USMLE Step III Exam (Day 2) Computer-Based Simulations - Consultations and Considerations

The in-depth computer-based simulations found on the USMLE Step III Exam are designed to offer a suitable representation of the types of patients and conditions that a doctor might see in any medical practice. However, even though these simulations are extremely detailed and allow the exam-taker an opportunity to prove his or her ability to work in a simulated environment that is very similar to an actual medical environment, there are a couple of things that the exam-taker should keep in mind. First, the individual taking the exam has the ability to request consultations with simulated medical personnel and medical specialists during each simulation. However, the option to request consultations during the simulation is primarily there to assess the exam-taker's ability to determine when a consultation is necessary rather than allowing the exam-taker to receive necessary information. Basically, this means that the consultations may not be very useful to the exam-taker in terms of providing the exam-taker with necessary information, but the exam-taker will receive points for ordering consultations at the appropriate times. Even though in a real-word situation a doctor would be able to request a consultation with another doctor, specialist, or other medical professional in order to discuss a patient's treatment and receive recommendations, the consultations found in the simulations are not very useful because each simulation is designed to assess the exam-taker's ability to act without supervision. As a result, the consultations in each simulation only offer a limited amount of information and, with the exception of certain simulations, will usually not offer recommendations that are very useful to the exam-taker.

Second, it is important to realize that other doctors, nurses, specialists, and other similar medical personnel found within the simulation will carry out the exam-taker's orders, but they will not write any orders or take any actions by themselves. In a real-world medical setting, the care of a patient is usually not the sole responsibility of a single doctor, but rather a team effort where the other medical personnel around the doctor would aid in the patient's care by carrying out routine tests and examinations, by informing the doctor of a change in the patient's condition and requesting new orders, writing new orders, or taking other similar actions by themselves. However, the simulation is only assessing the exam-taker and, as a result, the medical professionals within the simulation will only act when the exam-taker orders them to do so.