STEP II CS, biggest scam of all time?

[78222]

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1000$ + airfare + lodging for a test that is primarily used to subjectively judge whether I can speak English? You gotta be kidding me. We aren't even given extra financial aid to pay for this sucker (and of course we take it at the time in our careers when we have the most expenses). I can understand STEP II CK but CS is simply another way to bleed med students dry for as much $$$ as is possible.

 

[Termwean]

I completely agree (I took at the beginning of the year). Why do they need to know that I speak English anyways? After all...70% of my patients don't even speak english.😀

 

[Gibbles]

Actually, the biggest travesty of the whole thing is that you pay easily $1400, and yet, you will receive absolutely no feedback about your performance other than a "pass". Sure, if you fail, they'll tell you what aspects you can improve upon, but you'll still receive no input about how you can improve, how the patients felt about your encounter with them, or the general impression of the person behind the glass.

It's sort of like the last two years of medical school. At that point grades, passing, honors, etc. don't matter. Tell me what I'm doing wrong and how I can improve it and tell me how I can improve what I'm doing right even more. Everything else (including that coveted "A" or "honors" is worthless to me.

Another important note is the fact that CS is actually being phased out. Just like Step 1 and Step 2CK are now becoming Gateway.

 

[Seph09]

So true! The best part of taking CS was the chance to travel. I took mine in Chicago and had some Giordano's...yum.

 

[yaah]

I was part of the last med school class that didn't have to take it. I was exceedingly happy, and the more I read about it the more I realized what a piece of crap it was. They would justify it by saying things like, "We did a survey of patients and asked if doctors should have to take a test with simulating patients demonstrating that they could take an adequate history and communicate with the patient, and overwhelmingly patients said they thought it was a good idea!"

I don't know about you guys, but in my med school training I had simulated patients starting in second year and running through fourth year, many of them were graded interactions. If a school isn't able to certify students in this manner without a nationalized exam, then perhaps they shouldn't be med schools.

 

[rox]

I agree. I am a Non-US med student from oversees. I took my CS last month, I felt it's kinda a good idea for non-US students, but for a US student, it doesn't make sense at all especially given the extremely high success rate and the crazy expenses.

 

[CanIMakeIt]

I agree. I am a Non-US med student from oversees. I took my CS last month, I felt it's kinda a good idea for non-US students, but for a US student, it doesn't make sense at all especially given the extremely high success rate and the crazy expenses.

Until recently it was only for IMGs but I think someone at AAMC thought hmmmm there are only 4-5K IMGs taking this test for $1000 and that is not too much money but if we could expand it to 16,000 AMGs then we got ourselves a cash cow every year worth $22 million. It is a crap test. In real life you are not going to run out of the room when 15 mins are over. and no one finishes notes between patients. There is never enough time (at least not for new patient h&Ps)...this whole thing is totally bogus and BS .... needless to say I took it last week and I am still angry at them for making me waste $1100+hotel+travel ... why are we not protesting/petitioning against this stupidity?

 

[rox]

I would protest with you guys.

 

[pocketknife52]

While it

 

[johnsmith777]

If there was no StepII CS, how would the NBME make money?

It's all about the benjamins.

 

[PeepshowJohnny]

While it may be true that step 1 and step 2 are going to be combined into this Gateway exam in just a few years, that does not mean they are getting rid of the clinical exam (CS). My guess is that it will be a two day test administered after third year, the first day being the written part and maybe the second day being the clinical skills exam. Or hell, the NBME is so stupid that they would maybe make a three day test......who knows..........No one has said for sure that something like CS will be removed once the gateway exams begin.......in fact id be willing to bet otherwise

Yeah, the rumor I heard was that some NBME guy said something like (paraphrasing here) "While Step 2 CS would obviously not exist in its current form in the combined system, a similar test would arise to meet its necessary place"

Complete and utter garbage.

