PE exam knocking students out of residency programs

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Mad Jack said:
There were a couple of fantastic students from my school that failed. Good, likable people who were good on rotations. Maybe they choked under pressure, who knows.

The computers crashed during my exam and I damn near failed it because I had horrible carpal tunnel and could barely hand write my notes legibility. Pulled through but damn it was worrying
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Actually, I hope that happens to me. I feel like I can write faster than I can type.
 
DrStephenStrange said:
Actually, I hope that happens to me. I feel like I can write faster than I can type.
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The problem with writting is that the exam then becomes based on your readability as well. I hope you can write fast very neatly as well. Kauffmans book actually emphasized this which is how I know.
 
jkdoctor said:
From a large NBOME study:
"None of the differences in clinical skills training and test preparation was associated with statistically significant differences in pass or fail status."
Seems like a bit of a crapshoot!!
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BorntobeDO? said:
JK you are my hero, this is what I have been wondering for a while. Something isn't right with the fail rate.
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There's a huge amount of fallacy here...you guys need to read into it deeper. This is my analysis from a cursory glance of the first page of the research article.

It also states:
"The largest difference in preparation between students who passed the COMLEX-USA Level 2-PE and students who did not was a prerequisite SP examination at their school, with 5574 students (68.9%) who passed reporting having participated compared with 364 students (56.5%) who failed."

In other words, some schools will screen you more before you take the PE than the others. This means that you are more likely to pass the PE if the school administers some sort of prerequisite SP exam that you've passed. This also makes sense because schools bar students who have not passed their prerequisite SP exam from taking the actual PE. It's just another hoop to jump through for any medical student. The PE, like any other board exam (Level 1, 2, 3, etc) doesn't necessary determine whether you'll be a good future doc or not, as we all agree.

Also, just because you have great clinical skills training and test preparation, doesn't mean you'll still perform well. I can study quantum physics all day for two months, have great lecturers and mentors and still not understand a word of it while others can pick it up more quickly. There will always be students who fail the boards even at the greatest medical school institutions. However, with more training, the weaker candidates can overcome such a barrier. Maybe the standard clinical skills training isn't enough for these students and with some DO schools allowing these candidates to take the PE without some sort of prerequisite SP exam these candidates are destined to fail.
 
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PathDoctor said:
Da** right that something isn't right with the fail rate. Students now have better incoming stats and better COMLEX prep than 2005 students. Failure rate should be less than 3% imo.

COMLEX-USA Examination Performance Data - NBOME

COMLEX-USA Examination Performance Data COMLEX-USA Level 1 COMLEX-USA Level 2-CE COMLEX-USA Level 2-PE COMLEX-USA Level 3 The data on this page is updated […]
www.nbome.org www.nbome.org
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I wouldn't be so quick to think that. DO schools are popping up like weeds every year, and they generally bring the averages of incoming stats down. You're not counting for the fact that (and I don't have real hard data, just conjecture) perhaps most of these failures are coming from the new DO schools with a curriculum that hasn't fully been tested/implemented and have not developed a strong SP curriculum yet.
 
Thelonious Chunk said:
This exam should be gotten rid of. Let the medical schools determine the student’s abilities with OSCEs instead of this inconsistent, vague, and unfair cash grab. I know somebody who knows an SP for the PE who tries to fail half of the students she encounters. The consequences that the 8% who fail this exam face are heartbreaking. I agree with the sentiment regarding failing 2% at most if we can’t just get rid of it all together. Most attendings working currently never had to take this dumb exam.

Anyone who thinks this is a reasonable exam has likely never taken it.
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Is this person in Chicago or Philly?
 
Neopolymath said:
And of course we get one less minute for each section so we may thump our DO chests and say we did it faster and better. Makes me want to vomit.
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Not to mention we must stop and do OMT plus reassess in 30-40% of the encounters. Then you must document these findings and treatments.
 
Happy Cynic said:
Not to mention we must stop and do OMT plus reassess in 30-40% of the encounters. Then you must document these findings and treatments.
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Thoracic inlet. Muscle energy. Soft tissue. Quick and easy techniques. Maybe also BLT because you can literally make up whatever bullsh*t you want for that one and it will look correct to the camera and feel correct to the SP. Myofascial release would also be a good one but word on the street is they apparently grade that one more harshly? Avoid ones that take a lot of time to set up or require precise positioning or hand placement that can be scrutinized, like anything for ribs, sacrum and innominates.
 
