The COMLEX Level 2 PE - A Good TIme!

There is, in the saga of the advancing medical student, a particular board exam that tests the student's ability to perform physical exams and offer differential diagnoses. For osteopathic medical students this test is called the "COMLEX Level 2 PE" ("PE" for "Physical Exam"). For allopathic medical students this is called the USMLE Step 2 CE (Clinical Exam). As an osteopathic student I can speak only about the PE but I am guessing the allopathic experience is similar.

My PE was in Conshohocken, Pennsylvania, a distant suburb of Philadelphia. A nondescript, business building squatting near the river houses the testing center. After showing up several minutes early in a plain white coat and dressed with professional slacks and tie, I signed in and took a seat with eleven other medical students similarly attired. The room was filled with hushed voices and the air was thick with tension. A friendly if not slightly bored attendant behind a long counter checked my ID and inspected my stethoscope to make sure I have not surreptitiously snuck in some obscure medical algorithm on microfilm. I signed a non-disclosure agreement and it is because of this that I cannot share anything specific about the test itself. I can, however, share my thoughts about the overall experience.

After waiting what felt like an hour the dozen of us, like white-clad sheep led to the slaughter, were herded into another room where we were given a protracted briefing concerning the structure and length of the exam. It is a very long test, taking over seven hours. During the day we would see twelve "patients" (played deftly by trained actors and actresses) and would be responsible for evaluating them, performing any correct physical exams, and creating a set of differential diagnoses. We then would have a certain amount of time to properly record our efforts on a computer.

These seven hours went incredibly fast. Despite the stress I must admit there was certain sense of adventure for I never knew what was behind the next door. Overall, it was a fantastic experience assisted by a kind and professional staff.

How does one prepare for this? There are a number of professional texts available to cover the vast didactic knowledge needed. For osteopaths, there is also an intense two day course offered for those who want some additional strengthening of skills. The PE medical board exam costs about $1,250 so it behooves the prospective student to make whatever preparations are needed to pass the first time! I've often joked that, if this medical thing does not work out, I should get a job for the company that conducts these tests.

If you are reading this and are preparing to take the PE, might I suggest the following helpful hints:
- Get to the testing center about 15 minutes early
- Bring only what you need. The lockers are small.
- Wear a white coat that has no identifying marks, especially from your school. It's just easier.
- Get a good night's sleep the night before. This cannot be overstated.
- If possible, try to test in the morning. The "patients" tend to be less tired and in a better mood.
- COMBANK has a set of videos covering basic OMM techniques for this exam. I found these very helpful.
- Greet every patient with a smile and be professional at all times regardless of what may happen.
- ALWAYS WASH OR SANITIZE YOUR HANDS BEFORE TOUCHING THE PATIENT! I know you know this but in the heat of the moment it might be forgotten.
- Don't argue with "patients", staff, or admin personnel. They're their to help you.
- Try to enjoy the experience. NBOME has been doing this for a while and they know what they're doing.

There is little more I can share concerning the Level 2 PE. Thanks to God, I have passed this, yet another hurdle. I have one final exam (not nearly as large as the PE) and then I will be done with medical school.

Finally!

Until then, Dear Reader, please take care of yourself. For me it's back to the books.