Medical Licensing Exams Overview
Overview of medical licensing exams including COMLEX Level 2, USMLE Step 2, student preferences for taking the exams, reasons for D.O. students to take USMLE Step 2 CK, and board preparation methods used by students.
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COMLEX Level 2 COMLEX Level 2 CE (similar to Level 1) Computer-based cognitive examination 2 computer-based test sessions of four hours each taken on one day and contains a total of approximately 400 test questions related to diverse clinical presentations. $660 paid by student directly to NBOME https://www.nbome.org/exams-assessments/comlex-usa/comlex-usa-level-2-ce/ COMLEX Level 2 PE (similar to VCOM SP and COMPE) Performance evaluation 12 clinical encounters performed with standardized patients $1,295 paid by student directly to NBOME https://www.nbome.org/exams-assessments/comlex-usa/comlex-usa-level-2-pe/
USMLE Step 2 USMLE Step 2 CK (similar to Step 1) Computer-based cognitive examination Eight 60-minute blocks, administered in one 9-hour testing session, not to exceed 318 items $610 paid by student directly to NBME http://www.usmle.org/step-2-ck/ USMLE Step 2 CS (similar to VCOM SP and COMPE) Performance evaluation 12 clinical encounters performed with standardized patients $1,285 paid by student directly to NBME http://www.usmle.org/step-2-cs/
How many students in the Class of 2019 took USMLE Step 2 CK? 100 90 80 74 70 Virginia Campus Carolinas Campus 60 48 50 36 40 30 20 10 0 Class of 2018
How many students in the Class of 2019 took USMLE Step 2 CS? 100 90 80 0 70 60 50 40 30 20 10 0
USMLE? Why do some D.O. students want to take USMLE Step 2 CK when it is not required? To be eligible for certain audition rotations depending on specialty To be competitive with medical students from other colleges when applying for certain ACGME residency programs Want to know more about state requirements for licensure? http://www.fsmb.org/licensure/usmle-step-3/state_specific http://www.nrmp.org/wp-content/uploads/2016/09/NRMP-2016-Program-Director-Survey.pdf
How do students prepare for boards? 476 students from the Class of 2019 took COMLEX Level 2 CE during the summer of 2019 and 445 took COMLEX Level 2 PE. 158 students (88%) in the Class of 2019 at VCOM took USMLE Step 2 CK during the summer of 2019 428 students answered a survey about their board preparation and the resources they used o This presentation will share the survey data o This information is collected from all 3 VCOM campuses
When did students start preparing for boards? 50% 45% 40% 33% 33% 35% 30% 24% 25% 20% 15% 10% 10% 5% 0% First few rotations Midway through OMS 3 Last few rotations After last rotation
Did you incorporate board resources into your rotations? 41% Yes during all rotations 48% Occassionally during all rotations 11% No 0% 10% 20% 30% 40% 50% 60%
Most Recommended Resources for CE Question Banks: Uworld COMBANK COMQUEST Online study aids: Sketchy Micro Sketchy Pharm Review Programs: Online Med Ed Doctors in Training Books/Flashcards: OMT Review Step up to Medicine Master the Boards USMLE Step 2 CK Step up to USMLE Step 2 First Aid for the USMLE Step 2 CK USMLE Step 2 Secrets
Most Recommended Resources for PE NBOME eSOAP Note: https://www.nbome.org/resources/electronic-soap-notes-video/ Practice cases with classmates COMBANK COMLEX Level 2 PE videos COMLEX Level 2 PE Review Guide First Aid for the USMLE Step 2 CS COMPE DIT OMM videos
Start of Practice Questions 50% 45% 40% 34% 35% 32% 30% 27% 25% 20% 15% 10% 7% 5% 0% First few rotations Midway through OMS 3 Last few rotations After last rotation
Percentage of Respondents Completing Number of Questions 29% 30% 24% 25% 20% 17% 14% 15% 10% 6% 6% 5% 2% 0% 0-1,500 1,501-2,500 2,501-3,500 3,501-4,500 4,501-5,500 5,501-6,500 6,501 +
Question Banks Used 100% 90% 75% 75% 80% 70% 60% 48% 50% 40% 30% 20% 5% 4% 10% 3% 0% COMBANK USMLE in TrueLearn COMQUEST UWorld USMLE-Rx Kaplan
Which Question Bank best prepared your for COMLEX Level 2 CE? 60% 52% 50% 40% 29% 30% 18% 20% 10% 0% Uworld COMBANK COMQUEST
Duration of Study How many weeks did you prepare for COMLEX Level 2 CE AFTER you took COMSAE Phase 2? 50% 44% 40% 30% 20% 15% 13% 10% 8% 7% 10% 3% 0% 1 week 2 weeks 3 weeks 4 weeks 5 weeks 6 weeks More than 6 weeks The majority of students sat for CE in June (COMSAE was May 23) and PE May July.