 

[Gibbles]

Yeah, the rumor I heard was that some NBME guy said something like (paraphrasing here) "While Step 2 CS would obviously not exist in its current form in the combined system, a similar test would arise to meet its necessary place"

Complete and utter garbage.

This is more along the lines of what I've heard, as well, although I have heard that the current CS testing sites will no longer be used in the future as there is talk of not renewing the leases and selling the buildings that are owned or rented by the NBME.

If you ask me, the school-wide OSCEs that many of us take should be standardized for each school, but the scoring should be kept within the school instead of making it a regional or national affair. However, a "pass" should still be required to continue with your medical education.

 

[pdp2001]

If there was no StepII CS, how would the NBME make money?

just take my loans. no need for the money to even get into my account. not like it's staying there for any useful period of time.

 

[error404]

Total scam.

Yes, I think that its important that we demonstrate proficiency with patients. However, why this has to be done for $1500 in certain centers....

I think that we demonstrate proficiency with patients ALL the time already-- on the wards. My school even does a miniCS exam at the end of every year already. So, why can't schools take responsibility for the education of their students on this level too? Advise attendings to oversee our interactions more frequently, and generate a few evaluations over the years. Make a new graduation requirement that you have to have an attending "sign off" on you as having adequate clinical and interpersonal skills.

[Disclaimer: I do think the test has some relevance for IMGs looking to practice in the US, as the US system can be very different. But maybe anyone doing a rotation at a US school should be able to get a waiver if an attending signs off on their skills.]

 

[IzzyMD09]

😡

I mean the acting was so bad, I had a harder time not laughing as opposed to writing the PN, this test seems completely unecessary. I think the OSCE's at my school (yes I am an FMGger) were way harder, and they were also in Enlgish, but the acting was better to. The SP's clearly had no medical knowledge of the illness they were feigning, I cant believe this test is 1200 dollars, the sandwiches werent so great either.... I did steal a pen though, it is now the most expensive bic pen I own...worth 1200 dollars

🙂

 

[Nuriko]

No airfare and lodging for me!! (I live about 20 minutes away from one of only 5 test centers in the country) 😀😛

That being said, Im taking it tomorrow. And that doesnt make it any less of a scam. 😡

 

[Gumshoe]

Actually, the biggest travesty of the whole thing is that you pay easily $1400, and yet, you will receive absolutely no feedback about your performance other than a "pass". Sure, if you fail, they'll tell you what aspects you can improve upon, but you'll still receive no input about how you can improve, how the patients felt about your encounter with them, or the general impression of the person behind the glass.

It's sort of like the last two years of medical school. At that point grades, passing, honors, etc. don't matter. Tell me what I'm doing wrong and how I can improve it and tell me how I can improve what I'm doing right even more. Everything else (including that coveted "A" or "honors" is worthless to me.

Another important note is the fact that CS is actually being phased out. Just like Step 1 and Step 2CK are now becoming Gateway.

Awesome post. Why? Because it's right on.

I've heard the "phased out" thing for YEARS now; I've taken all steps ... but this thing isn't going away. I think psychiatrists (MDs in "administrative positions") instituted this sort of thing and of course it had the backing of the public and accreditation. Who would say "Oh that's not necessary"? Only people who are involved in it and know what it truly is could actually have the basis by which to say that, and judge it justly.

I doubt it's going anywhere and I doubt you can show me one shred of evidence that even points this way. I love your post but that part at the end got my attention.

Best wishes to all, in any case

GS

 

[scube]

I was part of the last med school class that didn't have to take it. I was exceedingly happy, and the more I read about it the more I realized what a piece of crap it was. They would justify it by saying things like, "We did a survey of patients and asked if doctors should have to take a test with simulating patients demonstrating that they could take an adequate history and communicate with the patient, and overwhelmingly patients said they thought it was a good idea!"

