Failed Comlex III by 1 point!

[pathical]

Hey all, I'm now a 3rd Year Pathology Resident, and I've just discovered that I have failed this stupid exam for the 2nd time! This time I got a 74, and 338. I feel like I've studied everything, I felt like I knew the answers for the most part . . . except the ones with multiple answers, or no answers (the comlex classics) ANYWAY, I'm mentally, emotionally and financially exhausted with this stupid test. I did well on steps 1 and 2 (>500) no problems and passed both on first try with very little studying. Now this stupid thing comes along and is giving me the lowest scores ever... (first try, 238 - 70)

The worst part is that I actually studied harder for this thing the second time than perhaps step 1 the first time!

My question is (keep in mind Pathology Residency doesn't help the "shoot from the hip" thinking format, or "guess what I'm thinking" format that comlex seems to reward)... but, besides put myself in the box of a FM doc who lives in the boonies... What else can I do to change my approach to answering these questions? I know the lack of a traditional intern year is hurting me and I respect that, however, [most often] I do not feel my knowledge base is the issue here. I don't want to sound conspiratorial, but I'm starting to think I'm being graded differently than others because I didn't go "primary care" or whatever. Silly I know but I just.... ??? Uuuhg!

"Kid walks into a room. The most likely diagnosis is?" LOL

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[njbmd]

Take a break from the Step III taking as long as you are not more than seven years from graduation in a state that has this requirement for license. Most of the time, when students fail any type of board exam, it's by one or two points. Yes, you failed and you need to know the consequences (if any) of your failure but other than that, rest up and live to retake another day. As you know from your previous attempts, failure isn't the end of the world but you also know that you have to get past the feelings of "uselessness" and keep moving forward. Don't allow your brain to make this exam an "issue" when it need not be. You do what you have to do and get it behind you when you are ready to get back into the study mode. Good luck!

PS: Passing this or any other board exam is not how long or how hard your study but about how smart your study. Get with someone who has not had a problem with this exam and find out what they are doing that you are not. You will get this behind you but stop "beating up" on yourself. It isn't going to help you get past this exam.

 

[pathical]

thanks for your nice comments. I just wish I could see how they graded that darn thing. Something seems fishy to me. I know I'm probably just being overly rational. (i.e., "the reason you failed the test sir is because you picked too many wrong answers.")

Does anyone know if they will give me my raw score if I ask? I called once already, and the phone answering staff was less than helpful. (charlie browns teacher voice.. "You need to mail in the test results page... plus a fee of .... and then wait... processing...., but just to warn you, they are very rarely graded differently... no, i've never seen a score changed before...."

this whole thing is a cash cow. if they wanted to make better doctors they would provide useful feedback so I could work harder in the right direction. instead, i apparently need to study with someone who did well so I can learn the correct mindset, and which protocols to review. "We're gonna get your mind right boy!" nevermind thinking, those skills don't seem to be rewarded as much, or needed much after step 1.

"Luke, now don't you go backslidin' on us..."

 

[FirstMANdown]

Hey Pathical,

I can understand your feelings on this. Most well to do physicians unfortunately will not interpret your failure on this exam as a "conspiracy", not that they should but the reality is, there is no way of knowing exactly how they grade these exam because USMLE/NBME is not a completely government runned institution and that is where the problem lies. If you really want to know how you did on the exam other than the nice little neat bar graph and score's they provide you, is to go to your local governor and have a federal inquiry about there test scoring policy. If, a federal judge requests for the proper documentations to be copied and sent for viewing(your test) then USMLE/NBME would have to supply that information. Now the real world, No one as far as I know has ever went to that extreme unless they have a possible hidden agenda. But, its not hard to fathom the idea about how these test are exactly scored because there are many grads like your self who are very bright, have a good background of knowledge and still at times fail these exams. All I can tell you is that this type of fight is not worth your time unless you have a rich family or are well connected with nothing else to do. Just find out what your weaknesses are and find one or more study buddies and figure out how to slay this beast of an exam. You have the knowledge and the common sense...now just learn the "know how on test taking strategies" for part III and you will surly pass next time around.
In view of your concerns, there are many DO's and MD's that feel the same way as you do. I think that this is one of the reasons why more and more of the newer,younger generation of doctors are excepting the even greater and bigger role the government has on its health care system and its workers. It is always a concern of the government to make sure its residence are passing these exams so they can join the work force. After all, all medical residence training programs are funded by the federal government and thus becomes a federal concern, as it should. Good luck to you! Keep up the good fight.(sorry about the spelling, no sleep for 16 1/2 hours).

