Step CS failure

[nirvana23]

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Much to my dismay, I actually failed CS!!!!!!!!!!!!

Let's skip the part that makes me want to ram something through some NBME official's throat.😡 😡

How will this affect my application in the match? I'm applying to IM. Anybody have any insights?

 

[Samoa]

Have you set up ERAS so that it automatically transmits your scores? If not, you're fine--the programs will never know. All you have to do is take it again and pass it before residency starts. And that's if your residency requires it to start.

By the way, where did you take it?

 

[nirvana23]

Thanks, Samoa.

Unfortunately, I did set up ERAS to send my scores automatically. I never in a million years thought that this would be a problem.

My application is solid otherwise... I dunno. Maybe I was overconfident assuming that I would pass CS. Nothing I can really do about it now.

I took it in Chicago in Dec.

 

[bruinkid]

do you remember what you did wrong?

 

[nirvana23]

do you remember what you did wrong?

Honesty? Nothing. Introduced myself by name, washed hands, etc....

I passed all of my OSCEs in school with flying colors. I don't get it...

 

[doc901333]

it happened to a bunch of us last reporting period. I failed data gathering b/c I don't think it is important to ask someone with chest pain what they do for a living or if they prefer to have sex with men or women. The high side to this is that ALL of the programs I interviewed with didn't believe in the test's validity after last reporting session. When they changed the standard in Sept many people failed. You are not the only one.
Good Luck.

 

[deleted113029]

Thanks, Samoa.

Unfortunately, I did set up ERAS to send my scores automatically. I never in a million years thought that this would be a problem.

My application is solid otherwise... I dunno. Maybe I was overconfident assuming that I would pass CS. Nothing I can really do about it now.

I took it in Chicago in Dec.

What component of CS did you fail? For US seniors it's ICE, for FMGs it's CIS/SEP. Data gathering gets most people as Doc90210 said.

I also took it in Chicago in December.

 

[IFNgamma]

well, nothing else to do for you except to try to register ASAP and retake it.

which part did u fail? try to remember what you did wrong and correct it next time.

 

[Samoa]

They specifically say that a complete H&P is not what they want. So how can they fail people for not getting one?

As for me, I'm really worried. I'm quite capable of doing a complete history and physical, if that were what they asked for. But it wasn't. Instead, I followed the instructions and focused the encounter on the chief complaint, with very limited attention to other issues. I asked enough questions to generate a differential, and did enough exam maneuvers to feel comfortable ranking them in order of likelihood, and determining what further testing should be done. I'll be very upset if it turns out those instructions were misleading.

 

[Moozer]

I felt like a lot of things were difficult / unclear. I had a ton of cases that required a neuro exam which makes you lose time in your write up...I didn't even get to check most of my HPIs...they may have been rambling piles of crud...We'll see what happens in about a what...MONTH AND A HALF?!! No nervousness to be built up in that timeframe!

 

[deleted113029]

I felt like a lot of things were difficult / unclear. I had a ton of cases that required a neuro exam which makes you lose time in your write up...I didn't even get to check most of my HPIs...they may have been rambling piles of crud...We'll see what happens in about a what...MONTH AND A HALF?!! No nervousness to be built up in that timeframe!

believe me when i say that i understand your anxiety. avoid the step 2 forum; SDN is NOT the place to reduce your stress level.

i didn't check my HPIs on any of my patients. i just trusted my short-term memory and just moved on. my notes consisted of crowded writing near the borders with arrows and carets...my notes looked like treasure maps.

drink a little wine/beer...it'll calm you down AND pass time. 🙂

 

[JulianCrane]

believe me when i say that i understand your anxiety. avoid the step 2 forum; SDN is NOT the place to reduce your stress level.

i didn't check my HPIs on any of my patients. i just trusted my short-term memory and just moved on. my notes consisted of crowded writing near the borders with arrows and carets...my notes looked like treasure maps.

drink a little wine/beer...it'll calm you down AND pass time. 🙂

Can you take notes during your patient interview??

 

[deleted113029]

Can you take notes during your patient interview??

yes. they provide scrap paper, a pen, and a clipboard. just remember to make eye contact when you ask questions before you start writing down their answers.

 

[Moozer]

believe me when i say that i understand your anxiety. avoid the step 2 forum; SDN is NOT the place to reduce your stress level.

i didn't check my HPIs on any of my patients. i just trusted my short-term memory and just moved on. my notes consisted of crowded writing near the borders with arrows and carets...my notes looked like treasure maps.

drink a little wine/beer...it'll calm you down AND pass time. 🙂

Thanks for the encouragement. I guess I'm kicking myself a little for not handwriting, but I type a lot faster than I write, so I figured that was the lesser of two evils. You're probably right though, just need to chill...I think the beer/wine thing is especially good advice...I better go get started on that right now! 😉

 

[CptMorganMD]

I am not a stellar medical student and I did not score in the upper percentiles on either Step 1 or 2CK, but the one thing I am comfortable with is taking an H&P. I am going into Psych and have spent a lot of time with patients even before getting into med school. I failed the Data Gathering portion of the ICE by such a wide margin that I only have an asterisk and 4 “x”s next to it on my score report. There is no explanation for that. I did not do my best work on those histories, but who does in the ridiculous amount of time allotted?

