Chances are, Step 2-PE will be your very last COMLEX exam during medical school. Hooray! You’re almost at the homestretch, but if you’re not careful, this exam could cause you a whole lotta headache.
Step 2-PE is supposed to be the easiest of the 4 exams. But it comes with a catch …
There is only one place you can take the PE: freakin’ Conshohocken, PA.
Alright, so what does this mean for you? It means that you will be competing with osteopathic medical students from all over the US for testing slots. If you think competing with the gunners from your class is bad enough, imagine competing with gunners from all schools. It’s not fun.
Once you get the ok from your school to sign up, sign up ASAP! Or else you may not get an early enough testing spot. I waited just one week to sign up, and the earliest spot I got was in October. In the span of one week, all the spots of July, August, and September were taken. Gunners be crazy!
Having only one testing spot (in freakin’ Conshohocken, PA) also means that it sucks to be you … if your rotation is not around the area. Luckily, my rotation was close to Philadelphia. So I only had to drive an hour to get to the testing site. But some people had to fly. Others had to drive for a whole day. Overall, getting there could be a huge, huge hassle.
Therefore, make sure you don’t fail. Because if you gotta do it over again … that just plain out sucks — especially if you were the kid who had to fly from California, had to rent a car, had to drive around an area you’re not familiar with, had to stay overnight in some craptastic hotel, and had to fork over a few thousand dollars to make the wonderful experience possible.
Now that the huge warning and rant is out of the way, let’s get down to business. Let’s talk about sex …
Oh wait. Wrong topic.
Let’s talk about COMLEX Step 2-PE. And I mean the nitty gritty stuff.
When Will You Take It?
Most likely, you will take the exam sometime in your fourth year. As I mentioned earlier, try to take your exam earlier in the fourth year, rather than later. The main reason for doing so is to guarantee that you will graduate on time and to transition smoothly into residency.
Look … there is a very small chance that you will fail the exam. It can happen to anyone. I’ve heard of stories about people who did well throughout medical school, rock both Step 1 and Step 2-CE, but then failed the PE.
So think about this scenario:
You receive the ok from your school to sign up for the test. Instead of following my advice, you drag your butt and dilly-dally around. Sometime around October or November of your fourth year, you realize that you gotta pass the PE to graduate. So you finally make your way over to the NBOME site to sign up. The earliest date you can find is in February, during the osteopathic match. “No problem,” you tell yourself, “I’ll just take my exam then.”
The fateful days come and you totally bomb the PE. You did not prepare for it because you thought it was a “joke” exam. Whatever, most people pass … right?
But then 3 months later, in May, you get a letter in the mail saying that you failed. Shoot! That can’t be right. You have a graduation coming up. You have a residency lined up. And now, just because of a “joke” exam, you can’t pass Go, and you can’t collect your $200. You’re royally screwed.
Had you taken your exam earlier, such as during the first half of the fourth year, and then failed, at least you can schedule to re-test and pass in time.
So when you should take the PE? As early as you can. At the very least, try to take it in the first half of your fourth year.
What Will Be on the Test?
Everything that a competent and empathetic primary care doctor will need to know.
Know how to write a SOAP note.
Know your diseases from head to toe.
Know the tests and treatments for those diseases.
Know your OMM.
Know how to show that you care for the patient as a human being.
Some people may tell you that you don’t need to study for it. That it is a piece of cake and is a “joke” exam. Well, I agree that the exam is a joke and is primary for enriching the NBOME, under the guise of making sure that we are competent doctors. (Old-timer doctors didn’t have the PE, and they were able to treat their patients.)
However, you will need to study for the PE. Get it done once and get it done right. It’ll really blow if you had to pay all that money and waste all that time to endure through the bullcrap exam a second time around.
What Resources Did I Use?
There are basically two main resources to help you prepare for the PE:
1. COMLEX Level 2-PE Review Guide
This is the only guide that I know of that specifically deals with the COMLEX Step 2-PE. Therefore, you don’t have much in terms of options.
The good thing about this book is the mnemonics. If you burn the mnemonics into your mind, you can make sure you ask all the really important questions. This will help you get high marks in the biomedical / biomechanical domain.
The book is also good for giving you a preview of what to expect, and how you should approach the encounters.
It also comes with practice cases. However, they are not so good. Answers are provided only for the first 2 cases. That is why you need to pair the JB Review COMLEX Level 2-PE Review Guide with …
2. First Aid for the USMLE Step 2 CS
First Aid for the USMLE Step 2 CS makes up for the deficiencies in the JB Review. In FA, you will have around 40 or so full-length cases — with sample SOAP notes. The SOAP notes really help you get an idea what the right answer would look like.
