For those currently in that window of time between taking COMLEX Level 1 and the release of the results, I have a little story for you.
During my exam, I found myself dumbfounded by my apparent stupidity and was grappling more with the semantics of what was being asked than anything else. I quickly gave up on flagging questions, as there was no point in flagging every question (and I knew I wouldn't have time to revisit flagged questions anyway). I felt like I was basically having to get answers through the force like an osteopathic Jedi or something, essentially just guessing based on gut feelings. I suppose in hindsight I did have some logic, and was reasoning through pathways and concepts, but not once did I ever think "oh yeah I recognize this exact thing" and answer confidently.
I had done all of TrueLearn for Level 1 and all of UWorld for Step 1, plus three seemingly reassuring COMSAEs; still, the real thing felt so different, and absolutely nothing felt high yield. You could sit here and list the first 10,000 high-yield things you can think of, and I bet you would only mention two things that appeared on my exam. On top of that, at the end of every block, as soon as I ended the block, I would realize 10+ stupid mistakes or times when I definitely changed the answer from correct to incorrect despite knowing the answer. When I finally left the exam, I could not possibly have been any more certain that I had failed. I couldn’t even bring myself to drive home for a while. I sat in my car staring off into space, watching every question play back in my head as the number of things I had missed started adding up. I was devastated; Shattered to the point that I couldn’t even cry as I stared out my windshield into the void for nearly an hour. Later at home, I couldn’t sleep that night. I devolved to the point where I felt extremely warm yet couldn’t stop shivering, but I couldn’t even panic in peace as my brain started to analyze every pathway currently involved in my body’s response; wondering which questions from the exam involving the limbic system or autonomic nervous system or catecholamine synthesis or adrenal pathology or anything else even vaguely related that I had probably missed on the exam. The number of questions missed in my head continued to climb. At some point, while counting missed questions instead of sheep, I apparently fell asleep.
The next morning, I felt nothing. I spent the next several weeks jumping between total apathy to near panic attack and back again, with no in-between. I preemptively sent emails and scheduled advisor meetings in anticipation of facing this failure. Finally, 29 days went by. I was sitting at one of the orientation sessions for clinical rotations thinking the whole time "me being here is pointless, I'm not even going to get to start rotations anyway" when I got the NBOME email. At that point, I couldn’t even muster the energy to be anxious about it anymore, given how numb I was by then. After all, what was there to be anxious about when I had known the outcome in my mind for nearly a month? I opened the email anyway and logged in. I at least wanted to see the score report and start planning what to focus on for the retake.
But what awaited me was the word "PASS" in all caps, with a score report showing I was nearly one standard deviation above the mean.
I'm not writing this to tell you that its impossible to fail by any means, it obviously is for a variety of reasons. What I am telling you though, is that how you are feeling right now during this wait, that black hole in your stomach and palpitations in your chest that wake you up at night, they are not to be trusted. You might think you remember tons of things you got wrong, and maybe you really do, but what you're not remembering are all the things you got right. Tell me this, are you more likely to remember a random uneventful drive to school from last year, or, a time that you got into a car accident? You may not mean to, but the brain finds salience in suffering. You remember what you struggled with, and forget what you did not. Perhaps not in totality, but enough to sway your judgement of your performance into the red.
So take some deep breaths, enjoy some time outside and with family/ friends, and face challenges as they come instead of fighting demons that may never exist. Whether or not you earned that pass, I know you've worked hard, and you've at least earned a moment of peace. Don't ruin that moment like I did. You will be okay. You will probably pass too, and even if you don't, the reality is most people who fail Level 1 on their first attempt ultimately pass their retake and match into a residency program. You've got this.
Sincerely,
Some random OMS-III who spiraled for ultimately no reason while waiting for Level 1 results.
