Step 2 CS failure: implications for a psychiatrist?

[medstudent234]

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I just found out that I failed Step 2CS. I read the First Aid book and prepared extensively for it, so I am kind of in shock. I have excellent Step 1 and Step 2 CK scores, have done great on my OSCEs, am a US senior, native English speaker, etc.

It was the CIS (Communication and Interpersonal Skills) portion that I failed, which is totally ironic because I'm going into psychiatry and have always been told on evaluations and by patients that I have great interpersonal skills, a caring and friendly beside manner, etc. During the exam I was always very nice and friendly with patients, asked about how they were feeling, sympathized and showed concern, communicated the differential diagnosis and plan, counseled appropriately if they had any risky habits, and asked if they had any questions or concerns. The dean of my medical school was very surprised that I failed and for what it's worth said that it often seemed somewhat random who failed this exam (it wasn't the students he was worried about when it came to clinical or social skills).

It's definitely a bummer to have to restudy and pay the $1250 to retake the exam (especially since I can't get any specifics from USMLE about what my deficiencies were), but I'm more upset about what implications this will have for my future. Assuming I pass the next time I take it, does anyone know whether this will affect my job prospects or fellowship chances in the future? I'm very interested in going into Child and Adolescent Psychiatry (maybe even a "top" program). Is it likely that some programs won't even interview me for a fellowship slot once they know that I failed the exam (an exam something like 97% of US medical grads pass on the first try)? Thank so much for any feedback!

 

[eli20]

That stinks 🙁. I know our school has really been pushing CS on us this year because last year they had way more people than usual fail for the same reasons - Communication/Interpersonal Skills. Honestly the entire thing sounds like a huge racket imo.

 

[Doctor Bagel]

That stinks 🙁. I know our school has really been pushing CS on us this year because last year they had way more people than usual fail for the same reasons - Communication/Interpersonal Skills. Honestly the entire thing sounds like a huge racket imo.

There was some talk a few years ago about getting rid of the test since almost all AMGs pass, and it's expensive and burdensome, especially when you consider that students are paying for it with loan money at high interest rates.

Anyway, no one will know that you failed it after you match, so the long term implications are just that it might affect your match. I don't know how programs look at CS scores -- it's possible a program would look at a CS failures as a fluke because they too know it's a silly test. Of course they might also know that almost everyone passes and worry that there's something grossly wrong with you. It's probably program dependent. I'm guessing you're not automatically releasing it, right?

 

[medstudent234]

I already released my Step 1 and Step 2CK a while ago and would have to specifically re-release CS or contact schools at this point to let them know I failed, which seems like a bad idea. 😉 All of my interviews are done. I know that UCSF requires it to be passed before they rank you and may specifically ask about it but that is the only school I'm aware of that has this policy (if anyone knows of any other schools please let me know). At this point all of the Dec dates are booked up so I will be taking it in Jan and won't have my score back until after programs have to rank me.

In regards to this statement: "Anyway, no one will know that you failed it after you match, so the long term implications are just that it might affect your match." Don't fellowships and jobs look at Step scores or just Prite scores? Thanks so much!

 

[Doctor Bagel]

In regards to this statement: "Anyway, no one will know that you failed it after you match, so the long term implications are just that it might affect your match." Don't fellowships and jobs look at Step scores or just Prite scores? Thanks so much!

You do include scores in fellowship applications, but I've never heard of USMLE scores as being anything that was really looked in making fellowship selections. I could be wrong, but I would be really surprised if it comes up. Jobs don't ask for USMLE scores.

 

[eli20]

I already released my Step 1 and Step 2CK a while ago and would have to specifically re-release CS or contact schools at this point to let them know I failed, which seems like a bad idea. 😉 All of my interviews are done. I know that UCSF requires it to be passed before they rank you and may specifically ask about it but that is the only school I'm aware of that has this policy (if anyone knows of any other schools please let me know). At this point all of the Dec dates are booked up so I will be taking it in Jan and won't have my score back until after programs have to rank me.

In regards to this statement: "Anyway, no one will know that you failed it after you match, so the long term implications are just that it might affect your match." Don't fellowships and jobs look at Step scores or just Prite scores? Thanks so much!

I've been trying to decide if I should try and get one by the end of december - which I'd probably have to fly out for despite being in a city that hosts CS, or to just wait and do it after knowing it won't be in for match.

