Annoyances

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Hey there,

Yep I just foundout yesterday that I had failed my Exam. I took it in Dec. I have no idea what went wrong. I guess I am probably the only american to have failed this thing. I thought it had gone well too. I foundout a very odd way too. MY SCHOOL CALLED ME to let me know thinking I had already received my score which I had not. Anyhow, I have no idea what to do now. This exam is so expensive. I had to pay for hotel etc when I was there the last time and it all came out to over 1000 dollars. I have like no money now. I am applying for the match now as well and thankfully did not report this score. However, what if they start requesting it? What do I do then?
 
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Annoyances

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Yeah I just got in the mail now all official. I most definitely failed. I guess I must have not asked a lot of stuff. I was very nervous. Its funny cause my friends who took it with me passed that day. We all felt like we forgot to ask a lot of things due to time constraints and nerves, yet I never would have imagined I would have ended up failing. I mean honestly. This absurd. Oh and I have above average Interpersonal skills I am like in high performance for that etc etc it was all good minus the data gathering. How horrible. Now I have to figure out how to get $ to retake this ****ty test before starting residency.
 

August_Bier

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I think it's normal to be nervous. This helped me:

Introduced myself and always immediately washed hands so I would not forget. Asked every SP regardless of complaints first the following:

PAM HUGS FOSS
previous episodes
allergies
meds
hospitalization / surgery
urinary complaints
GI complaints
sleep
family hx
obstetric/gyn hx
social/substance
sexual

and LIQOR AAA if in pain.

location
intensity 1-10
quality
origin
radiation
associated sympt
alleviating
aggravating


While doing that, thought about what was specific / relevant for this individual case and asked those after. This test is very far from real life. It is like a game where you have to go along and pick up certain points.

Before leaving, I paused and went through what I might had forgotten and asked even if I had already "rapped the case up"

Good luck.





Annoyances said:
Yeah I just got in the mail now all official. I most definitely failed. I guess I must have not asked a lot of stuff. I was very nervous. Its funny cause my friends who took it with me passed that day. We all felt like we forgot to ask a lot of things due to time constraints and nerves, yet I never would have imagined I would have ended up failing. I mean honestly. This absurd. Oh and I have above average Interpersonal skills I am like in high performance for that etc etc it was all good minus the data gathering. How horrible. Now I have to figure out how to get $ to retake this ****ty test before starting residency.
 
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Annoyances

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August_Bier said:
I think it's normal to be nervous. This helped me:

Introduced myself and always immediately washed hands so I would not forget. Asked every SP regardless of complaints first the following:

PAM HUGS FOSS
previous episodes
allergies
meds
hospitalization / surgery
urinary complaints
GI complaints
sleep
family hx
obstetric/gyn hx
social/substance
sexual

and LIQOR AAA if in pain.

location
intensity 1-10
quality
origin
radiation
associated sympt
alleviating
aggravating


While doing that, thought about what was specific / relevant for this individual case and asked those after. This test is very far from real life. It is like a game where you have to go along and pick up certain points.

Before leaving, I paused and went through what I might had forgotten and asked even if I had already "rapped the case up"

Good luck.
Thank you I have been feeling pretty horrible didn't tell anyone I failed it either. I am actually printing this out so that perhaps it will help me and I'll stop getting nervous. Its funny because with real patients I feel so comfortable but with these fake ones I just got freaked out and I guess screwed up in the data gathering process.
 

Pili

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Annoyances said:
Hey there,

Yep I just foundout yesterday that I had failed my Exam. I took it in Dec. I have no idea what went wrong. I guess I am probably the only american to have failed this thing. I thought it had gone well too. I foundout a very odd way too. MY SCHOOL CALLED ME to let me know thinking I had already received my score which I had not. Anyhow, I have no idea what to do now. This exam is so expensive. I had to pay for hotel etc when I was there the last time and it all came out to over 1000 dollars. I have like no money now. I am applying for the match now as well and thankfully did not report this score. However, what if they start requesting it? What do I do then?
It's very unlikely that anybody will request this score. Don't worry about it and re-register immediately. I know a bunch of US grads that failed, and good students to boot. And I know people whom I wouldn't let treat the roaches in my yard that passed. It's a consequence of the test being new and grading being tentative.
Make sure to smile tons next time, and appear confident.
What books did you use to prepare?
It sucks, I know. Don't let it affect your self esteem.
 