I don't know about you guys, but in my med school training I had simulated patients starting in second year and running through fourth year, many of them were graded interactions. If a school isn't able to certify students in this manner without a nationalized exam, then perhaps they shouldn't be med schools.

my school does the same thing. The real test after you see the patient isn't how well you interacted with the patient although the SP will tell you what they thought about you, usually I don't care. The real test is did you get the information that the person who wrote the exam felt was important. Seriously I lost points on a patient because I didn't ask about hemoptysis but I did however ask if their cough was productive, it wasn't. This kind of situation comes up all the time. They wonder why I'm not enthusiastic about "seeing patients". I learned how to play the game and pass. At least we done Step2 CS stuff every exam period. There are many ways to skin a cat but only one way to pass a clinical competency exam.

 

[scube]

I doubt it's going anywhere and I doubt you can show me one shred of evidence that even points this way. I love your post but that part at the end got my attention.

I've heard this several times in the last year. I even heard that the class of 2011 will be the last to take all three steps. I've heard it at AAMC meetings. My last psych patient told me about it. google it, everyone knows about it. the only source I haven't heard it from is the NMBE. weird.

 

[scube]

😡

I mean the acting was so bad, I had a harder time not laughing as opposed to writing the PN, this test seems completely unecessary. I think the OSCE's at my school (yes I am an FMGger) were way harder, and they were also in Enlgish, but the acting was better to. The SP's clearly had no medical knowledge of the illness they were feigning, I cant believe this test is 1200 dollars, the sandwiches werent so great either.... I did steal a pen though, it is now the most expensive bic pen I own...worth 1200 dollars

🙂

gotta love it when SPs try to do pain!!!

 

[Gumshoe]

I've heard this several times in the last year. I even heard that the class of 2011 will be the last to take all three steps. I've heard it at AAMC meetings. My last psych patient told me about it. google it, everyone knows about it. the only source I haven't heard it from is the NMBE. weird.

... which means it is BS. Sorry to divulge the obvious to coming years, but it's unfair to get their hopes up. This test ain't goin' nowhere --- everyone knows about it except the people who matter.

 

[maceo]

I don't know about you guys, but in my med school training I had simulated patients starting in second year and running through fourth year, many of them were graded interactions. If a school isn't able to certify students in this manner without a nationalized exam, then perhaps they shouldn't be med schools.

I agree with you. During third year you do countless history and physicals, writeups focused interactions with patient with residents standing right there. How could they not grade you from that? Perhaps its the 24 million per year they make on that exam.

My school was actually one of the test schoolsso i actually took it at my med school to test out the program but it was like 5 years before they started to administer it for real. i thought it was stupid back. it was allday on a saturday. I couldnt believe how ****ty that experience was.

 

[maceo]

😡

I mean the acting was so bad, I had a harder time not laughing as opposed to writing the PN, this test seems completely unecessary. I think the OSCE's at my school (yes I am an FMGger) were way harder, and they were also in Enlgish, but the acting was better to. The SP's clearly had no medical knowledge of the illness they were feigning, I cant believe this test is 1200 dollars, the sandwiches werent so great either.... I did steal a pen though, it is now the most expensive bic pen I own...worth 1200 dollars

🙂

dont say you stole a pen. They will come after you and cite you for usmle impropriety. just sayin' see the other thread.

hey just out of curiosity? if they combine step 1 and 2, how are those arse school administrators going to keep people back and charge them another years tuition for failing step 1?

 

[jake2]

The thing that ticks me off isn't so much the $1500 (... okay ... that does) but the fact there is about a 3% essentially random, as far as I can tell for AMGs, chance of having a scarlet letter of failing an nmbe exam on your record forever. And, if you weren't able to get an early test date as I wasn't, it has the potential to seriously screw up your career.

From my understanding, it's not the NBME but a private, for-profit company that actually does the administrating of the exam. Some guy found a way make tens of millions by essentially taxing every new doctor in the US, and all he has to do is seriously screw over like 3% of them. What a bargain for him, and for those 600 or so jerked around, screw 'em!

