Steaming about Comlex II PE!

[LovelyRita]

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Is anyone else out there getting a bit riled about the physical assesment exam that we will be required to take as part of our boards? And that just to take the test is going to cost $965? And that we must travel to Philly to take it? Anyone??😡

Are practicing physicians really that incompetent in their physical examination skills that ANOTHER test is required?

I'm going to have to pay $1000+ bucks to prove that I can communicate with people and obtain medical history, etc. I worked with patients for 7 years before I started DO school. I know I'm going to pass, no problem. Is this done as part of USMLE as well? If I take both COMLEX and USMLE will I have to take BOTH physical exam exams???

Let's talk about this please!!!!

 

[dobonedoc]

Time to take it like a man.

Just glad I got through the process prior to this latest assault.

I couldn't agree more. Another standardized exam is the LAST thing medical education needs.

 

[PACtoDOC]

I am going to take the other side of the stance but allow me to qualify my response. As the former president of my student chapter ACOFP, I drafted a resolution against COMLEX PE and it made it all the way to the National Convention. The bottom line is that the powers that be are going to implement this exam in both USMLE and COMLEX, and COMLEX will be a year ahead it looks like. Personally, I think the evaluating of new physicians in PE is a good idea, but you have to look at this in terms of a left wing vs. right wing issue. The people implementing this exam are the domocrats, and the people against it are the republicans who want the government to keep their hands off. Both sides agree that testing is good, and that competency is best evaliated by testing. However, the republicans in this case feel that medical schools are accredited, thus why not give them the ability to test graduates and save everyone the trip to Phili and the 2K it will cost for the trip? The democrats argue that there is no consistency in the testing process if it is not done by trained evaluators who do it regularly. FMG's already take an exam similar to this and it does actually make sense to have standardized competency evaluations for new docs. However, to me the big issue is the fact that the only testing site to start with will be Phili, and the high cost of the exam. If they could come up with 10-20 sites across the country and charge a more reasonable fee, I think the exam would be a good idea. But without these checks and balances it just looks like someone on the NBME and NBOME board has a brother in Phili who just opened a new Cheesesteak Stand outside the hotel where we will probably have to stay and take this damn exam!!

 

[BamaAlum]

Or in your case, Mary time to take it like a woman. 🙂 Seriously though, the USMLE Step 2 will also have a required PE portion. I find it hard to believe that someone could go through 4 years of medical school and not be able to do a proper physical exam. I guess it happens, though. I am not sure if you, as a DO student, take USMLE Step 2 will be required to take the USMLE PE as well. Of course there is not much point in us DO students taking USMLE Step 2 anyway since our residency apps will be in before we get our results of Step 2. I guess if you did poorly on USMLE Step 1 you might want to submit your Step 2 scores. Anyway, yeah it sucks. Just another hoop for us to jump through.

 

[Shinken]

Originally posted by DrMaryC
Are practicing physicians really that incompetent in their physical examination skills that ANOTHER test is required?

Actually, I don't think this is such a bad idea. Not every DO student has experience with patients. Book knowledge is thoroughly tested with all three steps of the COMLEX (or USMLE), now this test will create a standard clinical test for everyone. Schools are different in their clinical years, some schools might allow you to "coast" and some might require more of you. With the clinical skills exam, licensing bodies are assured everyone has at least some basic clinical competency level.

A study was published in JAMA last year comparing clinical skills of foreign med graduates with US grads. The foreign doctors pretty much beat the US ones in basically every category. As you may know, foreign physicians must pass a clinical skills exam if they wish to practice in the US. I don't know if this study had any influence in the decision to incorporate a clinical skills exam for US students, but it definitely shows a general lack of patient skills (the study included only US and foreign MD students).

 

[stomper627]

Originally posted by Shinken
Actually, I don't think this is such a bad idea. Not every DO student has experience with patients. Book knowledge is thoroughly tested with all three steps of the COMLEX (or USMLE), now this test will create a standard clinical test for everyone. Schools are different in their clinical years, some schools might allow you to "coast" and some might require more of you. With the clinical skills exam, licensing bodies are assured everyone has at least some basic clinical competency level.

Then the schools have been failing....not the students. The responsibility then should be place upon the schools to better prepare students for/during their clinical years. After all isnt that what they are for....to develop these skills? Im paying $23,000/year to learn these things, and now some beaurocrat comes in and tells me I have to pay more, because the schools are not doing their job? I think the schools should be paying this fee then.

The best thing about this test for us (class of 2005) is that it doesnt count. It cant....nothing previous to compare it to. We will be the beta test. We are paying this money for a test, that doesnt count.

stomper

 

[LovelyRita]

Originally posted by Shinken
Schools are different in their clinical years, some schools might allow you to "coast" and some might require more of you. With the clinical skills exam, licensing bodies are assured everyone has at least some basic clinical competency level.