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Annoyances

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Yeah I hope no one requests this score. The only thing I briefly looked through was first aide for Step 2 CS. Perhaps I should read more books I guess.
 

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Annoyances said:
Yeah I hope no one requests this score. The only thing I briefly looked through was first aide for Step 2 CS. Perhaps I should read more books I guess.
Lay low, very low.
 

mikeshana

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You probably did fine

You were probably one of the unfortunate that they had to fail in order to cover the financial aspects that they didnt plan out before putting this sh-t
together. (ie more US grads are "failing" than they thought would)

Mike
 

August_Bier

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The only thing you should feel horrible about ist the fact that you blew a thousand bucks - which is anoying no doubt. However failing the test has NOTHING to do with being or becoming a competent physician - can't agree more with Pili.

I don't know if you really have to read more books. The SP will mark of a box for every question you asked - so unlike in real life - if you ask a patient with CP if he is sexually active this will yield the same as asking if the pain radiates. So ask ask ask - and remember this test ist nothing but a stupid game.
 

Spiff

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I'm curious about what might have gone wrong here... how long did you spend in the room on average? How did you think your physical exams went... i.e. did you do an exam on everyone (even "psych" type cases?), not palpate/listen through clothing etc.? Did you try to ask all those history items that August_Bier mentioned? How did your notewriting go?

One thing that helped was to spend an extra few seconds in front of the door when they call "start" to write down a couple of general possible diagnoses/etiologies (i.e. if the CC is "passed out or dizziness" then just scribble down "orthostatic, cardiac, neurologic" or "psych, endocrine, neoplastic" for "fatigue")... that way if you get stuck on questions you can look at your doornotes and get some directions. Of course these are just basic ideas, and sometimes the case takes you in a little different direction.
 

monstermatch

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A couple of guys I know also failed the CS - good students, american grads. One for writing too little on his notes, another failed the "interpersonal" crap. Its a shame, and I feel for ya'll - I spent the day before my test going through all the cases in first aid for CS with a buddy and I think that got me my P. It reminded me of all of the stupid stuff that I would have otherwise forgotten - e.g., draping, be sure to cover all the ob/gyn stuff with every woman, always counsel people with bad habits (smokers, etc.), be prepared for the "special question" at each station, ("doc, am i gonna die?"). Its such a stupid, scripted encounter and you should forget about making it real - just follow the script in first aid for CS and try not to leave important stuff out of your note.
 

bsego2002

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Annoyances,

Don't feel bad. I failed too. I am AOA, 4.0 with excellent clinical comments on all rotations, excellent letters of recommendations. Do I think I am a poor clinician? Absolutely not. Do I think the test is a crock of %^#@$%? Absolutely. My score report sounds exactly like yours. The only deficiency was data gathering which was off the board negative.

I took the test August 30th and received results Jan 14th via my dean and didn't receive the printout until two days ago. Totally irresponsible. I have a good friend who is a lawyer, and I am attempting to figure out a way to litigate these bastards. Luckily I did not report my score. Unfortunately, my dean recommended I call the program directors to personally talk with them which I did until the 4th one I called told me they hadn't received the report. Son of a! At any rate, they didn't particularly care except to worry if I would fulfill graduation requirements. I went to our student promotions committee and they voted to not require passing CS for graduation and sent letters to the PDs stating such.

Luckily, I had not called the PDs at prelim programs I applied to. I looked on FREIDA and saw that most of them require passage of CS before starting. Only 1 program has contacted me asking me to release step scores which I did not. I'm counting down the days to the last rank list day. I then figure to be homefree except for passing the stupid test.

I signed up to take it April 18, so hopefully the results will be back in time. Supposedly, they will be opening more spots for people in our situation soon.

I've also tried to figure out why I failed the data gathering. I went into the test having not done a regular patient visit in 4 months, so the first two were a little rusty for asking all the questions. Then once I got in the groove, I acted like the patients were real true life encounters. I focused on the complaint at hand did the pertinent pe, came out wrote up my note and generally was done with 5 or more minutes to spare. I did not read any books beforehand. I like what others have said here about playing the game. Next time I am going to ask, ask, ask...so the SP can check off all of their little boxes. I'm going to read the books and memorize the "scripted responses" expected for each challenge question. I thought this would be an appropriate test that would accurately assess a true clinical examination. How stupid of me. It clearly is another example of playing the game.