How can you choose the technique given they pick the region? You can't just avoid a hip technique if they say hip pain and want OMM.
 
Neopolymath said:
How can you choose the technique given they pick the region? You can't just avoid a hip technique if they say hip pain and want OMM.
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The omm cases are really bread and butter so they're not going to give something alien. Also, the actors typically describe classic findings. If it's a hip case, most likely going to be psoas/piriformis related. What I did was just have a few hy differentials for each body region and 1-2 techniques for each. When in doubt or you freeze, treating lymphatics usually apply. It's indirect, gentle, and you can talk your way through why it works for inflammation/healing as you're doing it.
 
Regardless of what they say, a "standardized patient" is nothing like a real patient. The test has no external validity. With a real patient, I basically just need to say "hi" and they give me their full life, medical, and social history(often plus stuff I really don't want to know, but when you are a big buff bald white guy, people assume you are on board with certain garbage). With a "standardized patient" I need to figure out the magic words to get them to answer a question like a person.

I was white knuckling my clipboard during my Step 2 CS(I know, not the same exam but basically the same thing) as these actors refused to answer questions and I had to ask the same thing several different ways to get them to finally say what I already knew was the answer they were told to memorize(but not an answer they understood, hence needing to ask several ways).

Aside from the actors being incompetent, these tests make no sense from a performance standpoint. I didn't sleep the night before my CS (drove myself all night to the exam rather than splurge on a motel and already have a health issue causing severe daytime somnolence) and was so out of it from stress/exhaustion/health issues that I was in a delirium on my CS. I was basically on autopilot for the post encounters and had trouble remembering where to go after each encounter or even how to say words due to exhaustion. I was chastised multiple times for sitting at the station I was supposed to stand at. I was just totally out of it and barely conscious. Somehow that delerious, barely awake, abysmal performance was a passing performance. If that were my norm, I would have failed out of medical school.

For post encounters, I was just using my standard note algorithm and standard physical exam. Nothing specific to any patient. Just what had worked in med school and my AI.
 
Excelvan said:
@Goro is there any talk at all behind the scenes of abolishing Level 2?
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Haven't heard anything of this! Why would they do that?

About a decade ago, people had made noise about getting rid of one of the Steps and delaying Step I (or its replacement) to sometime in the clinical years.
 
V5RED said:
Regardless of what they say, a "standardized patient" is nothing like a real patient. The test has no external validity. With a real patient, I basically just need to say "hi" and they give me their full life, medical, and social history(often plus stuff I really don't want to know, but when you are a big buff bald white guy, people assume you are on board with certain garbage). With a "standardized patient" I need to figure out the magic words to get them to answer a question like a person.

I was white knuckling my clipboard during my Step 2 CS(I know, not the same exam but basically the same thing) as these actors refused to answer questions and I had to ask the same thing several different ways to get them to finally say what I already knew was the answer they were told to memorize(but not an answer they understood, hence needing to ask several ways).

Aside from the actors being incompetent, these tests make no sense from a performance standpoint. I didn't sleep the night before my CS (drove myself all night to the exam rather than splurge on a motel and already have a health issue causing severe daytime somnolence) and was so out of it from stress/exhaustion/health issues that I was in a delirium on my CS. I was basically on autopilot for the post encounters and had trouble remembering where to go after each encounter or even how to say words due to exhaustion. I was chastised multiple times for sitting at the station I was supposed to stand at. I was just totally out of it and barely conscious. Somehow that delerious, barely awake, abysmal performance was a passing performance. If that were my norm, I would have failed out of medical school.

For post encounters, I was just using my standard note algorithm and standard physical exam. Nothing specific to any patient. Just what had worked in med school and my AI.
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I think that it says something not about the assessment, but about those who failed, given that you were able to pass even in your highly compromised state!
 
Goro said:
Haven't heard anything of this! Why would they do that?

About a decade ago, people had made noise about getting rid of one of the Steps and delaying Step I (or its replacement) to sometime in the clinical years.
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I personally think Level 2 PE is on the brink of disaster. It might be the most pandemic unfriendly exam of all time. Bare minimum if this keeps going it won't be a factor in residency applications at all. Currently it's suspended until June 1, but if you read between the lines on the NBOME email you really get the sense of "this situation is unprecedented and we are honestly just hoping we can test again in June because we don't really know what to do if we can't."
 