Then THE SCHOOLS should take the brunt of this, as Stomper said. If a student rotates through 3rd and 4th year with lukewarm patient experiences (maybe due to a couple of poor preceptors or in a situation where you are behind the intern and the resident, reducing your learning time), then sit through the exam, that reflects poorly on the school, not the student.

So the schools should pay for this exam. Or else they need to have a serious discussion with the NBME/NBOME about more testing sites and a lower fee.

Also, it seems like this test was implemented "just because" the test exists for FMG's test. Whoa!! Have these (politicians?) no faith in accredited medical schools in the United States of America? They're treating us ALL like FMG's!😱

 

[Shinken]

Good points.

Unfortunately, it seems that the AOA and the NBOME feel that it's easier to just make a clinical test requirement than to force schools to standardize and improve their clinical experiences.

Also, I think a big reason why the NBOME is instituting the COMLEX PE is that the USMLE did it. Seems that whatever the USMLE people do, the NBOME follows suit. After all, the last thing we want is for the general public to say that MD's are "better" suited for medicine because they have the USMLE clinical exam and DO's don't. I know that's a poor reason to have the exam, but a valid concern.

 

[LovelyRita]

I wish I could have been more involved when the decisions to implement this for MD & DO students were being made...

I can begrudgingly see the valid reasons for the exam....VERY VERY begrudgingly, but this whole $2000 and ONE LOCATION concept has GOT TO GO!!!!!

I heard that our school isn't even going to make an allowance in our budgets for this, i.e., so that we can get loans? Any fact or fiction to this? Are any other schools allowing for it?

 

[Dr JPH]

I think the exam is a good idea...I better get that attitude...it's inevitable anyway.

But my major beef is this...if you actually FAIL this part of the exam...what does that say about the last two years you spent in clinical education?

The people who would actually fail the clinical exam should have been found out A LONG time ago.

So, really, its just another $1000 we're spending to prove to others that we can be a doctor.

 

[dobonedoc]

What a poor, lame analogy that Repubs vs Dems was. I mean really - This is not about Phili Sandwiches and the lack of checks and balances. This is about people taking real time with real money to travel across the country to take another poor exam. I suppose that like steps I, II, and III, there will be 8 weeks until you see some type of score. There will be no feedback about why you kicked its a$$, or why you failed, or why you only got in the 87th percentile. Then you have to explain to program directors why your score sucked. If you are lucky, and are in the top 5% of "Clinical Practitioners" you will not be hurt by your score, but when applying to a competitive residency program (Sorry former ACOFP pres) you have just another silly score on a transcript that can make you less competitive.

As for DO schools having weak rotations and other ignorant talk - As a DO, I rotated among DOs and MDs alike. My individual evaluations by attending physicians and program directors (MD and DO) speak for themselves. 2 years worth of detailed evaluations are worth far more than anything another 8 hour exam could ever hope to prove.

So I feel that anyone who takes the position that this is a good idea, or that FMGs have the edge because they have taken an exam, I say you are wearing blinders to the real picture. I've worked along side MDs, DOs, and FMGs. There are the "Great," the "Bad," and everyone in-between them in each of the groups. The degree does not determine what type of clinical person you are.

 

[LovelyRita]

Originally posted by dobonedoc

As for DO schools having weak rotations and other ignorant talk - As a DO, I rotated among DOs and MDs alike. My individual evaluations by attending physicians and program directors (MD and DO) speak for themselves. 2 years worth of detailed evaluations are worth far more than anything another 8 hour exam could ever hope to prove.

Yes, indeed I am ignorant...I'm only a 2nd year, and my only impressions re: rotations comes from lovely SDN and a couple of 3rd years hanging around. I have no doubt that I will shine like a star (being facetious!!!) on rotations, regardless of whose head I can't see over during rounds.

Oh yeah, and "take it like a man?!?" Heh heh take WHAT like a man??! 😛

Thanks for agreeing that this is a ridiculous and expensive test. Lessen the fee, open more test sites, give us free cheesesteak.

M.

 

[Cookie Monster]

Originally posted by DrMaryC
Thanks for agreeing that this is a ridiculous and expensive test. Lessen the fee, open more test sites, give us free cheesesteak. M.

Couldn't have said it better myself!

 

[Goofyone]

[BEGIN PISSIN' N MOANIN']

Where's that puking smiley when you need it?


Let's be honest about what this test is:

1. $$$$
2. Keeping up with NBME's, maybe (Or using it as a second excuse, anyway)?

For those that honestly think it's about making "more competent physicians," consider the NBOME's stated reason behind the test: "high patient demand." This is ironic since most laypeople, not to mention a surprising number of people IN the healthcare field, truly have NO IDEA what a physician's training entails, not to mention which and how many licensing exams we take.

