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- Apr 4, 2013
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I just wanted to close the loop and share my mistakes and give some info/hope to those down the line participating in the match with a failed CS.
I'm a US MD from a mid-ranked program who applied for general surgery with 250+ Step I and II CK. I took CS in September and found out I failed in December. I researched online and realized there was a paucity of advice and even fewer success stories for US MDs, and I felt confused and hopeless for a long time. After I failed, I felt devastated and thought that I was a poor communicator, then I was pissed that such a dumb, useless, money-making test existed, then I was anxious that I would fail again and get withdrawn from the Match and not be allowed to graduate, and then I survived, and you will too.
I failed CIS with mostly low performance, but my SEP and ICE sections were in the high performance range. I was shocked--throughout my clinical years, patients always told me that I'm a good communicator and I passed my school's OSCEs without issue. When it came to the actual exam, I thought I was taking it seriously at the time, but in retrospect I definitely didn't make a real effort to empathize, summarize, etc. because I just wanted to get through the encounters and have enough time to write my note, meet up with friends after the exam, and start my away rotation the next week.
By the time I failed, I had already submitted my ERAS with my Step I and II CK scores included. My school recommended against re-submitting my updated USMLE transcript with my failed CS score. I met with the school's director of simulation to go over the exam and communication skills. During that meeting, he really emphasized to me that a) he could tell in the first few minutes of talking to me that I wasn't a bad communicator, b) the test is extremely subjective, and c) because it's standardized, there was a certain checklist of items the USMLE wanted me to do in order to pass (i.e. empathy, summarizing, dealing with difficult patients), which I needed to hammer home the next time. Since there were no longer many open spots for a retake in December, I signed up for a January date with a score release for March--AFTER rank list submissions and only 1.5 weeks before the Match. I went through the rest of interview season shaking in my boots in fear that someone would ask me why my CS score was missing or that a program would need a documented passing score in order to rank me. None of my programs ever did. (Caveat: I will say that some classmates did get reminder emails from programs to resubmit their USMLE transcript after the CS score release, so it depends on each program's requirements. Overall, it might be beneficial to just not retransmit the score because it will likely hurt your chances more if every program on your list sees your fail vs. if only a few don't rank you because your score is missing.)
I studied for 4 days before my retake using FA, went over their exam tips which I found pretty useful, and then practiced only a handful of the cases which I didn't think were that helpful. I definitely made a lot of changes to the way I handled the encounters, but I still felt like trash after the day ended, worried that I spent so much more time on communicating that I did very brief physical exams, rushed the counseling, had to leave the room in the middle of answering a few challenge questions, and had less time to write the notes. I read a bunch of posts on SDN about other people's mistakes, which made me more anxious as I waited for my score. I ended up passing with my CIS score in the high performance category while my ICE score barely dipped into the borderline. I checked back in with my school to see if there was anything I needed to do with only 1.5 weeks left until Match, and I was told that my matched program would receive my full official USMLE transcript regardless and that there was nothing for me to do. Fast forward to last Friday when I found out that I matched at a highly-ranked surgery program and my #1 choice.
So here's some advice to fellow US MDs: 5% fail on the first attempt, and you're not alone even though it feels that way. Sometimes **** happens and you mess up--because it's subjective, everyone has a completely different experience. Some people who made the same mistakes I did (or even worse) end up passing yet others don't. It can happen to anyone. Trust that you have been trained well--if 95% of US MDs pass on the first attempt, I imagine the percentage is MUCH higher for US MDs who pass on the second try. Work hard, learn from your mistakes, be open to advice, try to stay away from SDN, and stop freaking out! Don't let a bad result on this test mess with your sense of who you are--the past few months really tested my self-confidence--but this isn't a reflection of your abilities as a student, friend, colleague, doctor, etc. Ultimately, it's just a very expensive hoop that you have to jump through to get where you're headed, so take it seriously and then move on!
I'm a US MD from a mid-ranked program who applied for general surgery with 250+ Step I and II CK. I took CS in September and found out I failed in December. I researched online and realized there was a paucity of advice and even fewer success stories for US MDs, and I felt confused and hopeless for a long time. After I failed, I felt devastated and thought that I was a poor communicator, then I was pissed that such a dumb, useless, money-making test existed, then I was anxious that I would fail again and get withdrawn from the Match and not be allowed to graduate, and then I survived, and you will too.
I failed CIS with mostly low performance, but my SEP and ICE sections were in the high performance range. I was shocked--throughout my clinical years, patients always told me that I'm a good communicator and I passed my school's OSCEs without issue. When it came to the actual exam, I thought I was taking it seriously at the time, but in retrospect I definitely didn't make a real effort to empathize, summarize, etc. because I just wanted to get through the encounters and have enough time to write my note, meet up with friends after the exam, and start my away rotation the next week.
By the time I failed, I had already submitted my ERAS with my Step I and II CK scores included. My school recommended against re-submitting my updated USMLE transcript with my failed CS score. I met with the school's director of simulation to go over the exam and communication skills. During that meeting, he really emphasized to me that a) he could tell in the first few minutes of talking to me that I wasn't a bad communicator, b) the test is extremely subjective, and c) because it's standardized, there was a certain checklist of items the USMLE wanted me to do in order to pass (i.e. empathy, summarizing, dealing with difficult patients), which I needed to hammer home the next time. Since there were no longer many open spots for a retake in December, I signed up for a January date with a score release for March--AFTER rank list submissions and only 1.5 weeks before the Match. I went through the rest of interview season shaking in my boots in fear that someone would ask me why my CS score was missing or that a program would need a documented passing score in order to rank me. None of my programs ever did. (Caveat: I will say that some classmates did get reminder emails from programs to resubmit their USMLE transcript after the CS score release, so it depends on each program's requirements. Overall, it might be beneficial to just not retransmit the score because it will likely hurt your chances more if every program on your list sees your fail vs. if only a few don't rank you because your score is missing.)
I studied for 4 days before my retake using FA, went over their exam tips which I found pretty useful, and then practiced only a handful of the cases which I didn't think were that helpful. I definitely made a lot of changes to the way I handled the encounters, but I still felt like trash after the day ended, worried that I spent so much more time on communicating that I did very brief physical exams, rushed the counseling, had to leave the room in the middle of answering a few challenge questions, and had less time to write the notes. I read a bunch of posts on SDN about other people's mistakes, which made me more anxious as I waited for my score. I ended up passing with my CIS score in the high performance category while my ICE score barely dipped into the borderline. I checked back in with my school to see if there was anything I needed to do with only 1.5 weeks left until Match, and I was told that my matched program would receive my full official USMLE transcript regardless and that there was nothing for me to do. Fast forward to last Friday when I found out that I matched at a highly-ranked surgery program and my #1 choice.
So here's some advice to fellow US MDs: 5% fail on the first attempt, and you're not alone even though it feels that way. Sometimes **** happens and you mess up--because it's subjective, everyone has a completely different experience. Some people who made the same mistakes I did (or even worse) end up passing yet others don't. It can happen to anyone. Trust that you have been trained well--if 95% of US MDs pass on the first attempt, I imagine the percentage is MUCH higher for US MDs who pass on the second try. Work hard, learn from your mistakes, be open to advice, try to stay away from SDN, and stop freaking out! Don't let a bad result on this test mess with your sense of who you are--the past few months really tested my self-confidence--but this isn't a reflection of your abilities as a student, friend, colleague, doctor, etc. Ultimately, it's just a very expensive hoop that you have to jump through to get where you're headed, so take it seriously and then move on!
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