My med school has an OSCE so similar to the CS exam that one case (a telephone case), was exactly the same word for word, and I passed every station there. I think I forgot to drape the phone, but other than that everything went fine.

I cannot prove that I did nothing wrong in the encounters, but the whole reason that our legal system has been set up this way is because that is impossible for anyone accused or wrongdoing. I would challenge the NBME to prove that I did something wrong, but they don’t use the video for that.

I wanted to get in touch with those others of us seniors facing this nightmare who want to do something about it, but the other thread got closed before the idea really took off. I am serious about getting in touch, I am not just writing this to scare anyone and I would appreciate it if anyone thinking of accusing me or insulting me could do it elsewhere. Where are our numbers?

 

[googoodolljen]

Well it is nice to know I am not alone, but I have a few questions about the allopathic world. I found out I failed the Humanistic Domain portion of the Osteopathic Clinical skills test this week that I took back in December. On the score sheet we are given, it states humanistic domain to mean simply "Doctor-patient communication, interpersonal skills, and professionalism." When I called to see if there was a way to find out any further details as to why I failed or to ask for a re-evaluation, I was told neither was an option and my only explanation for failing was stated in the description listed above. We are not given a score we are only given a pass/fail.

My question is, is this the only explanation received when taking the USMLE CS version? Also, how many dates are offered in order to take this in the allopathic world? Because when I went on to signup to retake it, the first available date possible is May 14, 3 days AFTER I am supposed to graduate.

My last question is, how much does the test cost for you (ours is $995) and how many sites is it offered at (we only have one in PA).

I am on the verge of seeking legal council to see if this is legit. No reason stating why I failed a test I STRONGLY feel I shouldn't have and possibly treatening not only my graduation, but also starting residency seems unbelievable to me. I can't believe this is happening.

The next worse part is that apparently the person I spoke with in regards to trying to fight to get some sort of explanation for failing was the director of the National Board of Osteopathic Medical Examiners and I apparently pissed him off because he called the Dean of my school and I am now being threatened that if I don't write a letter of apology, there may be further altercations. Unbelievable, this is my worst nightmare come true. All I want is out. Medical School has been the most unjust, defeating experience of my life!

 

[CptMorganMD]

Our school forces us to pay for one of two health insurance plans with Blue Cross and if you try to get out of it, they threaten to kick you out. So you write a check for more than $4k per year and make it out to the school instead of BCBS (fishy...). The endless stream of injustices started before classes did and continues today. The bottom line with med school is that they are going to make their money no matter how poor of a job they do. Even if they did so bad of a job that half as many people applied, they would still fill their seats every year. There is no consequence for their failure as an academic institution and without consequences there is no change.

Which brings us to Step 2 CS. I don't think anyone who speaks English legitimately fails this exam, but there are so few who fail it there is no impetus to fight it. Ours is $1005 (or $2010 in my case) and no one who takes it says it is worth a damn, regardless if they pass or fail. The schools don't care if you pass and neither do the residency directors, unless of course it will interfere with your graduation. The only reaso to retake it is that you must pass it to get your license and move on. It would cost more in legal fees to fight it than it would to retake it, and with a slight chance if any of success, it simply isn't worth going it alone. If there were a great enough number of people involved, they test would die. Most people would rather just pay their $1k and get on with it.

 

[JulianCrane]

How important is the patient note in comparison to data gathering in the score on the exam. What happens if you forget to include a couple of pertinent negatives in your note that u actually did on physical exam? My school has a mock CS thing and, after I came home from it, I remember that I did that for a couple of patients.

 

[ortho060802]

I don't think anyone really knows how this exam is graded. There is very little official info out there. I am sure you will get docked a point or whatever the grading system is but on the real test I think two real MDs read the note and grade it vs. some perfect note??? Then you just get a p or f. Good luck

 

[adcomm]

one of my attendings is a note grader and said that there is no checklist for the note, it's more like "would I find this note acceptable"

 

[loveumms]

In regards to taking the CS I have heard a variety of excuses.

I have been told that it began with only IMGs needing to pass due to the need to ensure language skills in US doctors. OK, I can understand that. Then supposedly patients got wind of this test and started demanding that ALL US doctors take it since they thought doctors were not able to communicate and be empathetic. Well, would the medical board require us all to work out every day if patients started saying doctors are out of shape? I know that is not really a great analogy but, it's the best I can think of right now.

I personally think its a crock of sh** and that it's only a way to make money off the already poor medical students. Think about it - there are approximately 24 people taking the test at most centers - that is ~$24000. It probably costs them about $8000 to employ the graders, SPs and proctors and that is being very generous. I think they probably make around $15 an hour - 24 SPs and then 5 proctors for 10 hours that day is $4350 then add $1650 for the docs grading the notes and then $2000 for health care costs. Then about $2000 for rent and overhead. That is $10000 a day it costs them to run the test. Profit is $14000 each day. I don't know how many test dates there are in a year but I'm guessing around 50 that equals $700,000 times however many sites (I believe 5). 3.5 MILLION.

How sad is that????

 

[Samoa]

preachin' to the choir...

 

[loveumms]

preachin' to the choir...

I was just making a point.