Also, and I think someone else already mentioned this, how many people can't do a freaking H&P by the end of their 3rd year of medical school? I honestly can't say for sure, but I'd bet my bile duct it would be few to none. Not to mention, the ones that can't probably will have already failed a couple of rotations, or decided that medicine isn't for them after all. To further illustrate my point, I'd wager that most med students (I'd be willing to bet at least 70% of the kids at my school) could pass this test with no problem by the end of their first year.

Anyway, it's really to late to do anything about it now. But what REALLY pisses me off, is the way they just threw this half-assed, flimflam plan together and announced it to c/o 2005 that they will be the first ones to take it next year. They've got ONE friggin site to do it. NBOME (or whoever) still hasn't announced a decision on what's going to happen if you fail. My guess: NOTHING. Pay another grand, take it again, that's it. The other option would be to offer a mandatory remedial course for $2000--which of course has to be taken in a special location. Oh, more income? How convenient!! [Maybe i shouldn't have written that, I don't want anyone gettin' any ideas!] C/O 2005 is a go for this blasted test and they can't even find out any info about it.

There is nothing so imminent that this test must be put into action so suddenly without a solid plan.

Actually, there is one thing: somebody is strapped for cash.

[/END PISSIN' N MOANIN']

 

[LovelyRita]

Maybe we should deliberately fail. Can you imagine if everyone "failed" it, how fantastic this whole thing would look?!

But then again, the bureaucrats would hike up their pants and say, "wull now, uh, yull hafta take it again so that'll be another $1000 please".

Schools should pay for it!! (have I mentioned that yet?!)

Rats.

 

[PACtoDOC]

I told you guys, its that fu#%ing Cheesesteak Vendor in North Phili who's brother is on the NBOME board!!

 

[LovelyRita]

Then the cheesesteak vendor GETS IT!!
m.

 

[bigmuny]

Goofyone is right on the money. Here is the scam. NBME/NBOME decide they need bigger bonuses and some new couches around the office, so they send out a survey to a couple of thousand people asking if they would prefer if new docs were tested on their clinical skills or not tested. Amazingly, there is an overwhelming response from patients indicating that they would indeed like their docs to have been tested on "clinical skills."We unfortunately get to pick up the tab for this.

 

[John DO]

Originally posted by stomper627
The best thing about this test for us (class of 2005) is that it doesnt count. It cant....nothing previous to compare it to. We will be the beta test. We are paying this money for a test, that doesnt count.

stomper

Unfortunately, this is untrue. I understand that this test has been beta-tested now for multiple administrations at no cost to the takers just for the purpose of standardization. There are statistics associated with it and it has been deemed valid. Supposedly, the NBOME has had this in the works for over 15 years, trying to outdo the ACGME. ACGME is just a little bit more efficient, given their resources, so they beat us to the proposal of the idea. In order to regain some semblance of originality, NBOME is now unveiling their version of the PE earlier than they anticipated, albeit an incomplete infrastructure for testing.

As for the comment above concerning ACGME students not taking it until next year, I believe that is also untrue. I have a friend in an MD school who was recently complaining about his excessive cost to apply for his boards this year, which included their PE exam (under a different title).

 

[DocWagner]

I am one of the graduates that NEVER had to take such an exam.
While I can tell you standardized tests are extremely important, I fail to understand the necessity of the high expense and the need for flying to a singular location! This is a physical exam and regardless of intent, the human factor cannot weeded out.
Furthermore, while we as physicians continue to up the requirements for graduation and competency, do we not also allow lesser degrees perform similar tasks without such rigorous standardized testing??
Will this somehow decrease medical error?? I doubt it.
Students, you need to continue to speak out...raise your voices.
While PharmD's (and others) continue to push for increasing independence, the AMA, AOA continue to place more hurdles in front of upcoming graduates. There isn't even a universal education degree for most midlevels (is it a certificate, or a BS or a MS?)
I find it extrememly interesting that the government will support help for the nursing shortage (is there a shortage or simply too many nurse managers who only push pencils now) and not find help for the INCREASINGLY high rate of tuition in medical schools.

Speak out.

 

[Goofyone]

Originally posted by DrMaryC
Then the cheesesteak vendor GETS IT!!
m.

Well, I'm going to foil this evil plot by not buying any cheesesteak when I get there!