I hope I can pursue ligation against the NBME and USMLE. Two points seem to be worth pursuit. The delay in score reports causing me to receive them when programs were compiling rank lists. The fact that they would have received them the same day my dean did would have certainly affected my ranking. I'm applying for radiology where there are so many good applicants. You can't tell me a program wouldn't see this failing as a reason to move me down the list when all other comparisons with another candidate were pretty equal. That has definite effects on my future career and I feel would provide merit for litigation. Second, the delay may prevent me from passing before starting July 1. Third, and surely a weaker argument is that I think the test didn't accurately test my clinical skills.

Any comments or suggestions are appreciated.
 

andwhat

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bsego2002 said:
Annoyances,

Don't feel bad. I failed too. I am AOA, 4.0 with excellent clinical comments on all rotations, excellent letters of recommendations. Do I think I am a poor clinician? Absolutely not. Do I think the test is a crock of %^#@$%? Absolutely. My score report sounds exactly like yours. The only deficiency was data gathering which was off the board negative.

I took the test August 30th and received results Jan 14th via my dean and didn't receive the printout until two days ago. Totally irresponsible. I have a good friend who is a lawyer, and I am attempting to figure out a way to litigate these bastards. Luckily I did not report my score. Unfortunately, my dean recommended I call the program directors to personally talk with them which I did until the 4th one I called told me they hadn't received the report. Son of a! At any rate, they didn't particularly care except to worry if I would fulfill graduation requirements. I went to our student promotions committee and they voted to not require passing CS for graduation and sent letters to the PDs stating such.

Luckily, I had not called the PDs at prelim programs I applied to. I looked on FREIDA and saw that most of them require passage of CS before starting. Only 1 program has contacted me asking me to release step scores which I did not. I'm counting down the days to the last rank list day. I then figure to be homefree except for passing the stupid test.

I signed up to take it April 18, so hopefully the results will be back in time. Supposedly, they will be opening more spots for people in our situation soon.

I've also tried to figure out why I failed the data gathering. I went into the test having not done a regular patient visit in 4 months, so the first two were a little rusty for asking all the questions. Then once I got in the groove, I acted like the patients were real true life encounters. I focused on the complaint at hand did the pertinent pe, came out wrote up my note and generally was done with 5 or more minutes to spare. I did not read any books beforehand. I like what others have said here about playing the game. Next time I am going to ask, ask, ask...so the SP can check off all of their little boxes. I'm going to read the books and memorize the "scripted responses" expected for each challenge question. I thought this would be an appropriate test that would accurately assess a true clinical examination. How stupid of me. It clearly is another example of playing the game.

I hope I can pursue ligation against the NBME and USMLE. Two points seem to be worth pursuit. The delay in score reports causing me to receive them when programs were compiling rank lists. The fact that they would have received them the same day my dean did would have certainly affected my ranking. I'm applying for radiology where there are so many good applicants. You can't tell me a program wouldn't see this failing as a reason to move me down the list when all other comparisons with another candidate were pretty equal. That has definite effects on my future career and I feel would provide merit for litigation. Second, the delay may prevent me from passing before starting July 1. Third, and surely a weaker argument is that I think the test didn't accurately test my clinical skills.

Any comments or suggestions are appreciated.
I took the practice exam in July, it was called the PIPE at the time, and I felt alot like you guys do right now... excellent letters of recommendation - honors in many rotations, and way above average clinical skills, so I had been told, and thought that it was true, and low and behold, I got my PIPE result back, and my data gathering was a minus big time, so I took a kaplan 5 day cs course in NJ, and used USMLE World.. oh man, better that I found out where I was weak sooner than later - fortunately I had a decent amount of freetime to figure this stuff out.... just found out that I passed the real deal, but I was very pissed that they thought that I was garbage during my PIPE exam - I went in literally blank though - didnt want to hear the junk advice from friends - 'oh yeah, if you did a decent number of H and Ps, bla bla bla, then thats more than enough' pure crap that was.. maybe not meant to mislead me, but I guess everyone has bragging rights,my advice is to just read the Kaplan notes.. Kaplan notes and USMLE World was more than enough for me, they covered the majority of the cases on the real thing too, including all of the physical exam maneuvers and what to ask the patients.. I definitely overdid it at the real deal, I mean I religiously asked in very much detail PAMHUGFOSS LIQORAAA, I even added my own, DOCFP - Duration, Onset, Change in pattern, Frequency, and Precipitant, for pain, and SHAFT DEATH - for dementia, Shopping Housekeeping Accounting, Travel, Driving Eating Ambulating Toiletry, Hygeine.. man it sucks because it seems like an added stressor in the very much complicated lives we all have to begin with I know.. but just go through these materials one more time, Kaplan notes ,the cases in the end are brilliant, and USMLE World - not as well organized, but includes the weird cases.. good luck guys..
 