AnatomyGrey12 said:
I personally think Level 2 PE is on the brink of disaster. It might be the most pandemic unfriendly exam of all time. Bare minimum if this keeps going it won't be a factor in residency applications at all. Currently it's suspended until June 1, but if you read between the lines on the NBOME email you really get the sense of "this situation is unprecedented and we are honestly just hoping we can test again in June because we don't really know what to do if we can't."
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"we need your money to keep our 300 foot yachts fueled up"
 
AnatomyGrey12 said:
I personally think Level 2 PE is on the brink of disaster. It might be the most pandemic unfriendly exam of all time. Bare minimum if this keeps going it won't be a factor in residency applications at all. Currently it's suspended until June 1, but if you read between the lines on the NBOME email you really get the sense of "this situation is unprecedented and we are honestly just hoping we can test again in June because we don't really know what to do if we can't."
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I agree; at this point in time, the PE shouldn't be considered doable.
 
Goro said:
I think that it says something not about the assessment, but about those who failed, given that you were able to pass even in your highly compromised state!
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What does it say about those who failed? That they were unlucky enough to fall prey to a sham of a test with no internal or external validity, taken seriously by nobody?
 
bananafish94 said:
What does it say about those who failed? That they were unlucky enough to fall prey to a sham of a test with no internal or external validity, taken seriously by nobody?
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the more senior members of this site are never on students' side when it comes to these things. You are right, a PE failure doesn't say anything about anyone who fails it. Doing something like forgetting to dry your hands before examining the SP does not and should not warrant failure leading to someone's career destruction, especially after they're already $150,000 deep into it.

COMLEX 2 is nothing but a useless, corrupt money grab that only hurts students and everyone knows it. Hopefully it will not be around much longer.
 
Excelvan said:
the more senior members of this site are never on students' side when it comes to these things. You are right, a PE failure doesn't say anything about anyone who fails it. Doing something like forgetting to dry your hands before examining the SP does not and should not warrant failure leading to someone's career destruction, especially after they're already $150,000 deep into it.

COMLEX 2 is nothing but a useless, corrupt money grab that only hurts students and everyone knows it. Hopefully it will not be around much longer.
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Even as a student who’s gone through it all the sheer scale of the stupidity and pointlessness and arbitrariness and the mind-boggling amount of money it earns its creators is pretty shocking. Remember, these exams are relatively new. The vast majority of people in power in the medical education system have no actual knowledge of what CS/PE is all about. The only people who get it are medical school graduates in the past 15 years or so. And if you’re part of the system I can see it being easy to dismiss medical students’ complaints as being unbelievable, even though if anything we undersell the corruption of these exams. In my opinion the best thing we can do is continue to speak up as we move into residency and beyond and push from the inside for its end.
 
bananafish94 said:
What does it say about those who failed? That they were unlucky enough to fall prey to a sham of a test with no internal or external validity, taken seriously by nobody?
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For an imperfect assessment, given that so many DO pass, as per the post to which I responded, it says to me that maybe, just maybe, the test mightn't be the problem, but the test taker.
 
Goro said:
For an imperfect assessment, given that so many DO pass, as per the post to which I responded, it says to me that maybe, just maybe, the test mightn't be the problem, but the test taker.
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So many, meaning 93%? I don’t know, 7% of medical students failing a board exam sounds like a hell of a lot to me. That means in any given group of friends there’s probably someone who failed. And this is a cohort of people who did well enough on the MCAT to get into medical school, passed Step 1/Level 1, passed their preclinical curriculum, went through an entire year of working with patients and taking shelf exams, many of whom have already taken Step 2/Level 2. 1% fail? Sure, that’s an outlier - maybe the student was poorly prepared or ill-equipped. 7%? That’s quite a lot. I’ll admit I’ve only studied the literature and many terrible flaws of Step 2 CS and for all I know PE is entirely different. But from what I’ve read it seems like they’re both cut from the same cloth. Do you support the continued existence of Step 2 CS and/or PE?
 
