Saturday, July 30, 2005

Not more tests!

Ah, the joy of the USMLE exams. I took the new Clinical Skills exam last week... what a waste of time and money. Had to drive 3 hours to the nearest testing site, stay overnight in a hotel, and then spend 7 hours interviewing standardized patients and writing encounter notes. All to show that I have some social skills and command of the English language. And it only cost me $1000! If they really want med students to show that we are capable to taking H&Ps, developing a differential diagnosis and treatment plan, and having some bedside manner, then there should be a required OSCE given at each med school. My school has them anyway, and they are much better run than the national one. The USMLE CS cases were ridiculous -- patient with abdominal pain, clearly not surgical but a history diverse enough to account for all possibilities and a completely normal physical exam. In writing my note, what do I proove? That I can look at a chief complaint and come up with a differential and list of labs that cover every possibility. Not exactly what happens in the real world. Real patients have specific complaints and physical exam findings that point the doctor in a certain direction. But not the SPs. They often seemed deliberately vague. "Describe my pain? Well, it's pretty bad."
The worst part about the CS exam is that it takes up time. I felt ridiculous trying to prep for it -- read through the First Aid book with case examples -- but felt like I had to because failing it would be more than embarressing. But the Clinical Knowledge exam -- ya know, the real test -- is in 3 weeks and I really need to devote all my study time to it. I wish they would just admit that this whole thing is about getting more money from us. Then they could just up the price of the other steps and save us all some time.


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