SoonerBJJ

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bsego2002 said:
I hope I can pursue ligation against the NBME and USMLE.
I can only add that I hope you and others do so. I am finishing residency now and this does not directly affect me at all, but I have a close friend that was totally screwed in the same way. She was all-everything throughout medical school and was especially highly recommended for her interpersonal and professional skills and she flunked this portion of the CS. There is clearly a problem with this system and somebody is making a killing ($$$) at medical students' expense. I hope enough people make enough noise to get something done about this. Good luck.
 
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Annoyances

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I gotta say I agree with you there bsegoo and I hope they do get sued. I also thought it was supposed to be like a real encounter instead of some weird game. I definitely will be reading more this time around. I think it's a scam as well to make $. I mean honestly it is a stupid exam. I hadn't had a regular encounter either in about 3 months prior to that exam. I was doing electives and they were not clinic related so maybe I was a bit rusty and that combined with my nerves got me but I seriously did not think I was that horrible. I focused on asking relevant questions to the complaints I guess I too will bombard the stupid standardized patients with questions related or not to their complaints. This exam is not realistic at all you don't sit there and ask tons of questions in like 10 minutes to a real patient you focus on the problem not sit there and ask tons and tons of questions about exogenous crap (Dr. I have a stomachache. So tell me does anyone in your family have a psychiatric disorder?). I seriously hate that exam now. Anyhow, I expressed my mailed my applications to try and meet deadlines. This is such a horrible situation I had to take out an extra loan now to pay for this exam, flights if need be, in addition to hotel. This is horrible. I am dead broke after interview season and the last exam. Once again I must stress I have never been told before that there was a problem with any patient I have ever taken care of. I have always been told I was wonderful had strong rapport with patients etc. I did a SUBI in medicine for god sakes and did very well. There was never any complaints. But I guess that is not enough for this exam and it's just some stupid game. I am not reporting this score and I think anyone else in this situation should take the same attitude because seriously did could cost many of us a match at this point since this is when ranking lists are being handed in. All because of some stupid exam with glitches. In terms of the pipe exam I did try to take it as well but unfortunately was not selected for it. I gotta agree too it takes so long to grade that exam and people who need to retake it don't find out in time and then have to wait 60 days to retake it on top of all that. I have been depressed all weekend now I am just angry but I've come to accept that they failed me and now I have to retake it.
 

dlung

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I just took it yesterday and agree with all the above sentiment. It's total bulls***. It doesn't evaluate anything, except maybe self-control from laughing at the pretend patients or lashing out indiscriminately against the ACGME.

The most ridiculous thing about the whole test is that they tell you ahead of time not to properly exam the abdomen! Give me a friggin' break--they want us to take it seriously, but then flat out tell us to half-a** it?

I swear I also had a patient that was baiting me to ask about something in their social history... I didn't bite 'cause the patient was potentially going to crash ... why the hell would anyone with any common sense sit there with a possibly actively dying patient to have a long, heart-felt conversation about some private "issues" they're dealing with? I'd be pissed if I got dinged for that.

Well, sounds like I won't know if I passed or failed until after I've started my internship anyways...
 

UptownDoc

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monstermatch said:
A couple of guys I know also failed the CS - good students, american grads. One for writing too little on his notes, another failed the "interpersonal" crap. Its a shame, and I feel for ya'll - I spent the day before my test going through all the cases in first aid for CS with a buddy and I think that got me my P. It reminded me of all of the stupid stuff that I would have otherwise forgotten - e.g., draping, be sure to cover all the ob/gyn stuff with every woman, always counsel people with bad habits (smokers, etc.), be prepared for the "special question" at each station, ("doc, am i gonna die?"). Its such a stupid, scripted encounter and you should forget about making it real - just follow the script in first aid for CS and try not to leave important stuff out of your note.
I took it September 30 and got my result mid-Dec. I cosign with Monstermatch. You have to go into this whole thing with the mindset that you are trying to collect POINTS. Just play the game. The standardized patients have a very specific checklist to fill out. I HIGHLY recommend "First Aid for the USMLE Step 2 CS". It isnt that big of a book and you'd be surprise how you can pick up easy points. And it gives you a heads up on the patients you will encounter. Definitely check it out. And remember, it has nothing to do with how good of a doc you are. Absolutely nothing. Good luck.
 
