Alright, so I don’t know about you but when I was a premed I was always SO curious about medical school exams. How often they happen, what grade you have to get to pass, how hard they are, etc. I wanted to know it all!
So in this blog post that’s exactly what I’ll be breaking down for you. By the end you’ll have a glimpse into what it’s like to have exams and finals in med school!
Now that I’m a first year med student the #1 thing I’ve realized is that they aren’t as scary as I would have guessed! I have always heard so many horror stories about failing your first exam, anatomy being next to impossible, drinking from a fire hose, and the list goes ON.
But I promise it IS possible to find your study groove early on and not do so bad!
Also, keep in mind that all med schools are VERY different so while this is my experience with medical school exams, it may be completely different at a lot of other med schools and it could be really similar to some med schools. It just depends on where you go, but I’m sure there are enough similarities to help you get a good idea of what they’re like either way!
This post is all about exams in medical school
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What Medical School Exams Are *REALLY* Like
At my school, we have a quiz every Friday which may sound daunting, but I promise this is actually my FAVORITE part of our curriculum! Why? Because I am the queen of procrastination and if it weren’t for these weekly quizzes to keep me accountable, I would no doubt be cramming for every final.
Instead, I have literally never crammed for an end of block final because I stay on top of studying EACH week. Then when the final comes after 4-6 weeks of whatever block we’re in, I don’t even have to do extra studying!
- Format: Multiple Choice
- # of Questions: ~40
- Timing: 1 Hour
- Pass Rate: 50%
So what do our questions consist of in the end of week quizzes? The majority of the quiz consists of the content that we learned that week related to the block we are in. So in renal and urinary we had questions on renal physiology and pathology and usually there’s 1-3 questions from anatomy lab.
So for example, at the time I’m writing this we are in the Neuro block so we might have 2 questions for our PCV (pulmonary and cardiovascular) block.
Lastly, we have 3-5 questions from DOCS and H&S. DOCS is where we learn communication, interviewing, and physical exam skills with standardized patients and H&S is where we talk about random topics like climate change, smoking cessation, racism, etc.
End of Block Finals
- Format: Multiple Choice
- # of Questions: ~80
- Timing: 2 Hours
- Schedule: The last Friday of each block
- Pass Rate: Ranges (so far it has been 65% – 73%)
Thanks to the fact that I mentioned above, I don’t think finals at my med school are nearly as daunting as they could be!
These end of block finals have a lot of similarity to our end of week quizzes, but there are some key differences.
First, there are no spiral questions from previous blocks. The content is only the content that we learned in that block!
Second, the pass rate is always higher than 50% but it is different for each block. Here’s what the passing rates have been so far for our end of block exams:
- Foundational Principles – 73%
- Heme & Lymph – 68%
- Gastrointestinal – 70%
- Pulmonary & Cardiovascular – 65%
- Renal & Urinary – 71%
Third, unlike our weekly quizzes where our grade doesn’t factor into anything in the future, our final exams DO get factored into our class rank in our 3rd year.
In our 3rd year they will factor a bunch of things like grades on our end of course finals, DOCS assessment grades, anatomy practical grades + grades from clinicals to rank us all. It’s not a normal rank like numbering the top to bottom student, but rather just noting whether a student is in the top 25% of the class or not.
- Format: read the question, tag the donor to answer
- # of Questions: 20
- Timing: 35 minutes (not enough time IMO!!)
- Schedule: Every COMPASS week (except the first)
- Pass Rate: Ranges (so far it has been either 60% or 70%)
Alright number four on the list is business casual outfits. Funny story, they told us two days before Alright, this is the only exam that we have in medical school that legitimately makes me nervous!! We have second order questions so it’s not like, “Tag the coronary artery”.
Instead it’s like, “okay if this patient gets in a car wreck and X artery becomes occluded, what artery does it anastomose with and therefore will still be able to perfuse X”.
So you have to first have the knowledge to answer the question THEN have the knowledge to tag the right thing.
And this is the perfect argument as to why weekly quizzes are amazing! If we had weekly quizzes for anatomy every Friday then I would be on top of my sh*t and not feel super unprepared for our anatomy practicals 😅.
But that’s not the case so I always feel behind. The TAs do give us practice practicals each week which is the main way that I study and prepare for our practicals, but I still haven’t figured out when the heck they release them each week so it’s not part of my regular routine yet!
What is a COMPASS week?
Glad you asked! We have these every 2-3 blocks and that’s when we take our anatomy practicals + DOCS assessment and then we have the rest of the week off!
So the beginning of the week is kind of stressful and full of exams, but then we are done sometimes as early as Tuesday or Wednesday then have NOTHING the rest of the week! I use these weeks to travel!
During the last COMPASS week I was done with all my exams Tuesday at noon then flew to DC Wednesday to visit my best friends from college. They are THE best!
Standardized Patient Interview + Physical Exam Assessments
- Format: Two standardized patient encounters (interview + physical exam)
- Additional Requirements: Upload a SOAP note for both patients within 24 hours – or one SOAP note and one oral presentation
- Timing: 45 minutes per patient
- Schedule: Every COMPASS week
- Pass Rate: 75%
For us, these are called DOCS assessments. Let me backup and first explain what DOCS entails for us at my school!
DOCS is a class where half of the class has it on Tuesdays from 1-5pm and the rest have it Wednesdays from 8am – 12pm.
We kind of started really small the first week of classes and have been continually building on our skills. So we first learned how to take a patient history and write a SOAP note.
Therefore, our first DOCS assessment didn’t include any physical assessments. It was just two standardized patient encounters and we had to upload our SOAP note for each encounter within 24 hours.
Then after that we started learning how to do interviews + a physical assessment. Therefore, our second DOCS assessment included the abdominal physical exam that we learned in addition to interviewing.
We also continue to build on our communications skills. Just last week we started learning how to talk with “difficult patients”. Our standardized patient was acting as a grandma who was upset because her 8 year old granddaughter had been discharged from the ER the previous night then had to come back in and get emergency surgery for appendicitis.
She was an amazing actor so she was really good at acting super angry, fake crying, the whole shabang! So I don’t know if our next DOCS assessment will be quite that dramatic, but we will be working on our communication skills with similar scenarios for the next one!
Practice Step Exams
- Format: multiple choice questions
- Timing: 5 hours
- # of Questions: 200
- Schedule: Every COMPASS week (except the first 2)
- Pass Rate: 2% (not a typo! We take these purely for practice)
We don’t take the real step exam until we are in our 3rd year of medical school so my school gives us a very low bar for these practice Step exams that we started taking in COMPASS 3. If we score below the 2nd percentile then we may be delayed starting our clinical rotations and they prefer us to score at least above the 5th percentile.
But for reference, we apparently had classmates already score a passing score, so the bar is really low! We are just taking it to get used to the format, questions, and to test what knowledge we have covered so far (which at the time I’m writing this is half or maybe slightly less).
I hope you feel like you have a solid grasp on what medical school exams are like now! I know I would have LOVED a post like this when I was a premed student so I really hope it was helpful, insightful, and put any nerves at ease that med school is impossibly difficult. It is doable (I promise!) and you can find a solid routine early on if you experiment and utilize the resources you school offers if need be.
Leave a comment with any questions you still have!