So I just wanted to post my experiences with this horrible, useless exam.
First things first, I got my score back today, and i PASSED. I took the exam all the way back in November and had to wait an anxiety filled 3 months for my score. I only prepped 2 days for the exam (and honestly, I think that is enough if you are an AMG - I'm a U.S. MD with 230's step 1 & 2, but it doesn't hurt to prep more, I just used FA which I think is the way to go.
The encounters were pretty standard with regards to topics, I felt like I had good flow (wasn't nervous), got pretty much everything I wanted to get done/ask without feeling rushed, and I left almost every encounter at least 2-4 mins. early.
Nevertheless, I "always" realized I forgot something minor (which usually involved the HPI) and was kicking myself afterwards. I pretty much maxed out the HPI box.
Things I made sure I did during every encounter: Smile, introduce myself and refer to patient by their name, wash hands, ask to remove drape when necessary, do heart & lungs on every patient, ellicit signs when appropriate (e.g., murphys, psoas, etc.), 3 complete neuro exams, counsel (smoking/alcohol/safe sex), summarize and ask if they have any other questions/concerns, go over my plan, and ask again if they have any questions/concerns (be prepared for the "challenge" questions), max out the DDx
Things that I did NOT do and probably should've: I was not overly empathetic (sorry NBME lol, but it doesn't feel natural feel for me to be "heartbroken" that a patient has a cold so I just didn't, and I don't remember ever saying "I'm sorry you feel this way/have this" although i did make sure I ask if they have any questions/concerns, I actually forgot to list the vitals on some of my patients when it was pertinent and at first I may have listed PE findings when I thought my patient was making a noise with his mouth to mimic a murmur, fill-up supporting findings in the DDx section, and lastly, my biggest gripe with the exam: list pertinent NEGATIVES to SUPPORT your DDx (yes, it actually asks you to do this next to you DDx, I didn't list any because I've never done so in real life and didn't know it was a requirement and it really feels counter-intuitive, although I absolute made sure I went through the pertinent negatives in the HPI/ROS).
In a nutshell: This test blows and its a waste of your time. Nevertheless, you don't want to fail. So, at least give yourself a 2 days (i.e. a weekend of dedicated prep in FA) to give yourself a good start. Some of the encounters are completely unnatural, but you just gotta play the game. Make sure you probe with your questions because some of the SPs aren't too bright (e.g., has your had a h/o illnesses? - No, has your child had a h/o [insert infection]? - Yes, 5 times in the past year). I completely tanked one of the T-cons, because the patient wasn't giving me anything, but in retrospect, it was my fault because with these SPs they may just say no unless you ask them EXACTLY the right question - lesson learned).
Oddly enough, I felt way more anxious about this exam than any other exam, ever, probably because you can never get it "all" done in the alotted time, I only prepped for 2 days and because it is fairly subjective. Anyway, I passed with above borderline (middle range) performance and I'm officially DONE. Best of luck to everyone. PM me if you have any questions.