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Blade28

I also second skimming First Aid. I did that while at the local bookstore (took around 1-1.5 hours), but was well worth it. They'll also alert you to some of the "tricks," like how the SP will almost always ask a tough question right before the physical exam.

"Doctor, is it cancer?"
"But I don't have insurance."
"Is my child going to die?"

Etc.
 

BlueEyesMD

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Does failing CS cout as an attempt in my records? I mean when I pass the test does the report say that I passed on the 2nd attempt. If it does, do u think it might affect the my application status

:confused:
 

swedcrip

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dlung said:
I just took it yesterday and agree with all the above sentiment. It's total bulls***. It doesn't evaluate anything, except maybe self-control from laughing at the pretend patients or lashing out indiscriminately against the ACGME.

The most ridiculous thing about the whole test is that they tell you ahead of time not to properly exam the abdomen! Give me a friggin' break--they want us to take it seriously, but then flat out tell us to half-a** it?

I swear I also had a patient that was baiting me to ask about something in their social history... I didn't bite 'cause the patient was potentially going to crash ... why the hell would anyone with any common sense sit there with a possibly actively dying patient to have a long, heart-felt conversation about some private "issues" they're dealing with? I'd be pissed if I got dinged for that.

Well, sounds like I won't know if I passed or failed until after I've started my internship anyways...
are you starting internship in July? Cause unless you're kidding I thought we had to pass this to start our internships.
 

dlung

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swedcrip said:
are you starting internship in July? Cause unless you're kidding I thought we had to pass this to start our internships.
Who told you that? I was exaggerating, but I believe you're incorrect... it'd be simiply ridiculous. Logistically, residencies across the country would be in shambles if they had to wait for those meaningless CS exam scores before allowing interns to start--there's a ton of people taking the exam in April and May... and from what people have been posting, it's taking at least 2 months to get those scores... and as long as 4 months... Anyways, it should be just like StepI/II... take it until you pass or flunk it 3 times...
 

pbmax

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I do not think you need to pass Step II CS to begin residency (or CK for that matter). The state licensing board in my state requires you pass all three steps obviously before you get full licensure, but you can technically be a resident without passing any of the three steps (provided you graduate from medical school).

I'm sure some residencies may be very diligent about making sure their applicants pass before they can start but for the most part most do not care about your scores after their match lists have been submitted.

And for the record, although I passed CS and did not study, I would recommend skimming through First Aid For CS for an hour or so just to figure out what questions need to be asked to get your points. I sweated about my result because I was not aware of the "game" that needed to be played to pass this thing. For cyring out loud, if someone comes into my practice with a musculoskeletal complaint, I'm not going to ask them about their entire social history. Just my two cents...
 

swedcrip

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CS might be a graduation requirement for us. I actually am not sure. I know CK is and we had to take that by December (they told us there was no deadline for CS). I took the test a couple days ago. I definitely agree that First Aid is wonderful (and quick). I wish I had spent a little more time with it. I think the long cases over the last half of it are probably unnecessary. But I'd check out the forms in those cases that kind of show how they "add" up points. It seems hand-washing, sexual history, asking if patient has any last questions, etc probably all count about the same.

Coulpe things I wish I had done different - early on I wish I'd have written down during the interview whenever a diff dx or test came into my head. A few times I told the patient I was getting something tested, then forgot to put it in the note. That's the kind of thing that's hard to let go and move on to the next "encounter". My handwriting isn't good enough, but still I didn't type. I'll let you know how that turns out. Save a little time in case the patient starts crying. I was rushing through my physical exam a couple of times and once really wish I could have held up to console the patient. Challenging questions often come right as I was going to wash my hands between the H&P. After answering the question, you gotta remember you were on your way to wash. I forgot once. Another time I might have forgotten too, sometimes the patient will be in pain and not sitting up and you can get a little distracted from the routine you fall into.
 

supertigger

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i know you've received a ton of advice already, but the best piece of advice i can give you is take some acting classes before you retake it. it's not real; the patients al follow a script. you just need to figure out what script they're reciting and try and play along.

as far as attempts go, i would imagine that programs would know that you didn't pass the first time simply because they know if you had to retake step 1 or step 2 ck (i have personal experience with the latter). if they ask, just tell them the truth about what happened.
 
