One day until COMLEX

My second step I board exam, this time the COMLEX, is tomorrow. More luck and vibes, please!

I just took a sample exam on the NBOME website. I am pretty happy, having gotten an 86%. A few of my errors were really stupid, and I knew the right answer. One could have easily been remedied by reading more slowly and not being distracted. I won’t being singing Intergalactic by the Beastie Boys and jamming out to my iPod in a crowded coffee shop during the real deal, so I may notice that the scenario about the fainting young woman includes the tidbit that she never injures herself on the way down, indicating malingering.

My pessimistic side is saying I just answered 50 questions on their website that most likely will not be on the exam, since they are on their website. Meh. I hope this indicates that I have a breadth of knowledge likely to be on the exam, but I am not sure.

One comment. We are actually allowed to type and save comments about specific questions on the exam, apparently. I don’t know if I will exercise this option. The instructions did not indicate if these would be read or considered by the powers that be, or a place for me to make notes in case I have time to return to the question.

I used to write comments on my paper exams at school, such as “WTF?” and “You said we didn’t need to memorize specific degrees of angles of components of normal gait!!” next to offending questions. Since it wasn’t on the scantron form, only on my paper copy of the test, I figured it was just garbage. I stopped doing this once I realized my test was always up there first (I am an obnoxiously fast reader and test taker), usually in the hands of a bored department head (or lackey) with not much else to do and no other tests to look over yet.

I never thought of it until one of the professors pointed out, in front of most of the class, that he noticed that I had corrected typos on my exam. I was slightly embarrassed, since my test taking speed is already a much discussed topic among my classmates. I felt a bit of redemption, since people should hear (and stop asking!) that I actually have time to read the questions. Um, yeah, I passed two years of medical school (not to mention the classes and standardized tests leading up to it) by skimming and picking “C”. (That’s my standard sarcastic answer to that.)

But, then I realized if he read my corrections, he most likely read my other editorial comments. I racked my brain trying to remember if I had written anything rude about any of his questions. I doubt it; he tends to be a straightforward test writer, but you never know. I stopped writing out the sarcastic comments at this point.

Anyway, back to the practice test and the ability to write comments. I did type one on the practice test, just to try it out. I doubt I will use it on the actual COMLEX, but I was spurred to try it out today. The stem of the question was the patient’s history. A middle aged male patient came in with various complaints, the chief complaint being headaches. Examination of the patient finds hemiparesis. Um, huh? My comment: “What patient would not complain of being paralyzed on one side?”

Mr. Patient, I know you mainly are concerned with your headaches, but did you notice you can’t move half your body and most likely couldn’t have even walked in on your own volition?

Lazy question writing. Just saying. Poor dude had a chronic subdural bleed.

7 Comments

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7 responses to “One day until COMLEX

  1. Mindy

    “What patient would not complain of being paralyzed on one side?”

    well, I might if the head aches were the worse symptom – but I have been called a hypochondriac by my doctor before so I tend not to bring up any symptoms but the ones I can no longer deal with. (ex-doctor but he damage is done)

    • MomTFH

      Sorry about being called a hypochondriac! It is deplorable how many conditions are written off as hypochondria or “stress”, especially among women.

      However, hemiparesis means paralysis over one side of the entire body. My father lived with hemiparesis for twelve years. It’s not weakness, it’s paralysis. He could not walk, he could not use his arm, etc.

      If you were paralyzed on one side, I cannot imagine that being something that would not come up, even if the headaches were pretty severe.

      • MomTFH

        Oh, and also, it’s not something that should be determined by physical exam. It could be confirmed by some muscle strength (or lack thereof) testing and deep tendon reflex testing, but the patient would have shown signs of it walking (or not) to the clinic room. That information is usually included.

      • My first thought was that his hemiparesis was pre-existing and long-standing, and he didn’t think to mention it. Would love exams to throw in actual people with disabilities who are presenting with something else. It doesn’t seem to happen often, in my experience.

        I wonder how coincidental it is that the two questions are a man staunchly soldiering through his subdural, and a faking swooning woman.

        • MomTFH

          Right, very sexist presentations. It’s no coincidence that diseases that affect mostly women, such as multiple sclerosis (which could present with lightheadness and weakness) and fibromyalgia are the diseases that are frequently attributed to stress, hypochondriasis, or malingering. Or that women’s descriptions are discounted, so they are undertreated for heart attacks.

          Now that I realize it was hemiparesis and not hemiparalgia, I can see how he might not have mentioned it.

  2. doctorjen

    Actually, technically hemiparesis is weakness on one side, hemiplegia is paralysis.

    Didn’t really stop by to nitpick – just to wish you luck on on the rest of step 1! Step 1 was the last board exam I took on paper back in the day, by Step 2 all testing was on computer. I took my FP boards on paper the first time, too. I re-certed last summer and taking them on computer was much better because I’m a zippy test taker like yourself and I was able to just go home when I was finished!

    • MomTFH

      You are absolutely right. Now it makes so much more sense. My dad went from hemiplegia to hemiparesis.

      Thanks for the good luck!

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