In addition, it has numerous mini-cases. In my opinion, the mini-cases is where the book really shines.
First, it will give you a generalized complaint (i.e. headache, sore throat, etc.)
Next, it will list the key characteristic of each complaint you should watch out for. If the chief complaint is headache, you should find out its location, if it is associated with nausea, if there is jaw claudication, and more.
Then, it will tell you what physical exam you should do. For a headache, inspect the head, eyes, ears, nose, and throat. Do a neurologic exam. And so on.
Finally, it will list the differentials and will teach differences among them. Again, with a chief complaint of headache, you want to consider migraine, tension headache, cluster headache, pseudotumor cerebri. It will also include a plan to help you pinpoint the diagnosis. So you should get a CT of the head, MRI of the brain, lumbar puncture, and whatnot.
Overall, it is best if get both books to help you prepare for the PE. Over-preparing is better than under-preparing. But if you can only get one book, get the First Aid for the USMLE Step 2 CS.
How Is the Exam Scored?
Basically, the exam is scored in a magical black box. So what do I mean by this? Everything is subjective. It is scored by the graders’ impression.
There are two “domains” that you gotta pass:
- Biomedical / Biomechanical Domain
- Humanistic Domain
The biomedical / biomechanical domain includes all your skills as a doctor … history taking, physical exams, SOAP writing, OMM treatments, etc. You should be somewhat competent at this by your fourth year. If you’re not, it is ok. Just study and practice.
The humanistic domain includes your communication and interpersonal skills. So at all costs, whenever you are with the patient, treat him or her like royalty. Be extra nice. Bend your back to accommodate the patient in any and every way. Make sure you communicate everything you are thinking, so the patient is on the same page as you. And always let the patient have the final say … do not argue.
If you fail even one of these domains, you fail. So make sure you prepare beforehand.
The patients will grade the history-takings, the physical exams, and anything included in the humanistic domain. So remember … use the butt-kissing you’ve learned in the third year to the absolute fullest.
The doctors or some type of grading specialists will grade the OMM and the SOAP notes. No butt-kissing is needed for this part. (Thank goodness.)
Alright, I hope you’re not too confused by now.
Chances are … you will pass the PE on the first try. The pass rate is 95% – 97%. These rates are better than the written exams. So don’t worry too much. Just worry a little bit.
How Long Is COMLEX Step 2-PE?
The COMLEX Step 2-PE will take 1 day and will be around 8 hours long. There are two sessions in a day:
- 8:00 AM – 3:30 PM
- 2:00 PM – 9:30 PM
(You should get there 30 minutes earlier than the starting time.)
In the first hour, you’ll have to take a survey, fill out forms, and get your picture taken.
In the second hour, you’ll go through orientation. You’ll watch a video and get all your questions answered.
And in the last six hours, you’ll take the exam. You’ll have a total of 12 patient encounters. After the first 4 patient encounters, you’ll get a 30-minute lunch. (The testing center will provide drinks and a lunch.) And after the second 4 patient encounters, you’ll get a 15-minute break. So there is enough time throughout the exam for bathroom breaks and whatnot.
Each patient encounter is 23 minutes long. You will have 14 minutes to gather the history, do the physicals, and talk to the patient. And the remaining 9 minutes are for writing the SOAP note. (Just know that as of July 1, 2014, you will no longer write out the SOAP note. Instead, you will type it. So if you’re an old geezer or a technophobe, start working on your typing.)
Since you’ll be so busy throughout the day, it’ll go by quite quickly.
How Much Will COMLEX Step 2-PE Cost?
A whole lotta money. For my exam in 2013, I paid $1,210. For you, if you’re taking it after 2013, it’ll most likely be higher.
NBOME is making a killing on these exams.
More About COMLEX Step 2-PE
For more details, I highly recommend that you read the Orientation Guide for COMLEX Step 2-PE. In the guide, you’ll see a sample doorway information, a sample SOAP note, and a list of common abbreviations.
In addition, I highly recommend that you watch the orientation video. It is only 30 minutes or so and will help prepare you for the big day.
New! Learn how to pass COMLEX 2-PE on the first try. See here to find out more.
This article is part of The Complete Guide to COMLEX. Click on the link if you want more tips and hints about the osteopathic medical board exams.