Thread: My 5th semester/ COMP experience

Aloha ValueMD readers and fellow Rossians! Its been awhile but I wanted to fill you all in on my experience in 5th semester and the COMP exam. I am currently studying for the Step but since it was "just one of those days" I thought I would write to you all.

I decided to go to Miramar for my 5th semester and I must say that it is definitely a 180 from the 4 grueling semesters on the island. To start off, you have a lot less stress and much lighter workload. 5th semester essentially consisted of large group lecture once a week, small group lectures/simulations and mini rotations throughout the rest. Your schedule isn't all planned out for you like it was on the island. Some weeks you will be very busy and other weeks you will probably have stuff to do for 2 days. Youre class will be divided into groups and the schedule will be made accordingly.

The rotations in my opinion were my favorite because you FINALLY get to see what life is like as a physician in different settings. I had one internal medicine rotation in an office setting, one Emergency med rotation (my favorite) and one Derm rotation. There are obviously a lot more options like orthopedic surgery, urology and peds. Rotations are really the luck of the draw. You can have great physicians or you can have physicians who treat you like nothing much than a fly on the wall. Depending on who you have you may be simply shadowing, doing patient interviews, doing physical exams, or actually doing some clinical work. Many of my fellow classmates got to do DREs, excise SKs, place a needle, etc. Overall, its very laid back as they just want you to get an idea of what you will be doing in your career.

Large group lectures are mediasited. Some lecturers are mediocre while others are fantastic. My semester had the opportunity to hear from physicians from Yale and Cleveland clinic. For those of you who have no idea on how to tackle epidemiology definitely utilize the epi lectures this semester because it will save you for the COMP/Step.

Small group is a mix of things from simulations to lectures. These are more personalized and you'll have the oppurtunity to learn alot of new things.

The faculty is so different from the one of the island. The junior doctors really make the effort to help you in every way possible so make sure you build a rapport with them. They are really the people running the show and will take the time to assist you with whatever you need.

Exams are nothing compared to the torture we endured at Ross. You have a midterm and a final and they really are not difficult at all. The biggest bulk of your grade I'd say comes from your papers you'll have to write and also the physical examination at the end of the semester. The papers consist of SOAP notes, physical exam write up, and a program called dXR. They are very picky in grading these so make sure your formatting and proper placing of information is in the right places otherwise they will dock off points.

You will be preparing for the physical examination throughout the semester so make sure you are practicing with your partner. This is probably the most important and largest of grade. A lot of the stuff you learned in Dominica for the PEs are irrelevant and they teach you a lot better techniques on how examine your patient (for those of you who remember how they taught us how to use the opthalmoscope and otoscope you'll know what I'm talking about).

Overall I would say it was a great experience. I had a lot of free time on my hands to explore florida and enjoy Miami beach. If I could recommend Fla, DM or MI I would say go with Fla. Most of my friends who went to MI didn't have a good experience as we did as they had fewer rotations (most of which consisted of going to Senior facilities) and less stuff to do. I had the opportunity to do three rotations each of which was twice a week for two weeks. It is more pricey in Fla in general but you get what you pay for. The weather is a plus factor and you are 15 minutes away from Ft. Lauderdale and 30 mins away from Miami. Everything you need in the area. You will definitely need a car to get around though.

They are changing around a lot of things for AICM. Like for example, this semester has fewer classes and more rotations. They really want you to focus on prepping for your Step and Comp for those who didn't pass the first time around. Also throughout the semester they are offer a course to help you in your preparation.

****************COMP: roughly 200 questions/ roughly 4 hours************
The most important thing you have to realize for the COMP exam is that its not going be like questions we had on the island. While you study on the island for minis its basically a regurgitation of the facts and figures you learned in lecture (simple ex.: Hairy Cell Leukemia picture = TRAP test). For both the COMP and the Step you have to take it one step further (ahah pun ). You have to know WHY things happen the way they do or what exactly is happening when you are treating a patient. Its really tough to change the way you've been preparing for the minis to how you prep for the boards. The most important thing I need to stress for prepping for this test is QUESTIONS, QUESTIONS, QUESTIONS. Do as many as you can everyday when you start studying. This was my downfall the first time around. Not only will the questions give you an idea on what you can expect but it will help you timing during the exam. The questions stems are about 1-2 paragraphs long and easy to run out of time. The first time around I had 30 mins left with 60 questions.