 

[pisekar]

There's a guideline for CS exam which can be helpful;

http://api.ning.com/files/eIBLc*V7b...1RvSe0zdEUH9dWd-nzeVxqC/Neeraj_s_CS_Notes.pdf

 

[FlowRate]

There was some talk a few years ago about getting rid of the test since almost all AMGs pass, and it's expensive and burdensome, especially when you consider that students are paying for it with loan money at high interest rates.

So what they did was increased the US MD fail rate from ~1% to ~5% mostly via the CIS score as a way of "justifying" the test. Nobody knows exactly what they manipulated, but there are stories similar to OP littering the 2CS boards.

 

[Doctor Bagel]

So what they did was increased the US MD fail rate from ~1% to ~5% mostly via the CIS score as a way of "justifying" the test. Nobody knows exactly what they manipulated, but that's what they did.

That's infuriating. To make the test seem valid, they just decided to fail more people? I still don't get the rationale for this test.

 

[FlowRate]

That's infuriating. To make the test seem valid, they just decided to fail more people? I still don't get the rationale for this test.

They took at page from the ABIM, who dramatically increased the fail rate of both first-time boards and MOC. The same ABIM that pays themselves $$$$ through shell corporations and corporate benefits.

 

[WingedOx]

fellowships don't look at board scores or PRITE scores (only one place asked for my PRITE scores though i believe pain fellowships might ask for -ITE scores thats it) and even if they did they are too desperate to pay much attention. people will be much more interested in your clinical performance during residency
no one is going to be interested otherwise and there is no reason you would have to tell anyone you failed it. for jobs none of this matters, all they care about is that you show up, can do the work and play nicely with others.

When I was considering fellowship and applied last year they actually asked me for my entire MSPE at both programs I looked at. I REALLY doubt they even looked at it, but still I had some red flags on that thing and it was awkward to have to dig out.

 

[hamstergang]

Don't fellowships and jobs look at Step scores or just Prite scores?

At my fellowship, we look at step scores but not PRITE scores. However, we barely care about the steps. If you had multiple tries at each step, then that means something, but failing a singular test wasn't important to us. By the time of fellowship, you have evaluations from actual rotations as a doctor which is much more relevant.

 

[step2cs01]

I've been trying to decide if I should try and get one by the end of december - which I'd probably have to fly out for despite being in a city that hosts CS, or to just wait and do it after knowing it won't be in for match.

Hey dude, same boat here. So I just realized my likely #1 requires passing STEP 2CS by JAN 24th to be ranked according to their site. Even if I snatch a date before Dec 31, it'll only be reported Feb 2 earliest. And i only just stumbled across this on their 'faq' section on website. So either that program is off the table for me or they may let me report it then, which would required me to switch to something last second that opens up. this blows, hahahaha.

does anyone else know how to determine if program require CS scores to be ranked? does not appear to be in FRIEDA or ERAS ( i can only hope my likely #2-4 don't have this same requirement).

 

[Bearrie]

I think it varies by program. I hadn't taken CK until after match. One program emailed me to ask whether I planned to. I imagine others cared and didn't rank me. Obviously at least one didn't care. I do wish I has taken it sooner and remember that for CS spots became available often by rechecking frequently (just be ready to go and get on a train/plane for the next day depending how far you are). If absolutely not possible things will still be okay. 🙂

 

[Bearrie]

I was rereading this. The "red flag" question like everything in psych depends on who you ask. Definitely don't say anything now. A good portion of administrators will be scared (irrationally given everything you said) that you won't pass before residency and the funding they secured for the position will be wasted if you can't start in July. Another chunk have no idea what CS really is (it didn't exist when they were in med school) and being administrators are inclined to believe that the usmle, prite scores, etc have validity and will assume you can't communicate etc even if they were (hypothetically) initially blown away by your eloquence and your PhD in linguistics from Brown. A third group will just really like you and not care about much else. There will probably be different voices in the room when it comes time to rank so best strategy would be take it asap and email them you passed before rank without mentioning initially failing. I'm pretty sure they will take your word for it. Even for CK, a (highly respected) program just emailed me close to match to ask if i took it and whether i passed--def did not ask for written confirmation. Others feel free to disagree, but if they are inclined to take you they will take your word for it when you pass.