 

[doctorFred]

it's all about the benjamins, baby.

 

[IzzyMD09]

AGAIN LET ME SAY THIS TEST IS A SCAM AND A HUGE WASTE OF MONEY

It was (no offense to ******ed people) ******edly easy

Want to pass....just be nice....you dont have to know anything, you dont have to do anything correctly

Just wash your hands, be nice, do a chest and abdominal exam, have closure, answer questions and be nice.....

Of course I could have done that after year 1,

This is coming from me an FMGger, I mean yeah I am fluent in English (my only language despite several attempts to learn French and Hebrew) but this test is a complete and utter waste of time and money...

If they are cancelling this test which they should, it demonstrates its inadequacy of providing any beneficial use to medical education, and I believe all students who have had to take it from year 2007-2011 should be completely refund the 1200 dollars it costs to take, the acting is horrible and the lunch was not that good!

 

[Law2Doc]

...
Want to pass....just be nice....you dont have to know anything, you dont have to do anything correctly

Just wash your hands, be nice, do a chest and abdominal exam, have closure, answer questions and be nice.....

Of course I could have done that after year 1,
...

I would tend to agree that a disproportionate amount of the score seems to come from having a nice pleasant conversation with the SP, asking the basic HPI questions (where is the pain, describe it, does it radiate, anything make it better or worse), not asking compound questions, telling smokers they shouldn't smoke, and doing the niceties like hand washing, draping the patient, maintaining eye contact, not repeating painful maneuvers, and saying things like "I'm so sorry to hear that". Do a mediocre job at a targeted physical exam, spend a minute at the end telling the patient your thoughts and what you would do next, and write a legible soap note (use the computer if your handwriting is lacking) and you are golden. Most people who do this manage to pass. Just my two cents.

 

[Knicks]

The thing that ticks me off isn't so much the $1500 (... okay ... that does) but the fact there is about a 3% essentially random, as far as I can tell for AMGs, chance of having a scarlet letter of failing an nmbe exam on your record forever. And, if you weren't able to get an early test date as I wasn't, it has the potential to seriously screw up your career.............

Sorry, but maybe I'm just too tired at the moment, but exactly what (from the quoted text) "has the potential to seriously screw up your career"??

 

[ZonaRidicularis]

.

 

[jake2]

Sorry, but maybe I'm just too tired at the moment, but exactly what (from the quoted text) "has the potential to seriously screw up your career"??

If you can't take it again early enough to get scores before internship starts. In most states, you need to pass it to be licensed. You thus risk loosing your internship/residency if you fail on a late test date. I'm sure most residency directors would make some accommodation, but you could potentially be seriously screwed.

 

[DominicanaMD]

1000$ + airfare + lodging for a test that is primarily used to subjectively judge whether I can speak English? You gotta be kidding me. We aren't even given extra financial aid to pay for this sucker (and of course we take it at the time in our careers when we have the most expenses). I can understand STEP II CK but CS is simply another way to bleed med students dry for as much $$$ as is possible.

Ugh....🙁.I completely agree. I'm taking it this summer!

 

[logos]

Sorry, but maybe I'm just too tired at the moment, but exactly what (from the quoted text) "has the potential to seriously screw up your career"??

The random 3% thing comes from the fact that a small number of students seem to fail randomly, without any rhyme or reason.

The statistical evidence that this happens is seen by comparing the pass rate ~95% with the pass rate for repeat takers ~95%. If the exam were testing something, one would expect the pass rate for second time test takers to be lower than first time takers. That is, you would expect that people who failed did so because they didn't have sufficient knowledge/skill/whatever to pass and thus would have a lower chance of passing on the second go around. That's why for example the step I pass rate for first time takers is around 95% but the pass rate for second time takers is only like 60 some percent.

 

[valleyrekt]

Step 2 CS in 2018....what a nightmare.