bananafish94 said:
So many, meaning 93%? I don’t know, 7% of medical students failing a board exam sounds like a hell of a lot to me. That means in any given group of friends there’s probably someone who failed. And this is a cohort of people who did well enough on the MCAT to get into medical school, passed Step 1/Level 1, passed their preclinical curriculum, went through an entire year of working with patients and taking shelf exams, many of whom have already taken Step 2/Level 2. 1% fail? Sure, that’s an outlier - maybe the student was poorly prepared or ill-equipped. 7%? That’s quite a lot. I’ll admit I’ve only studied the literature and many terrible flaws of Step 2 CS and for all I know PE is entirely different. But from what I’ve read it seems like they’re both cut from the same cloth. Do you support the continued existence of Step 2 CS and/or PE?
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I honestly have to agree with @Goro . I see so many threads on sdn with students being so afraid of failing PE and overanalyzing their mistakes and still passing makes me believe that those who failed are the ones who actually did something grossly wrong during their PE.

The pass rates for PE is about similar to that of Level 1 and Level 2. What are you suggesting? That we should make 100% of people who take the PE pass? There clearly is some deficiency for those that failed.

There has to be continued PE/CS board exams. It tests your ability to think clinically on the spot and also to show that you can be a competent physician and be professional with patients. Isn't that the whole point of being a physician? This is what you'll be doing for the majority of your career. Of course, you'll need the knowledge base, as demonstrated by your Level 1/Level 2 CK, but you also need to demonstrate that you can still perform in a clinical setting. MAYBE if you were doing rads or path I can see your reasoning for not requiring PE exams (in which case then maybe those residency programs don't put as much weight on them.)
 
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mathnerd88 said:
There has to be continued PE/CS board exams. It tests your ability to think clinically on the spot and also to show that you can be a competent physician and be professional with patients. Isn't that the whole point of being a physician?
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You realize this exam didn’t exist until 2003... it isn’t even a licensing requirement... so no, it isn’t the whole point of being a physician.

Absolutely nothing about PE is like a normal patient encounter.
 
mathnerd88 said:
The pass rates for PE is about similar to that of Level 1 and Level 2. What are you suggesting? That we should make 100% of people who take the PE pass?
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Well it looks to me that the first-time pass rate for Level 2 CE is 95.6% and for PE is 93.2%. So the fail rate for PE is over 50% higher, which isn't an insignificant number when you're talking about thousands of students taking an exam that can decide their futures. And no, I'm not suggesting that 100% of people pass, I'm suggesting that it's eliminated completely.

mathnerd88 said:
There clearly is some deficiency that those who failed are doing.
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What are the deficiencies? I certainly don't know how it's graded, do you? I honestly have no idea what they're even evaluating us on. If you fail CS they give you a very vague understanding of what domain you failed, but no information whatsoever on what part you actually failed or what you need to improve. Is PE different in this regard? Seems to me that it's a lot of very subjective ratings by actors.

mathnerd88 said:
There has to be continued PE/CS board exams. It tests your ability to think clinically on the spot and also to show that you can be a competent physician and be professional with patients. Isn't that the whole point of being a physician?
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Sure, that's a very important part of being a physician. Please explain what additional value this exam adds that the following do not,:
-OSCEs with standardized patients at your school.
-The entire pre-clinical curriculum, including exams.
-Pre-clinical patient experiences.
-Step 1/Level 1.
-Step 2/Level 2.
-The entire M3 year where you are constantly observed and graded based on your clinical acumen and professionalism.
-The first half of M4 year where you are observed and graded based on clinical acumen and professionalism in your field of choice via sub-Is and aways.
-Letters of recommendation from faculty who have worked with you.
-The entire interview process.
mathnerd88 said:
but you also need to demonstrate that you can still perform in a clinical setting.
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-As above

This is to say nothing of the fact that it costs an exorbitant amount of money, it's impossible to get a seat for it, and students have to front the time and money to fly all over the country to take it.
 
bananafish94 said:
So many, meaning 93%? I don’t know, 7% of medical students failing a board exam sounds like a hell of a lot to me. That means in any given group of friends there’s probably someone who failed. And this is a cohort of people who did well enough on the MCAT to get into medical school, passed Step 1/Level 1, passed their preclinical curriculum, went through an entire year of working with patients and taking shelf exams, many of whom have already taken Step 2/Level 2. 1% fail? Sure, that’s an outlier - maybe the student was poorly prepared or ill-equipped. 7%? That’s quite a lot. I’ll admit I’ve only studied the literature and many terrible flaws of Step 2 CS and for all I know PE is entirely different. But from what I’ve read it seems like they’re both cut from the same cloth. Do you support the continued existence of Step 2 CS and/or PE?
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I mean that's pretty close to the same failure rate for USMLE and the other COMLEX exams.