This is what worked for me, which may or may not work for you. I would recommend making a schedule. I started studying for the COMP the second time around right after 5th semester ended. For prep I used DIT, Kaplan videos, UWorld QBank and of course your bible aka the First Aid. By the second time I took the test I went through First Aid twice, once being with DIT. I also did 70% of the UWorld questions. Anything I didn't understand in First Aid, I used the Kaplan videos for clarification. On certain nights I would review some high yield concepts with my friends. I tried to study throughout 5th semester but it didn't really work out for me. I had classes and rotations so I couldn't really get on a solid schedule.

Passing the COMP for me was big feat. Remember that you need to take the COMP in order to sit for the Step and the process of getting that ticket is long (I can't set my date for another 4 weeks until NJ and the board processes my papers). Many of my friends who passed the first time were able to schedule their Step exam and take it early and are currently enjoying their summer.

I think thats all I have to say. Any questions, I'll be glad to answer them.

I agree with you - 5th was my best semester overall. I **LOVED** the ER rotation. I was a bit frustrated because I didn't have much time to study during the semester, but we all live and learn. Good luck studying for Step - I'm waiting for permission to schedule it also. It feels great, though, doesn't it? Comp was my biggest hurdle, and I'm so glad I've finally gotten past it. You're right, it was those darn questions. I must've done 3,000 q's before I took it a few weeks ago, and most of the nbmes.

Originally Posted by YoungCC

...Many of my fellow classmates got to do DREs...

Everyone sure finds their own bit of happiness a bit differently these days.

I just finished 5th (Miramar), and thought I'd BUMP this/chime in...even though I wouldn't add that much from the great post from the OP.

1) NEVER consider this a waste of time. I've had enough classmates of mine express that at one point or another during 5th. If you consider this what is, a transition from basic sciences to clinical sciences and stick to the syllabus as far as Step 1 study, it's impossible to consider it a waste of time necessarily. The large group lectures (mediasited) are unbelievably High Yield and some are given by the very people who review and write Step 1 questions. It's almost an unfair advantage cuz if you are enthusiastic enough, they will reveal the actual process of how they actually compose Step 1 questions! Having access like that is NOT a waste of time.

Small group is an introduction to clinical sciences critical thinking. It's a relaxed atmosphere apply what you already know, into a practical application w/ a fictional patient. Fictional patients don't die, and the doctors who lead small group WANT you to make mistakes to see where your faulty logic is, to correct you. Better them than some attending who might be cynical of your Ross white coat.

2) Be ready to do your best. Pay attention to the fact that grading is mean-referenced curve. This is NOT the same as MPS!!! For example, 90% is required to pass PE. In the structure of PE, it's easier to simplify it to say that a 95% is the mean which gets you a B-. A 90% is not an A, even tho that's how it is on the Rock. Pass doesn't equal A. It equals a grade based on the %! Practice practice practice it! It's not enough just to know how to do it. In fact they take things out of what we learn on the island because it is a timed well-person complete PE. Knowing it isn't good enough. You need the timing of it!

3) To study for Comp and therefore the Step also, understand pathophysiology. The one thing a few of us observed is if a question tells you exactly what is wrong w/ the patient, it's going to be a tough question! ie - "A patient with longstanding aortic stenosis..." is going to need 1 or 2 extra, potentially more difficult steps to get to the correct answer, as opposed to "Upon auscultation you hear a systolic murmur, and thrill upon palpation..." the answer is probably only 1 step away" You are almost guaranteed to have the former be a tertiary question, and the latter be a secondary question. That being said, it's NOT enough to know buzzwords. If you want to study properly for the Comp/Step, focus a lot on the pathophys, treatments or diagnostic evaluations.

