PE Comlex/USMLE

[apellous]

---

Members don't see this ad.

Anyone else out there thinks this is a bunch of crap. I feel that this is just another money making scheme hatched by the NBOME and AOA. They are basing this need off a crap survey of the general population that stated people want us to this as part of the boards. First of all what kind of people fill out surveys anyway. People with nothing to do better; like work, go to school, have a life. Second if the people want it let them pay for it 2000 buck for the test, travel (one test site that's bull$hit),lodging. I am not sure how other schools are but at CCOM they were are saying $hit like "we need to make sure doctors are able to talk/interact with their pts"1) you can not teach that and they dont try to anyway 2)This can not be a new Phenomenon, doctors that cant do a PE, are social ******ed, and can not communicate with pts.

So if some of the Drs are inept why not test us all since they are the ones teaching us wouldnt it be logical to start at the top. The only reason they are starting with us is that we have no choice but to take the &%!@ing test.

In my book if you cant manage a H&P by fourth year it is b/c you cant walk to the room on your rocker-bottom feet.

They have NO statistic proving the tests efficacy or predictions on how this $1500 exam will improve the quality of physicians.


All comments are welcome. If I am completely off base please let me know .

 

[vietcongs]

I agree. It is a bunch of $hit that we have to take the PE. At DMU, we have a physical diagnosis program that enables us to encounter standardized patients throughout 1st and 2nd year. Taking a PE as part of our Step 2 is ridiculous since we've already been put through many graded H&Ps. Who wants to spend an extra $1000 on Step 2, (including airfare and hotel ~$1500)..Maybe they should make standardized patient encounters a required part of medical school curricula rather than adding it onto the Step 2 examination. Just my opinion..

 

[doc05]

It is presumptuous to assume that we, as medical students, know what should and should not be part of step 2.

what you are saying is that knowing how to do an H&P shouldn't be prerequisite for licensure. get off your high horse and realize that you don't know all the answers.

the cost of the exam is high, but so is medical school. so is applying for a license. there's no way around this requirement, so start saving.

 

[Teufelhunden]

Yeah, this whole thing is a ******ed scam to make $$$$

Why in the hell should we have to take an exam that assesses our clinical skills, H&P proficiency, etc. I thought that's what happened every single day of our 3rd and 4th years?!

Think about it...how in the hell would we pass all our clinical rotations w/o being able to do an H&P?

This is stupid.

 

[gasman2003]

I too was very upset about this issue even though I didn't have to take the stupid test. We actually had a pilot program at AZCOM where we all took the PE test. It was so ridiculous...If I would have had to pay 1000 dollars to take that test I think I would have snapped.

Also, one interesting point is that the AMA actually fought and is still fighting the NBME regarding delaying the introduction of the PE in the USMLE until more funding is available and until studies prove that it does improve medical care.

I wrote a letter to the AOA asking them why they weren't fighting the implementation of this exam by the NBOME on behalf of osteopathic medical students but they never responded...

Patrick Hogan, DO
Anesthesiology Intern

 

[DOtobe]

Originally posted by Teufelhunden
Yeah, this whole thing is a ******ed scam to make $$$$

Why in the hell should we have to take an exam that assesses our clinical skills, H&P proficiency, etc. I thought that's what happened every single day of our 3rd and 4th years?!

Think about it...how in the hell would we pass all our clinical rotations w/o being able to do an H&P?

This is stupid.

This is exactly how I feel about the PE for the COMLEX! I think we can all probably already to H&P's in our sleep.

And here is what the NBOME says about the cost (taken from their "fact sheet" on the NBOME site):

What will this examination cost?
The expense of reliable high-stakes performance testing utilizing standardized patients has seemed prohibitive to some schools interested in starting such programs themselves. Unfortunately, the expense of licensing candidates without certification of proficiency in clinical skills may be much greater. NBOME has invested significant resources in research and development of COMLEX-USA Level 2-PE, in order to assure the highest quality examination and to minimize the eventual cost for the candidates. It is anticipated that the examination fee will be $965 in 2004.

$965 (not to mention the additional cost of travel) is their idea of "minimizing cost?" 😡

Also, according to the fact sheet, it looks like the testing is going to be done in Philadelphia.

You can go to the NBOME site and click on "performance exam" to read the fact sheet.

 

[ecf1975do]

fortunatley I am a 4th yr and wont have to take step 2 with the PE part... i am just curious how , logistically it is going to work out??? it is a 3 day test??? every student must go to phili for it??
i think it is doing to be interesting how it turns out.. of could the PCOM students dont have to worry about travel costs.. but those in cali, etc ..it is going to one expensive multiple choice test.

 

[Kosmo]

Originally posted by doc05
It is presumptuous to assume that we, as medical students, know what should and should not be part of step 2.

what you are saying is that knowing how to do an H&P shouldn't be prerequisite for licensure. get off your high horse and realize that you don't know all the answers.