PE is a dumb test. CS is a dumb test. Neither should exist, especially given they have basically nothing in common with real patient encounters however given that they do exist and literally 9/10 people pass it with minimal real preparation it's hard to argue that failures are intrinsically a result of the flawed test.
 
bananafish94 said:
Well it looks to me that the first-time pass rate for Level 2 CE is 95.6% and for PE is 93.2%. So the fail rate for PE is over 50% higher, which isn't an insignificant number when you're talking about thousands of students taking an exam that can decide their futures. And no, I'm suggesting that 100% of people pass, I'm suggesting that it's eliminated completely.


What are the deficiencies? I certainly don't know how it's graded, do you? I honestly have no idea what they're even evaluating us on. If you fail CS they give you a very vague understanding of what domain you failed, but no information whatsoever on what part you actually failed or what you need to improve. Is PE different in this regard? Seems to me that it's a lot of very subjective ratings by actors.


Sure, that's a very important part of being a physician. Please explain what additional value this exam adds that the following do not,:
-OSCEs with standardized patients at your school.
-The entire pre-clinical curriculum, including exams.
-Pre-clinical patient experiences.
-Step 1/Level 1.
-Step 2/Level 2.
-The entire M3 year where you are constantly observed and graded based on your clinical acumen and professionalism.
-The first half of M4 year where you are observed and graded based on clinical acumen and professionalism in your field of choice via sub-Is and aways.
-Letters of recommendation from faculty who have worked with you.
-The entire interview process.

-As above

This is to say nothing of the fact that it costs an exorbitant amount of money, it's impossible to get a seat for it, and students have to front the time and money to fly all over the country to take it.
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I can't tell you exactly how it's graded. Nobody knows. However, at least everyone is graded to a standard and the same way. As to answer your other questions, there has to be a standardized exam. Every school is different in how they grade OSCEs. Every preceptor is different in how they write the evals (I've encountered some preceptors that just gave 100's to every student who rotated under them.) I'm sure as you've read, some schools even allow COMAT of 105 to be considered honors, while other schools require 113. I've encountered rotations where students do not even use the EMR or write SOAP notes, and ended up only 'shadowing.' Step 1/Level 1 and Step 2/Level 2 are the only standardized exams that puts every medical student on the same level and compares them. The additional value that the PE exam does is to ensure the residency programs that this student can actually perform basic history taking and physical exam and be able to write a SOAP note in the EMR compared to other medical students.

Everyone knows that grades in medical school are highly variable as well as clinical rotations. With your logic, might as well eliminate MCAT for medical schools. Why don't we just allow people with 3.80+GPAs enter medical school? How would you compare a student who goes to a medical school known to give everyone honors vs another medical school known to give only passing grades? Why bother taking any exam at all?
 
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Lexdiamondz said:
I mean that's pretty close to the same failure rate for USMLE and the other COMLEX exams.

PE is a dumb test. CS is a dumb test. Neither should exist, especially given they have basically nothing in common with real patient encounters however given that they do exist and literally 9/10 people pass it with minimal real preparation it's hard to argue that failures are intrinsically a result of the flawed test.
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That's a fair take. But given just how flawed the test is, I don't know how seriously we can take any of it. There is a large body of literature that discusses just how flawed the results are and I really don't think the exam has any internal validity. For example, there's data about "sequence effects" that suggests the mere order of cases you're assigned independently affects your overall score. That's ridiculous. At the end of the day, we do not know how this is graded. We don't really know what they're testing. That's not the mark of a fair assessment.
 
bananafish94 said:
That's a fair take. But given just how flawed the test is, I don't know how seriously we can take any of it. There is a large body of literature that discusses just how flawed the results are and I really don't think the exam has any internal validity. For example, there's data about "sequence effects" that suggests the mere order of cases you're assigned independently affects your overall score. That's ridiculous. At the end of the day, we do not know how this is graded. We don't really know what they're testing. That's not the mark of a fair assessment.
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Can you show me this data and flaws you speak of? I want to look into it.
 
mathnerd88 said:
Lots of things didn't exist back then. MCAT exams back then were 8 hours long, cut down to 4 for a while, then now back to 8. You can't use that as an argument. I can tell you that in 5 or even 10 years, there will be drastically different requirements for medical licensure.

