Letters to the Annals of Internal Medicine In light of the information in these two letters to the Annals of Internal Medicine, the IPE and the MRAC should be strictly avoided. Contact me for further details. As my complaints against these people are filed, I will also publish them here. Above all else, currently, they are NOT letting you re take this test. If you take the testing offered by the IPE I would have it monitored independently. This is very serious business. Since you can't take these test again, you need to make sure that you know what you are actually taking. These are essentially step III tests. If you study the last THREE years of study material for Step III of the boards you will do fine on the multiple choice question portion of the testing. The CCS is given on a computer that is too slow. You need to practice on a computer that is too slow. The minimum is 200 MHZ and this computer is slower. You absolutely must realize that they may not be there to do an objective test. They may want to deliberately provoke you and otherwise distract you. To that end, these tests must be monitored by a video and audio recorders. The Transaction Stimulated Recall asked me to recall the last three hours of orders in order, WHILE also recalling what I thought and what I did about the data. I have one of the best memories, and so I was able to do a good job on that, however, no one can get all of that in order. I tried to get it in order but I was not expecting to be graded on that part, since well, no one can get that done perfectly, not even people with competition quality memories. My memory is just below that. The most strking thing about the encounter was the notion that the TSR was done in a colleageal manner. I was laughed at, yelled at, and otherwise told that I knew no medicine. To that end, I would not go in there alone, and I would seriously recommend that you have an objective recording of the event. You have a good deal of time between the CCS and the TSR. So during that time, write down in order what you did, and what you thought about what you did as it happened. You should be able to get most of it. That could not be more important. Start with a little presentation about the cases, and then go from there. Add in a little about the latest literature and what not and you will be done. This is the summary of things you need to do. Study the last three years of Step III material, keeping in mind that Peds, OB and what not WILL be on the test, but will NOT be broken out in the test results. I kid you not. Practice at a 60 question per hour pace.  Practice the CCS on a substandard computer. Get to a medical school and get on their computer simulations if you can. Look up USMLE WORLD for the suble things that go into the scoring of the CCS. After the CCS, write down everything, including any complaints about the testing, and then prepare a presentation about all of that data. You will probably run out of time because there are too many cases for one hour. I would consult with your lawyer about that. When I retest, I plan to tell the instructor that I have much more to say about the case, when he wants me to go on to the next case. If he says that I already got an A on the case, in front of witnesses, then I will go on. I am a teaching doctor, and so I can talk for 30 minutes on ALL of the cases, and for an hour on many of them, if I go over my canned lectures in my head beforehand. It is a real trip doing business with the IPE. Frankly, I aced the test but they made up reasons not to retrain me. I will be posting more about that as time goes on. Oh yes, PLEASE FEEL free to contact me. I will get you ready for this testing. It is not hard if you know what to study and what not. You already did this once. The difference is that the first time they did things in an honorable fashion. Also, if this happened to you, please contact me. IPE is the Institute for Physician Evaluation MRAC is the Medical Review and Accrediting Council Sponsored by Luminoso Sera Photography