right), and I strongly believe it has to be a problem with my study strategy. I find I tend to leave practice questions for last and never do enough of them. I get bored getting them wrong and turn to reading texts or review books. First time I took step I, I only completed half of the UW Qbank, but read through books like BRS Physio and Path-which were enjoyable (vs listing of facts and mnemonics). First AID bored me to sleep or I would get stop and read the news or something, so there were 2 or 3 chapters I just didn't get through. After passing 2 practice NBMEs, I jumped to take the real thing.

On judgement day, I consistently ran out of time on all blocks with 5-10 questions remaining. Scored 74 (failed by one scaled point). I was totally DEVASTATED. I took a quick trip away, to renew my mind and unload the stress, regrouped and finished UW along with reviewing FA, then faced the exam again. It felt easier and I did better with time-didn't finish two blocks but only with 1-3 questions remaining.

I KNOW I need to do more questions but somehow at the beginning of a block or rotation I falsely think that I have enough time to both read extensively and do questions.
This "delusion" is what I find to be most consistent!
Somehow, some part of my mind convinces me that learning from questions is "incomplete" and "patchy." and I need to launch a systematic attack by reading thoroughly on major topics then do questions! I don't dump the books for questions until a couple days before the exam when it's too late to complete the qbank/practice questions.

Any ideas on how to break this vicious cycle in which I have found myself?
(after every test I vow it won't happen again, but repeatedly it does!!! Very painful)

Basically, I know I need to do more questions but I get carried away -enjoying the reading-until I run out of preparation time... On the test itself I get bogged down when I encounter a topic I studied well and can't figure out a related question right away-so I might persist and spend 3 minutes on it in a compulsive fashion-thinking I will go faster on subsequent questions-never really happens! Often if, I do spot the answer to a question after a few seconds I am compelled to read it again to ensure I wasn't tricked-so no real time gains! Quite frustrating. I always run out of time on the shelf exams even though I speed through the latter half. Nah I don't think the behavior meets criteria for OCD.
I would really prefer to solve these issues without any sort of medication...

Thanks again for your input.

 

[Guillemot]

Getting the testing doesnt force you to have any treatment. Could be helpful also.

 

[MossPoh]

It isn't a label on anything. It isn't like you put that on your ERAS application. Just go through with it. The worst that happens is that you do test positive and get help...which may not be the worst. Really, the worst would be getting hit by a bus on the way to testing or something, but you get the point.

 

[235009]

By biggest apprehension about the neuropsych testing, is that I'm not sure how any ADHD or similar diagnosis would appear on my record-I'm afraid of being labeled. Also I worry about the limitations of the test in specificity etc-i.e. what are my chances of getting a false positive label that will follow me the rest of my life-especially since this type of test seems to be used mostly for people with significant neuropathology e.g. following the progress of kids who had neurosurgery for tuberous sclerosis!

u failed step 1 and 3 shelf exams and your biggest worry is being "labeled" with a learning disability? it seems that the reason you're resistant to this testing is that you are not fully grasping the gravity of your situation.

 

[criticalmass]

I do grasp the gravity. I'm not reacting with enough killer force though, maybe because I've been through so many "wars" with these exams, and I'm not going to let myself stroke out or get an MI over these in life anymore. It's like a coping mechanism, I've unconsciously adapted after these failures and disappointments. I even find myself listening to Sgt Mackenzie (http://www.youtube.com/watch?v=BB2Ad04mukI) after exams, so that some peace can flow over my soul - knowing that I worked hard.

Thanks all. This is really a rough time for me-where quitting even crossed my mind several times, but I on sincere reflection I'm convinced I can do much better.

I will likely go ahead and do the testing soon, as I can see how it can offer objective insight into what the problem might be.

 

[cabinbuilder]

Get tested before they kick you out of school all together for being unable to pass and being resistant to getting tested. There are some states (TX) where if you don't pass step II in 3 tries you will not be allowed to finish residency nor will you even be licensed in that state. Many other states are like that too when it comes to licensing. Do what the school is asking you before you are stuck with a bunch of student loan debt and no job to pay the bills.

 

[Ceejayluke]

I do grasp the gravity. I'm not reacting with enough killer force though, maybe because I've been through so many "wars" with these exams, and I'm not going to let myself stroke out or get an MI over these in life anymore. It's like a coping mechanism, I've unconsciously adapted after these failures and disappointments. I even find myself listening to Sgt Mackenzie (http://www.youtube.com/watch?v=BB2Ad04mukI) after exams, so that some peace can flow over my soul - knowing that I worked hard.

Thanks all. This is really a rough time for me-where quitting even crossed my mind several times, but I on sincere reflection I'm convinced I can do much better.

I will likely go ahead and do the testing soon, as I can see how it can offer objective insight into what the problem might be.

how did the testing go? did you find it helpful? are you matching this year?

 

[siliso]

ADHD or an anxiety disorder is not nearly as stigmatizing as failing out.