 

[MPR]

I know how you feel I learned I failed usmle step 3, my first attempt got 71

I failed because of the ccs portion which I have no idea how they grade...my ccs cases were tough...I got one with 3 problems..I have seen people writing various degree of ccs difficulty..so I wonder how they are making it standardized, if at all...is it a ploy just to get more money, will fail some, pass some...its ridiculous....but thats how some foreign medical school work, which is private, not government controlled...

I feel alittle jaded...but what can I do, but start studying again for this exam and prepare as much as I can for ccs portion

 

[tkim]

Hey all, I'm now a 3rd Year Pathology Resident, and I've just discovered that I have failed this stupid exam for the 2nd time! This time I got a 74, and 338. I feel like I've studied everything, I felt like I knew the answers for the most part . . . except the ones with multiple answers, or no answers (the comlex classics) ANYWAY, I'm mentally, emotionally and financially exhausted with this stupid test. I did well on steps 1 and 2 (>500) no problems and passed both on first try with very little studying. Now this stupid thing comes along and is giving me the lowest scores ever... (first try, 238 - 70)

The worst part is that I actually studied harder for this thing the second time than perhaps step 1 the first time!

My question is (keep in mind Pathology Residency doesn't help the "shoot from the hip" thinking format, or "guess what I'm thinking" format that comlex seems to reward)... but, besides put myself in the box of a FM doc who lives in the boonies... What else can I do to change my approach to answering these questions? I know the lack of a traditional intern year is hurting me and I respect that, however, [most often] I do not feel my knowledge base is the issue here. I don't want to sound conspiratorial, but I'm starting to think I'm being graded differently than others because I didn't go "primary care" or whatever. Silly I know but I just.... ??? Uuuhg!

"Kid walks into a room. The most likely diagnosis is?" LOL

It's probably how you interpret the questions, if you feel that your knowledge base is solid.

I would buy those sample questions, use a q bank of some sort, and take something like premier review. It's about test taking strategy, not knowledge.

 

[pathical]

Hey MPR thanks for sharing your plight. I wish you the best on "round 2"!

And, thank you for your insight tkim, I agree... Everything else aside, test-taking strategy does knock down more points than knowledge.

I agree with all the posts that recommend for me to discover my weaknesses and then hammer this thing. And so that is what i will try and do.

I do think this system is screwed up though. And I think that I will never know exactly how they wanted me to handle the pregnant 18YO, who's abusive bf is waiting downstairs.... I pick the best "right" answer (although during the COMSAE practice test, even with open books and internet, and taking my sweet time, I still only got a 650!! BECAUSE [IMO] THE ANSWERS ARE OFTEN SOME BITTER CLINICIAN'S OPINION [sorry for yelling]) , and I comment on it. Then, like magic I get back a failing test score . . . and the best they can tell me is that my "Scientific Understanding of Concepts" is low, or my "History and Physical" skills need improved. Or wait, my personal favorite.. "Diagnostic Technologies" a very low score for me (HELLO, I'M A PATHOLOGY RESIDENT AND THAT IS WHAT I DO ALL DAY LONG, EVERYDAY!!!) not that I'm the least bit frustrated lol

I'm sitting here asking myself, "Which question had a scientific concept in it? Oh yeah, it was the temporal bone chapman point connection." Ok, I'm done venting for the moment. Not that it matters since my "Osteopathic Skills (or whatever)" was one of my highest scores (still scratching head on that one) anyway...

Btw: did anyone have the question about the husband who came in to get a refill on his antidepressants, and tells you that he knows his wife is cheating on him and he plans to do something about it. Then in the next sentence it says, he has recently purchased a handgun. The next best thing to do: (don't quote me but it was something like) A.) refill his script and increase the dose. B.) Call the authorities and detain him C.) Advise him to get marital counseling D.) Call his wife and warn her E.) Admit him and get a psych consult

I picked C, but was on the fence about D or E. It's the way the question was worded . . . Which book do I study to get a handle on those types? Ahh, who cares, it was probably thrown out anyway since there is no good answer. I guess we'll never know. Yeah right, if that were true COMLEX would have to throw out over half of the test! LOL

I will pick my sword back up and join the ranks of "study harder/smarters" and "try-try-and-try againers". Because i have to. Because I'm over 300K in debt, and this system owns me. But until there is some decent transparency (if ever) in this process... I will always wonder if my old medical school dean isn't just secretly having me run this gauntlet a few times. She certainly was a hater of men I do recall. And frankly, even in the slim (but possible) chance that is the case; nobody would know, and she will continue to get away with it until one day when I'm lucky enough to have my test come across her (proverbial) desk AFTER her benzo's kick in, and she lets me pass. by 1 point of course!

