From Failure to Victory: Overcoming COMLEX
Every year, students from our school will fail the COMLEX exam.
That’s not pessimism or a knock on our school, it’s just statistics.
No one thinks they will be part of that statistic until they are. It can be an incredibly isolating experience watching your classmates continue with their rotations while you backslide into studying once again for an exam they have all already passed. It is taboo to talk about failure, but it shouldn’t be.
Truthfully, I have struggled with anxiety my entire life.
As a child, I didn’t have a word to describe it. All I knew was that I cried a lot more than other kids and would get upset easily. Tests were a nightmare for me, especially standardized tests. Some standardized tests were not timed, and I enjoyed taking those much more -- I would take a very long time on them. Once, in fourth grade, I spent a day and a half taking an exam. I didn’t mind spending the time as long as I could control the pace at which I answered the questions.
Fast forward to college and medical school, where every exam is high stakes, and every exam is timed. Time has taught me how to control my anxiety, and after taking hundreds of exams I have almost mastered my testing anxiety, but standardized tests are still my personal hell.
With this in mind, can you imagine how COMLEX scared me?
I tried to rationalize and soothe my anxiety with logic. I passed all my classes, followed a study plan over seven months using First Aid, Sketchy Micro & Pharm, Pathoma, and thousands of practice questions. None of my professors expressed concern about my ability to pass. In fact, I attempted and passed several practice exams. I was ready; ready to be done studying for this obnoxious exam. Every indicator said I would pass. For some context, this was happening in the era of the COVID crisis, racial justice, economic uncertainty and a tumultuous election. Being able to focus entirely on studying for an exam while so much was happening in society around me was a challenge.
I took the exam. It wasn’t what I was expecting. There was a lot of OPP, and I hadn’t spent much time studying that. “I did well on my OPP exams in school,” I thought. “I should be fine.”
By the last section, I was exhausted. My nerves felt frayed, and the adrenaline from the beginning of the eight-hour exam was long gone.
I rushed through to the end. I wanted to be finished with the whole wretched affair.
For a month I awaited the results. The exam was pushed back in my mind, for I knew I’d passed -- with a low score perhaps, but passing nevertheless. Then, while on rotation, I received the email: your score is in.
I couldn’t wait until the end of the day to find out my score, so I clicked in on my lunch break.
Failed.
Wait, what? “There must be some mistake,” I thought. I stared at that word.
FAILED.
I looked around for a score and did not see one, so in a desperate attempt to change the results I looked for my opened a different tab on the website. Yep, I did fail. Not by a lot, but it was a failing score.
Greif, embarrassment, frustration, and failure washed over me. Tears started falling down my cheeks. I needed air. I went outside and walked around the parking lot. My face mask was cold and wet with my tears. I realized my lunch break was going to end soon and I still had to get through the rest of the day of seeing patients; patients I now felt like a fraud seeing.
I pushed down my emotions for the moment and told myself to focus. “Remember the patients,” I recall thinking, “they are the most important thing right now, think about everything else later.”
As I returned to work, I imagined pushing my emotions into the pavement with my feet with each step -- not to lose them forever, but to leave them here. I would pick them up when I returned at the end of the day. With every step I felt lighter and more in control of myself.
That evening, I mourned the failed exam and wallowed in self-pity. It’s not something I usually do, but then again, I don’t usually fail at something this important.
I started looking into how this failed exam would affect my future. Could I still get into residency? The thought of spending more months studying again for this exam made me sick. I started thinking about quitting medicine all together> I thought about running away to a foreign country and starting over. My husband is from Norway, so moving there could work. It was an enticing thought, so much so that it became by back up plan if I were to fail a second attempt.
But a second attempt I would take.
Quitting is not in my nature. Stubborn tenacity allowed me to get this far. I was not going to let one failed exam stop me.
The school arranged for me to take a boards bootcamp prep course spanning 10 weeks. It was a large expense followed by more expenses of practice tests and paying for the COMLEX exam again. I followed instructions and spent over eight hours, six days per week for the first eight weeks, then 10 hours per day for the last two weeks. By the end, my studying stamina was so great that I did not rush when taking the exam but followed their recommendation of focusing on finishing 10 questions in 10 minutes, then the next 10 questions in 10 minutes, and so on.
With that pacing, I had time at the end of each section to review questions. I even found one error that I was able to correct because I had the time. I did not feel rushed. I did not get fatigued and, better than that, the questions felt easy. I was able to answer the majority of them with some level of confidence.
It felt incredible to be done with the exam; to be done studying. Whatever the result, I would never have to study for that ridiculous exam again. I had two plans -- one if I passed and one If I failed -- and I was at peace with both. I knew I could make a good life and be happy with either one. It was now up to fate which path I would follow.
Four weeks later I got an email in the middle of the day on another rotation. Again, I could not wait until the end of the day to find out.
At lunch time I went to the website and saw the best word in the English language: PASSED.
A wave of relief (and slight disbelief) washed over me. I couldn’t believe it was over. Then I wondered: what was my score? I went to the scores tab and saw a surprising score. I checked the percentile of the score and was satisfied with my performance. Then I compared it to my first score and was blown away: it was a 100-point increase from my first exam.
I did a quick Google search to see if it was common to increase COMLEX score by 100 points. It’s not.
My new score, more than anything else, validated my abilities and knowledge. I could be confident once more that I could do this; that I could become a doctor.
On my way home from rotation that night I bought champaign, a small chocolate cheesecake and some berries, celebrating the hard-won victory.
No longer a failure, I was victorious.
As I reflect on my experiences, one thing I wish I had was someone to talk to who understood what I was experiencing; someone who had failed the first attempt and had made it through to the other side. So that is the main purpose of this essay, to share my failings in an attempt to reach out to the students who have the unfortunate experience that I did.
Contact me if you want to talk about it. Contact me if you have a fear of failing; we can talk about that too.
The peace I felt going into the second exam knowing I was okay with either outcome was incredible. Critically thinking about what will happen if you fail, facing that possibility, and being okay with any outcome takes the power away from this terrifying exam.
Best of luck to everyone preparing to take this COMLEX. You are not alone, you will survive, and no matter the outcome, you will be victorious.
Allyssa Jonnson
Third-Year Osteopathic Medical Student (OMS III)
Pacific Northwest University of Health Sciences