USMLE Nightmare: Med Student's Responses Fail to Record

Roni Robbins

September 10, 2021

Any other fourth-year medical student whose last test before becoming a resident was lost and who learned days before the start of the residency application season that he had failed a rushed retest may have second thoughts about continuing on the doctor route, at least in the immediate future.

But not the 26-year-old student from a southern US medical school who recently posted his struggle on Reddit. Using the name Variations on the popular social media site, he garnered more than 1500 upvotes recently in two postings regarding his situation. A number of users commented that they or someone they knew also faced difficult test situations.

Variations would only provide his initials, AK, to Medscape Medical News to avoid jeopardizing his applications to physical medical and rehabilitation residency programs.

"I'm not going to let it stop me," AK told Medscape. "Not everything in life goes the way you want. You can't let this define you." Instead of wallowing in self-pity, AK took to social media to spell out his circumstances and to seek advice and encouragement in his pursuits. He's also considering legal action.

In June, AK received a letter of apology from the National Board of Medical Examiners (NBME), which he shared on Reddit – and with Medscape. The letter said that "because of a very rare technical problem, we did not receive the record containing your responses" to the Step 2CK US Medical Licensing Exam exam that had been administered a month earlier. "We sincerely regret any inconvenience this problem may have caused you."

NBME issued a full refund and allowed the student to retake the exam for free until September 30. Not as easy as it sounds, according to AK. The summer is a busy time for fourth-year students. Away rotations, sub-internships, and other important elective rotations are needed to secure letters of recommendation for residency programs in an application season that began September 1, he told Medscape. And a failed test on your record for whatever reason is a red flag in the competition for a residency spot, he added.

Scrambling for a Retest

After fighting with NBME to no avail, AK tried to find any open testing center in the southern United States. Despite "playing jigsaw with my rotation schedule to find a proper studying and testing window," there weren't any spots within a 300-mile radius of his school that would allow him to take the test and that had a reasonably short turnaround time. The only available spot he found was in New Jersey near where his parents live. He had to petition for a week's leave from his away rotations to take the test on July 8. At first, the school was not willing to give him extra vacation time to study for a make-up exam, so he only had 4 days to study between rotations. He had to buy new test prep resources after his previous test materials expired, and requests for financial assistance "fell on deaf ears," he said.

The retest completed, AK applied to 70 residency programs. On August 25, he received notice that he had failed the retest. "This has jeopardized my entire application for the upcoming cycle.... There is no way that this performance is indicative of what I could have done, especially having used nearly a month of time specifically for my original Step 2 study period. To replace that experience in May with just a few days of review while in between rotations, which having to fly up ― it is no wonder I did so poorly," he said.

AK expects that 20 to 30 of his residency applications to highly ranked schools will be thrown out because he failed the test. But perhaps he will be able to convince other programs to accept him in light of his plight.

Of the mishap, NBME Communications Director Barbara Del Duke told Medscape, "It is extremely rare that an examinee's test data does not get transmitted. In the rare instance this does occur, the impacted examinee is provided a cost-free retake and support to reschedule their exam. We sincerely regret the issue."

As if the testing debacle wasn't enough, AK also was evacuated from his school after a recent hurricane. At the time he was contacted by Medscape, he was staying temporarily with a friend.

His school has agreed to give him until October to study for another test, which he will take in November, "and hopefully have my score out by December so I can be back on track for interview season/rank list time," he wrote on Reddit recently to update followers on his progress.

AK told followers his school had agreed to document his situation for his Medical Student Performance Evaluation, and a medical prep company offered him its test prep package and 8 hours of one-on-one tutoring free of charge.

"Just dropped $650 signed up for Step 2CK again yikes, but I'm willing to hold my head up high in the face of all this...and keep fighting," his Reddit post continued. "I'm going to stick with applying PM&R this cycle and let programs know this is exactly what happened and this is exactly what I'm doing about it.... I don't want this situation to compromise my story and what I am capable of."

As for providing remedies for "rare" exam mishaps, NBME's Del Duke offered that "any examinee who experiences an issue on test day is encouraged to contact Customer Service so that we can provide support and assistance."

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