 

[Hayduke]

Originally posted by DocWagner
I am one of the graduates that NEVER had to take such an exam.
While I can tell you standardized tests are extremely important, I fail to understand the necessity of the high expense and the need for flying to a singular location! This is a physical exam and regardless of intent, the human factor cannot weeded out.
Furthermore, while we as physicians continue to up the requirements for graduation and competency, do we not also allow lesser degrees perform similar tasks without such rigorous standardized testing??
Will this somehow decrease medical error?? I doubt it.
Students, you need to continue to speak out...raise your voices.
While PharmD's (and others) continue to push for increasing independence, the AMA, AOA continue to place more hurdles in front of upcoming graduates. There isn't even a universal education degree for most midlevels (is it a certificate, or a BS or a MS?)
I find it extrememly interesting that the government will support help for the nursing shortage (is there a shortage or simply too many nurse managers who only push pencils now) and not find help for the INCREASINGLY high rate of tuition in medical schools.

Speak out.

Right On DocW!
We have a visit coming w/ the prez. of the AOA. If you were an MSI w/ the chance for some "mic-time" what would be your queries/statements? I have a pretty good idea of what I want to ask (increasing # of schools w/no proportional increase in # of quality res. slots), but what would my senior/hopefully wiser osteopathic colleague want to ask?

H

 

[DocWagner]

Likely I would say;

Since the physical exam is highly subjective, what is to be gained by controlling the testing site and costing ALL osteopathic medical students such high costs? Wouldn't it be MORE adventageous to hold a course for potential TESTERS and then hold the Physical Exam portion of COMLEX at MANY SITES?! Wouldn't that not only decrease scheduling headaches for the AOA but also candidates?

Furthermore, without universal standardization of the physical exam (medicine IS an ART and Science)...except for TOTAL incompetence, how is the test interpreted? Realistically, academic internist A does the exam this way and community internist B does the exam that way. Osteopathic students are NOT primarily at academic centers, rather COMMUNITY centers. There is NO control from place to place.
Rather than TESTING students at the END of the year, why not implementing tests DURING the academic year at each institution the students rotate...so that goals may be attained while learning and rotating.

 

[LovelyRita]

Hayduke,
Darryl Beehler came to our school a little while back. He was asked about the COMLEX PE, and a little bit about costs, etc. His reply was rather short, and was rather empty, kind of shoulder-shrugging, sheepish. Like, he was aware that people were po'd, but there wasn't anything he could do about it.

Clearly, both MD and DO students have to take the exam as part of the boards. Why not use this opportunity to let DO schools shine by offering their students the benefit of NOT HAVING TO PAY FOR THE EXAM AND TRAVEL OUT OF THEIR OWN POCKETS!

If the AOA pres were to come, that's what I would suggest. It's going to be implemented no matter what, BUT it remains to be seen how the logistics are going to work out! (Who's going to pay for it, implementing multiple sites, etc. ) Since this is the case, we have an open window to help determine the future of this test for current and future DO students!!

Thanks Hayduke (&DocWagner too) for posting. Get your friends together on this at your school.

M.

 

[Doctor Peloncito]

Originally posted by JPHazelton
So, really, its just another $1000 we're spending to prove to others that we can be a doctor.

make that 1500-2000 for those of us who will have to fly to Philly and stay at a hotel. It's a lot easier if you are from the city where the test is being held.

 

[LovelyRita]

Here's a bit of fresh air in this stink storm (for UHS students anyway). Just heard that the exam WILL be part of our MSIV budget, and that UHS WILL be providing some travel money, depending on student's distance from the site. I don't exactly know what that means, but when I find out I'll post.

M.

 

[daveyboy]

Originally posted by DrMaryC
Here's a bit of fresh air in this stink storm (for UHS students anyway). Just heard that the exam WILL be part of our MSIV budget, and that UHS WILL be providing some travel money, depending on student's distance from the site. I don't exactly know what that means, but when I find out I'll post.

M.

I suspect it means that you will allowed to borrow more money and go even further into debt.

 

[Goofyone]

Originally posted by daveyboy
I suspect it means that you will allowed to borrow more money and go even further into debt.

Exactly. Either way, we're paying for it.

 

[IN2BATE]

im on call rite now......................BUT:

just got comlex 3 back today. Passing all three comlex exams.........great.

almost done with internship.............................also great.

not having to take Physical Exam..........PRICELESS!

FOR ALL ELSE THERES MASTERCARD.

Ha Ha

IN2BATE
PGY 1 NSU-COM alumni Class 2003

 

[Yosh]

That is CLEARLY no way to go about making friends...

Kidding....

I had a bunch of friends grad Nova '03.....

You had a great class...and you

DIDN'T HAVE TO GO TO PHILLY!!!!

 

[Hayduke]

Reviving this thread from a few days ago...
So the prez. came and went. My hoped for student "face time" never materialized. I reckon his time was a little short on the campi.

So we're a little bruised/ angry/ impotent feeling.

1.How do we convey to the "powers" that training testers at a single location makes more sense?

2.How do we tell 'em that a late game gouging when we are most vulnerable does not curry future docs' favor?

3.How do we get the AOA to start serving and stop selling?!!!!

H