When did students take USMLE Step 2 CK? 100% 90% 80% 64% 70% 60% 50% 40% 30% 18% 20% 11% 7% 10% 0% After COMLEX After COMSAE but before COMLEX Before COMSAE I did not take USMLE
The advice that follows is the advice that was stated over and over again so for every bullet point imagine 50 + students telling you that same advice!
What is the most important thing you would tell an OMS 3 student about Level 2 CE prep? Learn as much as you can throughout the year on rotations so it's easier to sit down and study for boards. Study continuously throughout rotations. Do not get out of the student mode while going through 3rd year rotations. Supplement questions with each rotation Study hard for end of rotation exams Practice questions Stick to your study plan Review ethics scenarios, epidemiology, and biostats! Don't brush it off! The rumor is that Level 2 is easier. It s different but not easier.
What is the most important thing you would tell an OMS 3 student about Level 2 CE prep? The practice questions were different than the actual test; go over reading EKGs, CT scans, and heart sounds. It takes more time to prep for this exam than you think...plan to study just as much for this exam as you did for Level 1 Longer question stems than expected. Expect the unexpected. Do what you know is best for your self. You have prepared for exams for the last three years, you know how you learn best. Do not worry about what others (including VCOM) says you should do. Study the way you know will prepare you the best. Schedule time for yourself and family. Focus on learning something new each day from clinical experiences. Know the second steps in management not just the first. Don't pick too many resources. Find a program or resource that works for you and stick to it.
What is the most important thing you would tell an OMS 3 student about Level 2 CE prep? Pay attention and prepare each day for your rotations. If there is a patient with a specific disease entity that you will see the next day, or saw that same day, that you are unfamiliar with, read about it on UpToDate or other resources. Also, read up on medications that you need to touch up on. This sounds like a lot - it will take 30-45 minutes max. You do not have to do it every day either. Just make sure that everything that you re involved with, you understand. This will make you look prepared. This will help you get good evaluations. This will help you do well on the VCOM tests. This will prepare you gradually for Step 2. RULES. Step 2 won't give you basic presentations with basic treatments. They will give you a presentation where you can't use the classic treatment and so you need to think about the alternates. You need to be smart. Use rotations as practice
What is the most important thing you would tell an OMS 3 student about Level 2 PE prep? Practice, practice, practice. Pay attention in the clinic and practice writing notes. Work on timing, even if you never have an issue with time usually. The timing for PE is very tough. Do exactly what you did for VCOM SP. Try to write as many notes as you can during your rotations Don't blow off humanism, videotape yourself and possibly go over your SP videos with someone from VCOM before taking the actual exam It is very common to the school practice ones, but a little more vague. Patients did a very good job playing their role and giving you very open ended chief complaints. I would be prepared for anything and everything, but also know that although you may not run out of time at the school practice ones at the testing center many classmates agreed that we would run out of time both inside and completing the SOAP note.
What is the most important thing you would tell an OMS 3 student about Level 2 PE prep? Practice a variety of OMM techniques and know how to integrate OMM into your exam and note. Take COMPE seriously Practice a variety of OMM techniques and know how to integrate OMM into your exam and note. A lot of students blow this off and think they can walk in and ace it. Remember, this is a board exam! You need to study for it. What you have been doing on rotations is not what you have to do on this exam. You have to get back into SP mode, which you lose during rotations.
The regrets that follow were stated over and over again so for every bullet point imagine 50 + students telling you that same thing!
What would you change if you could do it over again? Started studying a board prep book earlier in rotations. Better study plan Study harder earlier in rotations More questions. I wish I would have started questions earlier than I did. More OMM Give myself more time to go through study material Practice with a partner earlier.
What would you change if you could do it over again? Nag my attendings to teach me about patient treatments while we were actually in the room with the patient. Like give a quick 2 minute lecture on a pathology I am looking at and just a pro tip. It sinks in and is better learning when the patient is right there to interact with. Finish question banks ahead of time and review them again. Studied epidemiology/statistics/ethics I wish I would have studied more drugs (mechanism of action, side effects, etc). Started preparing with each rotation
What would you change if you could do it over again? Summary of Regrets: I wish I had done _____________ earlier!
Who can help you? VCOM s Center for Institutional, Faculty, and Student Success (Debbie West, Alexandria Brice, Robert Campbel) VCOM s Counseling Services (Dr. Fadel, Dr. Magalhaes, Dr. Taylor) Your Faculty Advisor, DSME, Preceptors, Clinical Chairs Associate Dean for Clinical Affairs Associate Dean for Simulation and Technology Director for Standardized Patient
Your next steps.... Do well in VCOM curriculum. If you know that material you are preparing for boards! Visit the NBOME and NBME websites to learn more about the board exams Get your resources together and start using them, especially practice questions Make a plan! If you don t know what your resources are yet or if you haven t done anything yet, please reach out to the Center! Your well-being contributes to your success, so take care of yourself. Read your VCOM email and look for information regarding the exams