And I disagree. I have seen seasoned doctors perform EXACTLY what I did for my encounter during my PE. You can diagnose most of the diseases by taking a proper history, which is what the PE aims to do. You can miss so many things if you take a crappy history or perform a crappy physical exam. I have seen residents accidentally almost kill a patient because they missed some points in their history taking.

The real goal of the PE is to actually test the student if they can perform adequate history taking and come up with differentials and a basic treatment plan based on the history they got and be professional about it. I think the PE should be a necessary screen to weed out students who may demonstrate unprofessional behavior.
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Then my preceptors have all been collectively crappy doctors because I have yet to see it a single time.
mathnerd88 said:
As to answer your other questions, there has to be a standardized exam.
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No there doesn't. The test was designed as a way to see if FMG's could basically do an adequate patient encounter in english. It was clearly a money grab. Why do you think the pass rate went from 96% every year to 93% every year? Were all of a sudden 3% more students that terrible in a one year span?
mathnerd88 said:
Step 1/Level 1 and Step 2/Level 2 are the only standardized exams that puts every medical student on the same level and compares them. The additional value that the PE exam does is to ensure the residency programs that this student can actually perform basic history taking and physical exam and be able to write a SOAP note in the EMR compared to other medical students.
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When was the last time you wrote a PE style SOAP note in an EMR? Be honest, because I've written a lot of notes in multiple EMR's and none of them are remotely close to the PE SOAP note.
mathnerd88 said:
Everyone knows that grades in medical school are highly variable as well as clinical rotations. With your logic, might as well eliminate MCAT for medical schools. Why don't we just allow people with 3.80+GPAs enter medical school? How would you compare a student who goes to a medical school known to give everyone honors vs another medical school known to give only passing grades? Why bother taking any exam at all?
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Strawman. No one is saying no exams. We are all saying that THIS exam is worthless. There is no internal validity. The only validity study out there is a one cohort study from a single school that is exceptionally weak.

I don't know about you but I find studies like this exceptionally weak. Relationships Between Scores on the COMLEX-USA Level 2-Performance Evaluation and Selected School-Based Performance Measures | The Journal of the American Osteopathic Association
 
AnatomyGrey12 said:
Then my preceptors have all been collectively crappy doctors because I have yet to see it a single time.


No there doesn't. The test was designed as a way to see if FMG's could basically do an adequate patient encounter in english. It was clearly a money grab. Why do you think the pass rate went from 96% every year to 93% every year? Were all of a sudden 3% more students that terrible in a one year span?


When was the last time you wrote a PE style SOAP note in an EMR? Be honest, because I've written a lot of notes in multiple EMR's and none of them are remotely close to the PE SOAP note.


Strawman. No one is saying no exams. We are all saying that THIS exam is worthless. There is no internal validity. The only validity study out there is a one cohort study from a single school that is exceptionally weak.

I don't know about you but I find studies like this exceptionally weak. Relationships Between Scores on the COMLEX-USA Level 2-Performance Evaluation and Selected School-Based Performance Measures | The Journal of the American Osteopathic Association
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Seriously

Exactly 0 physicians write a soap note the way the PE wants it
 
AnatomyGrey12 said:
Then my preceptors have all been collectively crappy doctors because I have yet to see it a single time.
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I've noticed that in my rotations that the physicians who do perform a full history like the one in the PE actually catch a lot of the mistakes other physicians do when they don't take a full history. It makes sense some preceptors don't do this because it does take a lot of time and sometimes, unnecessary. Every physician has their own style, but they still need to elicit a relevant full history and ROS otherwise things will be missed.

AnatomyGrey12 said:
No there doesn't. The test was designed as a way to see if FMG's could basically do an adequate patient encounter in english. It was clearly a money grab. Why do you think the pass rate went from 96% every year to 93% every year? Were all of a sudden 3% more students that terrible in a one year span?
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3% is very insignificant. If you look at the pass rates for Level 1 and Level 2, they also have varying pass rates per year within that range.

