Tuesday, July 24, 2012
Passing the NBME Comp
As you have gathered from my recent posts, 5th semester students must pass the Comp (short for Comprehensive exam) before they can sit for the USMLE Step 1 exam. The exam entails all the material from the first two years of basic sciences and you get a total of four times to pass it before you are dismissed from the school. You need a raw score of at least of 64 to pass. You get your first chance to pass it 2 months into 5th semester. Approximately 60% of the class passes the first Comp and clearly if you pass it the first time, a huge weight is lifted from your shoulders and you can just relax and coast for the rest of the semester (i.e. be like me). If you did not pass the first time, instead of taking the NBME Comp, the school requires you to pass both the Physiology Shelf and Pathology Shelf exams two to three weeks later. This is actually a new policy AUC just implemented last semester and I think it's a lot nicer than having to take another comprehensive exam because it allows for students to just focus on physio and path and to hell with the rest of it. If you pass both shelf exams that is the equivalent to passing the NBME Comp and congrats you are home free.
Should you fail one or both shelf exams then you have to start gearing up for the next NMBE Comp exam and that's usually scheduled for the last or second to last week of the semester. Blood pressure is going crazy at this point, right? Thoughts of failing out of school, losing two years of your life and being $100,000s in debt start flooding your mind and I don't blame you, that is a pretty scary prospect. However, even if you fail that last Comp, there is still hope! Honestly, this school does as much as it can for you to pass. They don't want to fail anyone out, especially this late in the game and at this point you really just need to help yourself. AUC sends you back to the US for a two week review course somewhere in Texas or Pennsylvania or something like that to cover all the material again. Then the rest of the time is spent preparing for your last and 4th chance to pass something. These students on their last chance then fly back to St. Maarten and sit with the new 5th semester class taking their first NBME Comp, and if you don't pass then that's it... you don't proceed with med school.
The honest truth is, dear readers, the Comp really isn't that hard to pass as long as you put some work into the semester. 98% of you will pass it in one of the first three times and that's fine. Fifth semester is extremely busy and carving out some time for yourself to study can get tricky. It really is a rare instance when a student gets dismissed from the school for failing all 4 attempts, and I can pretty much 100% guarantee you it's for no other reason than they just did not want to put the hours to really know the material. If you fail the fourth Comp even after that review course and the additional two months of having nothing to do but to study... shoot yourself (KIDDING, don't do that). But seriously, re-think this whole being a doctor thing, because clearly it isn't for you if you are so unwilling to give it the attention it so necessarily requires. But again, these are very rare instances.
Someone commented on one of my posts a couple days ago asking what people did to pass the Comp. Everyone's got a different approach, here are a few of the things people did:
-- Q-Banks!!! Whether it be Kaplan or UWorld, the people who did a block (46 questions) or even 20 questions a day for the first two months did well on the exam. Do a block and then do the explanations of each question whether you got it wrong or right. You are bound to learn a lot from this. Also, Kaplan Qbank does this cute little thing where you can look up the content of the question on the corresponding page of First Aid (it has the right page number for the last 3 editions) and MedEssentials (the Kaplan equivalent of First Aid) and that also allows for more learning.
-- Doctors in Training (DIT) Videos. The 2012 version of DIT is out and I recommend the lower semester students getting the videos from an upperclassmen since we all pretty much have it on our external hard drives. I never did DIT but I think it's about 35 hours and it just goes page to page with the 2012 version of First Aid. Someone said it takes about 2 weeks to get through and if coupled with questions, I think that's more than enough to pass the Comp.
-- Goljan Audio tapes with his Rapid Review Path book. The bootleg audio tapes are out there so definitely get them. He's fantastic. There isn't enough good things I can say about Goljan and his stuff. As for his path book, you must own it. I wish I had done more path in my preparation for my Comp because our exam was almost entirely path. Also, I know of some people who just did all of the Pathoma videos with practice questions and they did well on the Comp.
-- Kaplan Books. This is what I mainly stuck to. Aside from some of the Goljan audio and a little GI pathoma, I didn't really do much of the above. I didn't do that many practice questions in the Qbanks (but I really wish I had) and I barely used DIT or First Aid (which doesn't really bother me). For the first two month, I was really all about consolidating all the most important information from various sources and putting them into flashcard form (for anyone who sees me in class, you MUST know my obsession with flashcards). I was doing this not for Comp, but just to get my study tools in order for when I go home and start my Step 1 preparation. In my perfect world, I want to have all the information I would ever need for Step on my flashcards and only have First Aid to refer back to if needed.
I managed to get through all of Anatomy, MCB, Med Micro, Immuno, Pharm, and Behavioral/Med Ethics. Please note when I say "get through" that is completely different from "learned and memorized". I only did three organ systems for path (GI, heart, RBCs) and did not do any physio by the time I had to take the first Comp. Honestly, the amount of work I put in for Pharm and Behavioral is what saved me for the Comp. Don't feel bad putting all your work in those two subjects during the semester because it really does make a huge difference.
If I could do the semester over again, I would have made sure I did the entire Goljan Rapid Review book before the first Comp. Path really is the most important subject and what's also nice about Goljan is that he integrates high yield MCB, Micro, and Physio into his book so just learning that would have been huge. Ah well, such is life. I'm doing it now and I know it's going to pay off when it really counts-- Step 1!