"Now see, we can't have ya runnin' 'round out there with any of that stuff they call confidence now can we."

 

[TruTrooper]

I agree that test-taking strategy has more to do with this test than actual knowledge. I give you permission to hate this test. I felt like I studied well for this test and still sat down and was like "WTF!?" Luckily I passed but that doesn't mean that the experience didn't leave me with a sour taste in my mouth.

 

[DOCTORSAIB]

What did you use to study?

Have you tried COMBANK. I did and although it's not the most comprehensive question bank it's very similar to the COMLEX. They hit a lot of the high yield topics which you CANNOT MISS under any circumstances. I'm serious. That is how you ensure a passing score, by know the common stuff inside and out.

If your fund of knowledge is lacking, then pick either FA for Step 2 (it's better than the one for Step 3), Crush, Secrets or Strong Medicine. Pick ONE book. Read it like it's your religion. Then do questions out of Kaplan's Qbook to make sure you understand CONCEPTS. Then reread the sections you're weak on from your book. Then 2 weeks before your exam rip through COMBANK. It's only like 800-900 questions so shouldnt be too hard.

And skim Saverese. The OMM questions are gimmies bro. Again, you CANNOT miss these questions.

If you do this you will pass. Just train for it like a UFC fighter does for a fight. No pain, no gain. G'luck!

 

[Shinken]

I feel like I've studied everything, I felt like I knew the answers for the most part . . . except the ones with multiple answers, or no answers (the comlex classics)

"Kid walks into a room. The most likely diagnosis is?" LOL

Actually, your attitude towards the exam is probably hurting you.

Why am I telling you this? Because those "multiple answer" questions are what the COMLEX (and primary care) are all about (believe it or not, there truly IS one best answer). This exam unfairly rewards primary care residents like me simply because the questions are phrased and are constructed in a way that mimics what I see every single time I'm at the clinic seeing my patients. If you can get into that mindset, the exam will no longer be a mystery to you.

A perfect example of what I mean is the example you gave us about the husband that purchased a handgun. I would've chosen answer E (that was the best answer). That's exactly what I would've done in real life. If someone presents to your clinic and you think he's a danger to himself or others you admit him to a psych ward for evaluation and treatment (against the patient's will if necessary). You don't let him go home (which is what answers A, C and D imply). Also, calling the police to detain him is silly (what would be the charge? No crime has actually been committed...yet). Answer E was obvious and jumped out at me right away. I would've picked that answer quickly and moved on to the next question. See what I mean? Yes, it's a test that unfairly rewards primary care residents, but that's exactly the mindset you have to be in to beat the test as a pathology resident.

For example, many people that take the COMLEX complain about the lack of information in order to make a diagnosis. Hence, many people understand what you mean when you say "kid walks into the room, what's the diagnosis?" Believe it or not, that's exactly what you need to know. The most common diagnosis for a given presenting complaint. No labs, no imaging, just good ol' statistical odds of a disease. A guy that presents with diarrhea most likely has good ol' diarrhea, not undiagnosed carcinoid syndrome. In the absence of any other information, if the choices include carcinoid syndrome I will definitely not choose that option. I wouldn't complain that there's no lab data to direct me to or away from that answer, I'd simply ignore it, just as I would never entertain carcinoid syndrome as the top diagnosis in my differential in a patient that walks into my clinic with diarrhea of acute onset two days ago.

My advice to you is this:

1) After reading every question and before reading the answers, imagine you're a primary care doc in an outpatient clinic and what your response would be. Then, read the answer choices.

2) Instead of using USMLE 3 or COMLEX 3 review books, get a good Family Medicine Board Examination review book to study from. That'll probably be more useful for COMLEX.

Good luck in your next try!

 

[FirstMANdown]

Actually, your attitude towards the exam is probably hurting you.

