scrupulous79 could not have summed up the sheer random nature and frustrations I have with COMLEX II this past year! I would second everything already stated.
Of note worth re-iterating:
1. The legal issues, though unfamiliar, are not new. Other students who took this test in the past said the same thing. There were at least 6-8 questions about what to do if you're the doctor in a rural emergency room whose hospital is out of free beds.
2. CONCUSSIONS/sports accidents were all over day #2.
3. A word about OMM -- use Savarese. Also, know PARASYMPATHETIC levels in addition to sympathetic. The latter get all the hype and press, but there were about 5-6 questions dealing with parasympathetic levels (e.g. which occipital bones, which sacral axis, which muscle that attaches to sacrum and would therefore be in somatic dysfunction, etc).
4. Step II tested not only Step II material, but also Step I and Step III. There were questions on this year's step II that were something like ... "someone has an infection here...the most likely bug is (blank)...the pathophysiologic mechanism is (blank)..." -- I was refreshed to see these questions -- they were possibly the most straightforward ones on the exam (this is sad), though a bit misplaced due to their content.
Unfortunately, the COMLEX is not designed for all medical students. I was more concerned with calculating the free water deficit in a hypernatremic patient, determining the FeNa+ in an oliguric patient, thinking about the metastatic patterns of certain neoplasms, cramming the approximate developmental milestones of growing children, and thinking of the differential diagnosis of a solitary lung nodule. Instead, this exam dealt more with anecdotal practical knowledge, largely that knowledge concerned with office-based primary care. Correct me if I am out of line, but the purpose of medical school, contrary to the practice reality of many osteopathic schools, is not to learn about medicine in the way of a seemingly old-world apprenticship format. We are to learn the facts, interpret them, apply them to cases we see on standarized exams, then go out as housestaff and use that intuition and knowledge to truly learn from our patients (emphasis being that this is where the TRUE learning takes place). This approach has been TIME-TESTED and is THE most efficient way of disseminating vast amounts of knowledge and understanding to the greatest number of individuals. One-on-one mentoring has its place, but not at this early of a stage in our medical careers. Although we catch pearls of wisdom and learn 'how-to-be-a-nice-guy-that-everybody-likes-as-a-model-practicioner', we also pick up on idiosyncracies, short-cuts, and bad habits based on anecdotal evidence. Okay, off my soap-box.
The students I spoke to who felt this was a straightforward test were those planning to go into office-based primary care. In fact, as scrupulous79 stated, there is *nothing* you can study from to hit up most of the obscure topics. One book that actually comes close to addressing some of these topics is SWANSON'S FAMILY PRACTICE REVIEW (ISBN: 032300914X). Compared with Prescriptions or First Aid, which focused more on the clinical disease states that comprise the body of USMLE step II material, Swanson's has a lot of useful, "mom-&-pop-kind-of-information" that one would need on day 1 out of a family practice residency and that is also more reflective of COMLEX content.
Looking ahead to Step III (not that far off if you take it early in your internship year), many interns from last year's class I spoke to praised Swanson's as a "one stop source" of info. for COMLEX III. For what it's worth--I already have a copy.
One bit of silver lining RE: COMLEX II--we as a class ('04) are not going ot have to travel and dump out over 1,000 extra bucks plus travel expenses, hotels, etc. for the OSCE/CSA/PE component of Step II.
