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Failed COMLEX PE: Now What

I don’t wish a failure on anyone in medical school, especially on a test such as the COMLEX PE. 

To make matters even worse, there seems to be no rhyme or reason to why some people fail and others don’t. Most students have proven themselves to their schools by passing all the required OSCE’s and also to all their third year preceptors by doing basic physical exams on people.

Yet, they still somehow end up with a failed COMLEX PE.

This article will be straight to the point and direct, well because you are probably reading this because you failed the COMLEX PE, and you need a quick solution or guidance on what to do now.

This article includes:

  • What to do now that you failed the COMLEX PE.
  • What book to use to study.
  • How to practice for patient encounters.
  • When to take the exam again.

What to do now that you failed COMLEX PE.

I will start by saying that I did not fail the COMLEX PE, but a buddy of mine was a top ten in the class kind of guy (he was 2 spots above me… grrr) and he ended up failing the PE, and for no good reason too.

So, while I didn’t fail it myself I do have some first hand experience with someone that did. I saw how upset it made him, and then I also saw how he fought back and took it again.

First of all, take a moment to allow yourself to be upset. This is one of those situations where if you are upset then that is okay. The trick is not to be upset for too long.

Feel free to take a day and just be mad about the PE.

After you have given yourself ample time to be upset about the exam, it is time to go to work. This is because you most likely took it at the end of third year, this means you have about a 4-6 month window to get the dumb test done again so that you can have a passing score by the time match day comes around.

You really have two options here. Immediately get on and try to find a reschedule date, or do that after your day of being upset.

It would be the smartest move to immediately get on and see what days are available and book one of them that you can, then take a day to be upset, because schedule dates can be full almost immediately it seems like.

This way you have a guaranteed spot for a retake.

You are going to want to reschedule it by Nov/Dec of your 4th year at the absolute latest. This test takes 8 weeks to grade (for some reason), so this is the lastest you should schedule it to get a score back by match ranking.

I personally would schedule it by Oct/Nov so that you have a result before you rank programs, and obviously earlier if you can.

After you re-schedule and take a day now you need to think about study strategy.



What course to use to study.

The COMLEX PE can be such a frustrating test, because in reality you shouldn’t have to actually study for something like this right?

It is going and seeing patients, something you have done for an entire year now during 3rd year.

The truth is though, that this test is way more then just seeing patients. It is a test that is basically designed to see if you can “check the boxes” of the things the NBOME wants you to be doing.

There is a humanistic domain as well as a biomedical/mechanical domain.

The humanistic domain is made up of all the touchy feely stuff of medicine.

  • Did you greet the patient?
  • Did you wash your hands?
  • Did you ask them if they had questions?
  • Did you help them up and down?

That portion of the test is made up of a ton of stuff similar to that.

So, you can see it becomes a “box checking” exercise. “Did you make sure to do this and that before doing this.”

The biomedical/biomechanical domain is your physical exam skills. They want to see that if someone comes in with chest pain that you know how to adequately work it up and do the appropriate physical exam.

This doesn’t mean that you run through everything you learned about the cardiac exam and do every little component, instead it means do the pertinent stuff that will help you get to a diagnosis, but make sure you do it correctly.

And guess what, the standardized patient pretty much grades you on everything except for your OMM and your note.

This is important to know because then if you verbalize everything you are doing, you are more likely to “get that box checked” by the standardized patient.

You see, while you are out writing your note in nine minutes, the standardized patient is in there grading you and resetting the room.

This means they have to have a quick way to grade you. Which essentially means they have a list of things they have to say yes or no to that you did or didn’t do.

It becomes important then to realize what the important things are right?

That is where this Course comes into play.

The Crush the COMLEX PE Course is the absolute best prep resource for the COMLEX PE.

The course goes into depth of all the little nuances and requirements tha the NBOME wants you to do on test day.

There are also a ton of practice cases included as well. This means that after your read through the requirements of the test you can put in the work and practice with someone.

This leads me to the next topic, which is practicing.

How to practice for patient encounters.

In my personal experience the best way to practice for the COMLEX PE, is to simply practice by doing.

One of the bonuses of the Crush the COMLEX PE Course is over 40 high yield practice cases.

What I did, and I think it worked well for me, was to pull up one of those cases, set a timer and I would act it out and have a standardized patient encounter with my wife who would be my fake patient.

Now, you can do this with anyone that is willing to do it.

It is a stupid thing to have to act these patient encoutners out and all that stuff, but it really is a great way to prep for the COMLEX PE.

Prior to actually starting the encounter.

Make sure to get yourself a piece of paper and all the tools you need for a case.

Then without looking at the case, give the case description to the “patient” so that they can become familiar with the case and be a better actor for it.

After that, set yourself a timer on your phone for 14 minutes and go to town.

Walk through the case in such a way that you are putting the information you learned in the first few sections of the Crush the COMLEX PE Course to use and practice.

Practicing on the cases is an awesome way to get the routine and muscle memory down so that come test day you don’t really have to stop and think, you just go.

Long story short.

The best way to best the COMLEX PE is to practice practice practice.

Before you practice, make sure you understand the rules and “check boxes” of the exam. 

When to take the exam again.

So I already kind of touched on this above.

Make sure you give yourself enough time to get a grade back before rank lists for residency are submitted.

With rank lists being submitted sometime around the middle to end of February, you need to have a score back before then so that programs know you have passed and are good to go.

This means you need to take the exam at the latest by December of interview season.

I would highly recommend that you take it for the second time by October, this way you still have a little bit of time left over to take it a third time if needed.

The idea is to not fail it a second time, but things happen right? You didn’t plan on failing the first time, so be extra prepared the second time so that you don’t miss the match process for another year.

In case you missed it, the absolute best way for you to prepare for the COMLEX PE is the Crush the COMLEX PE Course.

I hope this article has helped you and will make your life a little easier in preparing for the COMLEX PE.

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