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! 

2012 AUC First Time Step 1 Pass Rate

The dean just released the stats for the students who have taken Step 1 this year through July 20th. Of the 174 students who sat for the exam in the last 7 months, 98% passed the first time with an average score of 223! Congrats to our last two classes!!

5th Semester

Fifth semester is a unique semester. The hours are different (you never see anyone from the other semesters), the scheduling is different, the classes are different. If I'm being perfectly honest, it does seem a bit disorganized at times and if you struggle to follow my post from here on out... yea, that is the mess known as 5th semester. Not only do we have to take Behavioral II and Pharmacology II for the first two months (with extended hours) of the semester, but we also have ICM small groups most mornings, genital exams, clerkships, Med Ethics and Intro to Clinical Clerkships (ICC) lectures, all while preparing ourselves for the first Comprehensive exam.

For my busiest days, my schedule looked something like this: 9-11 ICM small group, 11:40-2:50 Behavioral/Pharm, 3-5 ICC or Med Ethics. Med ethics is a 10 day course that starts the first week of school in addition to pharm and behavioral. It's not hard, but you do have to prepare for the two quizzes and the final. Once that's over with, an additional half hour of lecture is tacked on to behavioral and pharm, but at least you get Wednesdays off. However you also then start up ICM 5 where you meet in *small groups* at least three times a week and you discuss different cases. ICM 5 *lectures* take place on Wednesdays at 12:30 and then you have quizzes on Fridays. Unlike all the other ICM courses, ICM 5 lasts the duration of the semester and your final grade includes quizzes, reports, leading case discussions, genital exams and you are required to do two hospital rotations at the St. Maarten Medical Center. So far I've done a pediatrics rotation and I've got my emergency rotation this coming Sunday.

Another random mini course we take for about one week is ICC. Typically ICC is supposed to begin after the first Comp, but this semester they it moved up before our final exams due to scheduling difficulties. I actually really enjoyed ICC and found both instructors to be engaging, but the fact that we had to sit in lecture everyday for 2-3 hours right before our shelf exams and Comp was asking a little too much of us (stress levels were a wee bit high). I definitely would have gotten more out of the class had it been after Comp.  Both instructors are practicing physicians and AUC graduates who basically run through all the tips and tricks for surviving clerkships. From learning about the chain of command in a hospital to learning how to write a SOAP note, they did a solid job highlighting what is essential to know for the basic sciences to clinical transition. I feel like I have a better handle and understanding of what will be expected of me when I start my cores in January. 

Once you get through all those classes, and pass Comp on the first try, life is pretty sweet for the last month. Physio live review goes on for seven hours every day for 5 days, but thankfully its optional (thus I have not been going), and then the mandatory Kaplan Live Review starts up with my Kaplan crush Lionel Raymond the following week. It's a 7 hour, five day integration of path, pharm, and biochem.  After that.... I'm not sure what's left to be honest. Aside from a couple of meaningless exams and the Kaplan Comp, there's really nothing left for me to do except prepare for my departure. Pack up... sell my stuff... eat out...get tan....beach it. I may actually turn into a tourist.  

Time for a 5 week bender?

Scores were released an hour ago and I PASSED THE COMP! I can't believe this. Honestly though, with all the hoops we had to jump through this semester, there was just so much material I was never able to even get to. Aside from knowing my pharm and behavioral really really well, there really wasn't much else I was that comfortable with. I hadn't looked at MCB in months, I only knew my bacteria for med micro, didn't even touch physio, and only knew heart, RBCs, and GI for pathology. Somehow it was enough to pass and I am pretty much, unofficially done with basic sciences. Yes, I still have to sit for both the physio and path shelves, but the grades don't matter in either. I also have to take the seven-hour Kaplan Comprehensive exam, but the score needed to pass is so low even a toy Pomeranian can pass it.

Just five weeks left. Five weeks left and my Caribbean medical school adventure ends. Really this feeling... it's something else. There are no words.

Now for the big one

Behavioral Shelf. Check
Pharmacology Shelf. Check

I've officially completed my last two courses of basic sciences. Not only that, but I ended it on a pretty high note, which leaves me quite optimistic about my Step 1 preparation. For the last two months I've been studying this mountain of material and it's all well and good to take practice exams on Kaplan and UWorld, but I don't get an accurate assessment of how I'm doing until I take a Shelf. A few of my upper semester friends who I consider both wise and intelligent said that the best practice you can get for Step 1 are the shelf exams. Seeing that they are all "retired" questions from the Step, it makes a lot of sense to me. The quality, style, detailed-ness is spot on to the real thing so yeah, after getting my scores back today, I feel so relieved, happy, confident and just so invigorated to keep all this up! It's always nice seeing the pay off after all the work I put in. It just makes me want to work more.

I have one big exam left– the Comp. A 200 question, 4 hours and 15 minute beast complete with ZERO BREAKS. It's a marathon and it all goes down this Friday the 13th. Thankfully we get three chances to pass the comp, but I would be thrilled if  I finished it off on the first try. We'll see how it goes. The light at the end of the tunnel is shining awfully bright these days... and it's not just that blazin' Caribbean sunshine.

Gift from the University

Headphones are here!! and the timing could not have been more perfect since yesterday I took my last round of block exams EVER! The way I see it, these headphones are pretty much a congratulatory gift from DevRY saying "yeah 5ths, you did it. Now take these headphones and get back to studying for your Shelves/Comp." Since arriving to the island 18 months ago, I think I've taken roughly 65 exams so I don't think there's anything more fitting than getting a 300$ present for finishing basic science classes. Thank you, DeVry.

As for the headphones-- pure amazement at their noise-cancelling capabilities. All white-noise eliminated, and they are also quite comfy to wear (not to mention very sexy). I can imagine it now....600 AUC students rocking these headphones when we fly back home in August and all the Saba and Ross students watching from the distance in envy. Delicious.

We ended up getting the Bose QuietComfort 15s, which I wanted anyway because "over-the-ear" is just better than "on-the-ear", and yeah, definitely going to get a lot of use out of these the next 2 weeks. Two exams down, three to go!