AnatomyGrey12 said:
When was the last time you wrote a PE style SOAP note in an EMR? Be honest, because I've written a lot of notes in multiple EMR's and none of them are remotely close to the PE SOAP note.
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Not exactly the way the PE is written, but every SOAP note in the EMR includes HPI, ROS, a variation of SMASHFM, physical exam, Assessment and Plan, etc. Again, every hospital has a different EMR and a different way things are done. Either way, the skill is translatable if you have to learn it the way PE wants you to or what another hospital wants you to.
 
mathnerd88 said:
3% is very insignificant. If you look at the pass rates for Level 1 and Level 2, they also have varying pass rates per year within that range.
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1. 3% is not insignificant, that's an additional 200+ students a year. 2. Since the 2013-2014 testing cycle the pass rate has consistently been at 92-93% with very minimal variability. Before that time it was more consistently at 95-96%.

There is no validity to this test. There is no data that supports its existence.
 
mathnerd88 said:
However, at least everyone is graded to a standard and the same way.
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Extraordinary claims require extraordinary evidence. I am not convinced that with the thousands of students being graded by dozens if not hundreds of individual actors with different cases, and the notes graded by dozens if not hundreds of different physicians, that everyone is graded even remotely the same way. What's your source?

mathnerd88 said:
With your logic, might as well eliminate MCAT for medical schools.
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How? You said it yourself - the MCAT adds additional value to the application process. It's a standardized exam that levels the playing field. I know how to study for it, and we all know how it's graded. If you get more questions correct, your score increases. You don't have to contend with the kind of bias you have to deal with on CS or PE.

mathnerd88 said:
How would you compare a student who goes to a medical school known to give everyone honors vs another medical school known to give only passing grades?
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Let's see...Step 1/Level 1, Step 2/Level 2, shelf scores, MSPEs, letters of recommendation, performance on sub-Is and aways, performance on interview day, the list goes on and on and on and on and on. Why, you think CS should be scored so as to better compare students?
 
Just for the record, I did not even come close to failing Step 2 CS. However, I do know very good students who did that had their fourth year turned upside down by this brazen money grab. I don't think anybody deserves that, and I've never seen one iota of evidence that supports the existence of either CS or PE. Of all the problems with medical education, I believe this may very well be the most egregious. I just want to make my motivations clear here.
 
bananafish94 said:
Just for the record, I did not even come close to failing Step 2 CS. However, I do know very good students who did that had their fourth year turned upside down by this brazen money grab. I don't think anybody deserves that, and I've never seen one iota of evidence that supports the existence of either CS or PE. Of all the problems with medical education, I believe this may very well be the most egregious. I just want to make my motivations clear here.
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At least from what I heard from our school, generally the people who have been failing the Level 2 PE have traditionally been doing poorly on their OSCEs and SP labs.

There are plenty of students who are rock stars when it comes to exams and medical knowledge, but have terrible bedside manner or are just not professional when it comes to patients.

We will never know exactly how these exams are graded, but we also have to understand that chances are that the students who failed the PE/CS probably had some deficiencies in their patient encounter. It is not so random as this thread is making it out to be. We only hear from one side of the story from the students who failed, but we also don't know exactly what they did during the patient encounter. Also, understand that students who failed will most likely complain that they did nothing wrong during their encounter and did everything correctly.
 
mathnerd88 said:
At least from what I heard from our school, generally the people who have been failing the Level 2 PE have traditionally been doing poorly on their OSCEs and SP labs.
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That doesn't mean they have problems with real patients. Unless there is data showing that performance with standardized patient exams predicts performance with real patients there is no external validity to that information.
 
V5RED said:
That doesn't mean they have problems with real patients. Unless there is data showing that performance with standardized patient exams predicts performance with real patients there is no external validity to that information.
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They might not, but every medical student goes through the same pathway to become a doctor and at least 92-93% pass every year. I'm sure there are people out there who have failed Level 1 or Level 2 CK who would make great doctors, but are screened out of many residency programs and some will never become a doctor because of that. Some people are just bad test takers.

I know people in my class who are top quartile of my class, do super well on class exams, but then did very terribly on boards that in no way reflect their knowledge base. Does that mean they shouldn't be doctors too because they can't get into a residency program due to poor/failed board scores?
 
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