I disagree, it is by no means unreasonable to demand evidence that the new PE will improve the quality of medical care. They are forcing us to be guinea pigs at our own expense.
Moreover, I don't think the OP implied that knowing how to do an H&P shouldn't be prerequisite for licensure. But this is something that medical schools themselves can, and already do, evaluate quite competently during 3rd and 4th year. If the NBME disagrees with this point, they need to provide evidence to the contrary, and then show that their solution will improve matters... and they need to do this at their expense.

It is silly to presume that we, as medical students, don't have enough knowledge to recognize a faulty system. And doubly so to blindly accept such a system merely because we are presented with it.

 

[neilc]

actually, there was a study done that showed US grads did worse on the clinical skills test than foreign grads. so, after that, it seems a bit odd that they would require foreign students to pass this test and not the US guys.

it sucks, but look at it compared to the usmle steps 1 and 2, or the comlex...during the basic science years we learn tons of basic science, pass tests, etc...but, these exams are a way to demonstrate these skills on a standardized level. the clinical skills exam simply does the exact same thing as the other steps for a different skill set.

so, if you are going to claim that these skills are adequately taught and tested in med school, than you should also be arguing against the usmle, comlex and whatever else.

 

[Kosmo]

Originally posted by neilc
actually, there was a study done that showed US grads did worse on the clinical skills test than foreign grads. so, after that, it seems a bit odd that they would require foreign students to pass this test and not the US guys.

Which clinical skills test? And what study? Either way there could be any number of explanations for this. Including the large number of foreign grads who have already been practicing for some time before applying for licensure in the US. And though I haven't seen this study you refer to, one would expect that a foreign grad who is required to take such a test and make all the necessary preparations might fare better than a US grad (or pre-grad) who takes the test as part of a study without any repercussions with respect to performance.
And ultimately, this still doesn't address the question of whether or not this test actually improves medical care.

it sucks, but look at it compared to the usmle steps 1 and 2, or the comlex...during the basic science years we learn tons of basic science, pass tests, etc...but, these exams are a way to demonstrate these skills on a standardized level. the clinical skills exam simply does the exact same thing as the other steps for a different skill set.

so, if you are going to claim that these skills are adequately taught and tested in med school, than you should also be arguing against the usmle, comlex and whatever else.

You are absolutely right, and it's not out of line to infer from my previous post that that is exactly how I would argue. And for much of the same reasons, i.e., that it is questionable that the cost of development and administration of such tests provides a sufficient benefit for overall health care, over and beyond what the medical schools provide. Not only that, but such tests completely standardize medical education: the majority of US schools tailor their curriculums to the USMLE, thus eliminating any creativity in the medical education process.

90% of the students at my school pass Step 1 on their first try (right around the national average,) and 95% eventually pass; does that seem like a worthwhile test?

 

[gasman2003]

Neil, I don't think the problem is so much the idea of the test but moreso the great cost that this incurs on US graduates. The fees charged to IMGs for the CSA are too high, but yet are more understandable because these students are from non-US medical schools who may have different curricula, etc.

Anyway, to administer a survey to the US public asking the question "Should medical students have to pass a physical exam skills evaluation at their own expense?" and then be surprised that the answer is yes is simply horrifying. If this exam is for the greater good of the american people then this exam should be funded by the american people as a whole.

I guarantee you that if the survey instead asked, "Are you willing to support a new personal income tax increase in order to fund a physical exam evaluation for medical students?" that the answer would be NO.

The people who are pushing for this exam do not have the students' best interests at heart. Even the AMA agrees that this test should not be implemented until the cost can be brought down and/or shared with people other than medical students.

I think all of us US trained physicians would submit to such an exam if we weren't required to burden all the cost.

Also, like I said earlier, I took a practice version of this exam and it was a complete joke.

Patrick Hogan, DO
anesthesiology intern

 

[neilc]

i agree, the cost is ridiculous. i am fortunate, and the travel costs will be minimal...but, even the $1000 bucks is crazy.

hopefully, that will drop a bit, but i don't really expect that too much.

i just chalk this one up to the man holding us down.
🙄

 

[apellous]

I rather take my 1000 bucks add it to 10-20 others and pay a good lawyer to stop this stupid exam from taking place in the first place.

I am not sure if I noed this fact in my first post but the test does not even count. You are required to take the exam but not pass it. the class of 2008 will be the first class that has to pass it.

Doc05 your an idiot. I am sure you have for your whole life done everything you were told to do and never challenged the system tell you what to do. Good for you.

 

[Bull's eye]

The part that I would dread the most would be, not that I couldn't do the H&P, it would be that I didn't do the H&P exactly the way the test writers wanted me to do it. It's like a "guess what I'm thinking" sort of thing. I could imagine the frustration of being told, "Well John, sorry but you forgot to ask about her maternal aunt that was also diagnosed with rheumatoid arthritis, and you forgot to ask about the reason why she had a TAH& BSO. Good job on getting the other info and the diagnosis of RA, but you fail."