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"WHAT"

Many applicants hear "what" few times and pass the exam, its not a major problem to hear it 3-4 times in total. However, if you were hearing it in each patient and more than once, this means you have a communication/SEP problem.

This is from the USMLE website:

"""The SEP subcomponent includes assessment of:
  • Clarity of spoken English communication within the context of the doctor-patient encounter (eg, pronunciation, word choice, and minimizing the need to repeat questions or statements)
SEP performance is assessed by the standardized patients using rating scales and is based upon the frequency of pronunciation or word choice errors that affect comprehension, and the amount of listener effort required to understand the examinee's questions and responses."""
 
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