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Blade28

I think different med schools may require passing Step 2 CK/CS for graduation purposes. I know for our school, we had to pass both by December 31st of last year.
 

rydia006

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I hope you and your lawyer friend consider suing them. I think a lot of people would be willing to give you the support.

Annoyances,

Don't feel bad. I failed too. I am AOA, 4.0 with excellent clinical comments on all rotations, excellent letters of recommendations. Do I think I am a poor clinician? Absolutely not. Do I think the test is a crock of %^#@$%? Absolutely. My score report sounds exactly like yours. The only deficiency was data gathering which was off the board negative.

I took the test August 30th and received results Jan 14th via my dean and didn't receive the printout until two days ago. Totally irresponsible. I have a good friend who is a lawyer, and I am attempting to figure out a way to litigate these bastards. Luckily I did not report my score. Unfortunately, my dean recommended I call the program directors to personally talk with them which I did until the 4th one I called told me they hadn't received the report. Son of a! At any rate, they didn't particularly care except to worry if I would fulfill graduation requirements. I went to our student promotions committee and they voted to not require passing CS for graduation and sent letters to the PDs stating such.

Luckily, I had not called the PDs at prelim programs I applied to. I looked on FREIDA and saw that most of them require passage of CS before starting. Only 1 program has contacted me asking me to release step scores which I did not. I'm counting down the days to the last rank list day. I then figure to be homefree except for passing the stupid test.

I signed up to take it April 18, so hopefully the results will be back in time. Supposedly, they will be opening more spots for people in our situation soon.

I've also tried to figure out why I failed the data gathering. I went into the test having not done a regular patient visit in 4 months, so the first two were a little rusty for asking all the questions. Then once I got in the groove, I acted like the patients were real true life encounters. I focused on the complaint at hand did the pertinent pe, came out wrote up my note and generally was done with 5 or more minutes to spare. I did not read any books beforehand. I like what others have said here about playing the game. Next time I am going to ask, ask, ask...so the SP can check off all of their little boxes. I'm going to read the books and memorize the "scripted responses" expected for each challenge question. I thought this would be an appropriate test that would accurately assess a true clinical examination. How stupid of me. It clearly is another example of playing the game.

I hope I can pursue ligation against the NBME and USMLE. Two points seem to be worth pursuit. The delay in score reports causing me to receive them when programs were compiling rank lists. The fact that they would have received them the same day my dean did would have certainly affected my ranking. I'm applying for radiology where there are so many good applicants. You can't tell me a program wouldn't see this failing as a reason to move me down the list when all other comparisons with another candidate were pretty equal. That has definite effects on my future career and I feel would provide merit for litigation. Second, the delay may prevent me from passing before starting July 1. Third, and surely a weaker argument is that I think the test didn't accurately test my clinical skills.

Any comments or suggestions are appreciated.
 

taurus70

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Don't feel like this result reflects on you as a future doctor, and you should be commended for posting it. It just means you have to repeat the dumb test. I skimmed the first aid CS more than a few times and practiced with some friends just to get the timing down. You've already taken CK so you have more than enough knowledge. You just need to get your rhythm down pat. BTW, you may get some more feedback if we can get this post "bumped" to the Step 2 forum.
 

commander

10+ Year Member
Sep 23, 2008
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Medical Student
We had something similar to the CS exam in our school and I agree it is most unfair exam ever.
Lets all write a petition to get rid of it!!!!
 

jiy76

Where's The Booze?
15+ Year Member
Sep 2, 2002
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Brooklyn NY
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Medical Student
I hope you and your lawyer friend consider suing them. I think a lot of people would be willing to give you the support.
It sucks that the guy failed the exam, but on what basis are you suing these people? Who told you to take the exam August 30? I agree they should make better efforts to make the exam either easier or quicker to grade. People shouldnt wait 3 months for their score. That was the MCAT problem back in the day until they computerized the exam. However, you knew the score reporting delay to begin with.The score reporting time needs to be fixed I agree on that part but until then we just need to accomodate.In addition no one is saying you are an incompetent clinician if you fail the exam you might have had a bad day; either way just retake the exam and be better prepared for it.