Why am I telling you this? Because those "multiple answer" questions are what the COMLEX (and primary care) are all about (believe it or not, there truly IS one best answer). This exam unfairly rewards primary care residents like me simply because the questions are phrased and are constructed in a way that mimics what I see every single time I'm at the clinic seeing my patients. If you can get into that mindset, the exam will no longer be a mystery to you.

A perfect example of what I mean is the example you gave us about the husband that purchased a handgun. I would've chosen answer E (that was the best answer). That's exactly what I would've done in real life. If someone presents to your clinic and you think he's a danger to himself or others you admit him to a psych ward for evaluation and treatment (against the patient's will if necessary). You don't let him go home (which is what answers A, C and D imply). Also, calling the police to detain him is silly (what would be the charge? No crime has actually been committed...yet). Answer E was obvious and jumped out at me right away. I would've picked that answer quickly and moved on to the next question. See what I mean? Yes, it's a test that unfairly rewards primary care residents, but that's exactly the mindset you have to be in to beat the test as a pathology resident.

For example, many people that take the COMLEX complain about the lack of information in order to make a diagnosis. Hence, many people understand what you mean when you say "kid walks into the room, what's the diagnosis?" Believe it or not, that's exactly what you need to know. The most common diagnosis for a given presenting complaint. No labs, no imaging, just good ol' statistical odds of a disease. A guy that presents with diarrhea most likely has good ol' diarrhea, not undiagnosed carcinoid syndrome. In the absence of any other information, if the choices include carcinoid syndrome I will definitely not choose that option. I wouldn't complain that there's no lab data to direct me to or away from that answer, I'd simply ignore it, just as I would never entertain carcinoid syndrome as the top diagnosis in my differential in a patient that walks into my clinic with diarrhea of acute onset two days ago.

My advice to you is this:

1) After reading every question and before reading the answers, imagine you're a primary care doc in an outpatient clinic and what your response would be. Then, read the answer choices.

2) Instead of using USMLE 3 or COMLEX 3 review books, get a good Family Medicine Board Examination review book to study from. That'll probably be more useful for COMLEX.

Good luck in your next try!

Seems like very good advice, but with a condescending overtone. I have to say, I did go by your advice as you described and it helped me get over the hump. I would say Swanson and Jason family medicine is what I would study for step 3 if I did it over again, that is usmle not comlex.

 

[pathical]

Thank you all so much! I agree shinken, my attitude is probably hurting me . . . and your right, there is a single best answer. Thank you for acknowledging my though process as understandable however... it's crazy how a test like this can make you feel so stupid. especially when you getting your butt kicked all day long (just doing normal resident work and study)... and your colleagues start looking at you funny . . . people respect you less . . blah blah blah.

Ok, so on to changing my attitude and getting some family based books. And I see what you mean about admitting the guy with the gun. From now on, I'm admitting everybody who owns a gun! lol just kidding.. and I do see you point.

think like a pcd. think like a pcd... Ok, I'll keep you guys posted-

 

[promisabel]

Hey, pathetical. I just wanted you to know that I took the test in august, and made a 348. It is frightening, because I studied very hard for this test, and am not used to failing (as I realize none of us are), never even close. The only part that I scored "low" in was the osteopathic principles portion. Which is upsetting, because I did study for that portion. Ironically, I scored very high on health care delivery. Everywhere else I was borderline to high. When I was reviewing each section, I was confident that I answered at least 60% of the questions correctly, 20% probably correctly, and the final portion I was confused about. For whatever reason. I am a psych resident. This was my second attempt, as well. I also think there is something weird about the scoring. The first time I took the test, I was unprepared and having personal problems... I finished it in 4 hours, because I didn't care. This time, I cared. I just wanted you to know that I understand your frustration. I am preparing again, too. Good luck.

 

[pathical]

I gave them my 50 dollars and jumped through the hoops of "formally" asking them to do a regrade because I was so close. I was under the impression that at least (worst case scenario) I would be given a bit more feedback so I would know where to focus my studies.... Instead I got the equivalent of a 2 bit e-mail with a touch of fresh ink.

IOW: We looked at your score and compared it to the passing score and confirmed that your score was in fact less than the passing score. Here is my signature and extension if you have any questions. Thanks for your 50 dollars, I took the kids out to eat at Sizzler and we all pigged out... on you!