The OP covers most of the rest I'd write. Best summary of my post is that 5th is ONLY a waste of time if you tell yourself it is! Find the utility of 5th thru parallels.

~ Good luck incoming 5ths!!!

I disagree, 5th semester is a complete money maker for Ross/ Devry. When we should be studying for STEP 1 we are being retaught more clinical things we've already been exposed to on the island. Yes the exposure to actual clinics is great, however the fact that we still have to write H&P's and SOAP notes again is worthless, considering that most hospitals don't even use these anymore, since paperless entry has created preset formats. In fact, I am tried of being told this is pointless by the physicians I see. Not to mention that somehow the format for doing physical exams, and writing H&Ps magically changes from the island to Miami making everything we previously learned nearly worthless.

As far as the new curriculum goes, students are requested to take their step between 4th and 5th semester.
COMP is now taken at the end of 4th sem along with a step 1 review course implemented into the curriculum (making 4th sem the harder than ever before). Apparently there is a 2 month break between 4th and 5th semester.
So my question is, what is the purpose of 5th semester if you finish step1 already?

Originally Posted by hemeonc88

As far as the new curriculum goes, students are requested to take their step between 4th and 5th semester.
COMP is now taken at the end of 4th sem along with a step 1 review course implemented into the curriculum (making 4th sem the harder than ever before). Apparently there is a 2 month break between 4th and 5th semester.
So my question is, what is the purpose of 5th semester if you finish step1 already?

To make sure you're not going to make a total butt of yourself in the hospital.

According to the Dominican Medical Board (a bunch of us met with them during our 5th semester in Miramar), the purpose of 5th was never about studying for Step1. It's ways been about learning the Physical Exam, and introducing Step2 topics. I am personally VERY impressed with this new change in the curriculum, and I think it'll be pivotal in helping students finish program on time, get great Step1 scores, and get scheduled right away (since if you take Step1 before 5th, they've got a few whole months to get your score & paperwork in order, then schedule you.) So yeah, huge step forward for Ross.

Originally Posted by manofsin

I disagree, 5th semester is a complete money maker for Ross/ Devry. When we should be studying for STEP 1 we are being retaught more clinical things we've already been exposed to on the island. Yes the exposure to actual clinics is great, however the fact that we still have to write H&P's and SOAP notes again is worthless, considering that most hospitals don't even use these anymore, since paperless entry has created preset formats. In fact, I am tried of being told this is pointless by the physicians I see. Not to mention that somehow the format for doing physical exams, and writing H&Ps magically changes from the island to Miami making everything we previously learned nearly worthless.

While the Physical exam component is exceedingly complicated compared to what you will be doing in the hospital, the ability to take and write a good HPI is essential for hospital rotations and residency. In fact this skill willhelp to set you apart. While , you can get away with a template for some ward/unit rotations, all HPI's are written by hand at my hospital. 70% of the diagnosis is based on your hpi.

I like the idea of 5th going post-Step. That's great. But to state 5th is meaningless misses the whole point.

Few schools, except Ross, grant a student the ability to learn by experience in something as important as medicine! There are 4-5 "Harvey" sessions, but guess what? Harvey will probably die when you and your team scr3w up. It was a regular occurrence. ('cept for me in my groups, we ALWAYS somehow incredibly saved Harvey toot, toot)

I talked to Dr. H after 5th was over, and did mention it would more useful to have some cohesiveness to the HPI process. HPI's are going to be your bread n butter for the rest of your life in almost every instance, after all. I suggested to her that they begin teaching the same HPI on the Island. Yes, they are almost completely different from each other. I got a low score on my 1st HPI for 5th, even though I wasn't even getting re-corrects on the island. I told Dr. H it would be more useful to be using the same "system" to write an HPI from semester 1 on.

And 5th the emphasis is the transition from basic science to clinical science. It's amazing how different the two are, yet they are still very much intertwined w/ each other. If you think you are clinically savvy by the time you get off the Rock, you are ABSOLUTELY fooling yourself!