The CBSE: Why You Should Care and How You Can Pass By Lindsey Bustos & Anthony Wright

The Comprehensive Basic Science Exam (CBSE) is administered by the National Board of Medical Examiners (NBME). Typically, the CBSE is used by medical schools to gauge their students' readiness for the USMLE as well as for dental students interested in applying to oral and maxillofacial surgery residency programs. So where do podiatric medical students come into play? Currently we are not allowed to sit for the USMLE yet, therefore the CBSE is the closest exam to the USMLE we are able to take in order to prove our parity.

Parity is something that DPM’s have been fighting to increase for quite a long time, as podiatrists we do not have a physician's license. This comes into play for example in the United States Military which classifies podiatrists as healthcare clinicians and limits our promotion opportunities, bonuses, and board certification pay. Another example, Southern California Kaisers consider podiatrists midlevel providers and therefore they are not company stakeholders unlike Kaiser physicians. Then there's insurance companies not paying us the same for doing the same work as a MD/DO. All of these differences yet we still get sued just like physicians and everyone refers to us as “Dr.” If this frustrates you, good! Past DPM’s have paved the way for parity and proving that we can pass the USMLE is just the next step in that game plan.

It isn't all about money however, personally, we feel that if we are at WesternU CPM getting the same education as a DO student there is no reason why we shouldn't be able to take and pass the same test. We wanted to prove that not only to our profession but more importantly to ourselves. There can sometimes be this association that pod students chose podiatry because it was an “easier” route then going to an MD/DO program. Yet, for all of us who have attended WesternU, we know this could not be further from the truth. 

Another motivator comes from the people who have taken the process this far, and we are not just talking about the classes above yours, we’re talking about people like Dr. Wan who have set up a ten year plan to get us here (don’t let Dr. Wan down!). We have to show a pattern as a profession that we consistently increase our pass rate and eventually sit for the USMLE. This project is now in your hands. The class of 2022 had multiple people pass and now it is time for the class of 2023 to step up to the plate! We want to extend our hand to help in any way that we can. Remember it's a long and hard road but you have one thing that previous classes did not have, a roadmap that shows how to actually get it done. So now the only question is are you willing to use it?

The second year of medical school was indeed grueling and this can be said even without our profession’s boards glooming over you. During the winter break of second year, some of us attempted to develop a plan of how to study for not only the APMLE but also the CBSE. First mistake - studying for the CBSE is not the same thing as studying for the APMLE or vice versa. It's unfortunate, but these are completely different tests in our experience. Having said that, if you can pass the CBSE you will pass the APMLE as long as you tack on lower extremity anatomy (which you should be studying RIGHT NOW). First things first, you’ll need a schedule, you can make one at by downloading the free Rx Study Planner.

Second mistake - trying to review all the systems again before getting into practice tests. You must confidently tell yourself that you have learned all of this already and now it's time to drive it home with endless amounts of practice tests! Allow your wrong answers to guide your reviewing. We highly recommend doing the USMLE-Rx question bank throughout all of didactic. Why? Let's say you do a 25 question practice test and don’t even get a single question correct, have you failed? Not even close. Getting those questions wrong is so valuable, because when you review you don't want to just know what the right answer was, but the thought process you should have had to get to the right answer. USMLE-Rx and the NBME website are the two places to go for practice. On any given day you should be hitting at least 50-100 questions and reviewing them is key. Every other weekend should be a practice test followed by review of that practice test (during dedicated).

I’m sure we’re all familiar with the First Aid for the USMLE book, well if you’ve ever taken a peak at their recommendations for how to study they say it right there:

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The truth is we are going to need longer than one blog post to walk you through the algorithm to pass this beast. If there is one single thing we could impress upon you, it’s the mindset. You must buy into this process, we were determined to pass the CBSE as if we were DO students fighting for a residency.

Having this mindset allowed us to push through all the hurdles that are coming for you, and let us be clear, we are not saying if the hurdles come but when! Medical school is tough, none of us can deny that. We have podiatry courses on top of our shared curriculum. We have our own boards to get to third year and yet we are asking you to put the CBSE as a top priority. We know how crazy that sounds, trust us cause we were in your shoes. Our class' mindset was that regardless of everything on our plate, it was our turn to step up to the plate and do our part in this project that so many before us have given their everything for. We are the only podiatry school who is even attempting this huge task and that comes with a lot of responsibility. We are trying to set the tone and direction for the future of our profession and everything in life that is worth it requires hard work and sacrifice!

You will see that making the CBSE a top priority is not adding more work to your shared curriculum. We are simply asking you to use the same resources that will allow you to pass the CBSE, to be used to help you crush didactic! All of the resources we recommend including: Sketchy Micro, Sketchy Pharm, Pathoma, and USMLE-Rx question bank are resources that will help you now! These tools (when used correctly) can boost your didactic scores. So think about this, yes we are asking you to do a lot, but the upsides include the chances to have higher scores in didactic, pass your didactic exams, learn how to get questions correct when you have no idea what they are asking you, and passing an exam that only a few podiatric medical students have passed in the history of our profession. What do you have to lose? We are training to be physicians and surgeons. If you have survived to this point you are capable and we have got your back!