ERAS Filter

[winner123]

You sound proud of your accomplishment, considering your whole point is that the score is meaningless.

I would congratulate you, but your score says nothing about your knowledge, work ethic, or clinical reasoning so you're out of luck.

So, u r doubting my score!How can u do that if according to u score is everything.
I ain't proud at all.It is just usual.My point is just that there r many applicants out there who ,somehow, cud not do gud on the steps but in reality have all the necessary ingredients to be very fine doctors.
Good Luck!

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[JeffLebowski]

This statement of yurs shows that u have a problem understanding english language.
I never said that all the finest doctors in the US have low Step-1 scores.Wat I said is that there r many doctors who have done badly on steps but later proved to be very fine practicing doctors.
I hope u join some international english langauage teaching course.
Good Luck!

That's not what you said.
I don't know what to tell you buddy, the direct quote is, "there r hundreds of examples of those IMGs who did poorly on the steps and then proved out to be the finest doctors out there".

But giving you the benefit of the doubt that you meant to say FINE instead of FINEST (as you now say), I agree, you can become a fine physician, and according to you there is plenty of evidence suggesting that the Step 1 score achieved by your examples appropriately places those candidates into training programs that suit them, because they eventually become successful. So the current system doesn't stop anyone from becoming a truly FINE physician, does it? To be honest, I'm not sure what you're complaining about any more, or if you understand the arguments we're making.

 

[winner123]

You've presented your thoughts. Given the way residency selection is done right now, what do you want out of posting here? If you want to change minds, then you need to convince folks with more than anecdotes about successful FMGs with low scores and how the USMLE isn't designed for resident selection. If you want to vent, then that's ok too, and we'll cheer you on and say the situation sucks.

I m just saying that there is a problem with the system and that there r many better applicants whose applications r not even looked at due to ERAS filters.

 

[howelljolly]

I m just saying that there is a problem with the system and that there r many better applicants whose applications r not even looked at due to ERAS filters.

Thank you for your novel insight into the situation. We hadn't thought of this pitfall in the use of ERAS filters.

:troll:

 

[JeffLebowski]

I m just saying that there is a problem with the system and that there r many better applicants whose applications r not even looked at due to ERAS filters.

How are they better? And more importantly, what component of the application do you think should receive the weight that Step 1 currently carries? And in what was is that MORE fair than the current system?

And why do you assume that programs are seeing less capable applicants when they apply a Step 1 filter?

Let's try a thought experiment to walk you through the concept.
You seem not to take any issue with the fact that the USMLE differentiates passing from failing and you seem to feel comfortable with that differentiation being valid. Do you think it would be appropriate to put a cut-off for Step 1 at the PASSING level? Passing equals a score, so that's a cut-off of 185. Is that fair? Your assertion is that the SCORE itself means nothing. Don't you think the passing level is pretty arbitrary as well? Why do you have faith in the passing score cut-off but not in any ERAS filter score cut-off? Because the USMLE says they didn't specifically design it for residency selection? Do you really think there's that much difference between a 183 and a 187? One person is considered and one is not. ERAS filters are really just an extension of the concept of setting a passing level for the USMLE. This exam TESTS MEDICAL KNOWLEDGE, CLINICAL REASONING, AND ABILITY TO PERFORM UNDER STRESS. Why would getting more questions right not mean anything? It means something, and if you subscribe to the idea that PASSING means something, you have to accept that the score means something, which means that it's acceptable to use to stratify applicants if deemed appropriate by people who have experience in this arena (not you).

Suggest a better system to select applicants into training programs than the one that has currently been designed (by highly experienced leaders in the field with extensive knowledge and experience of what it takes to be a physician in their field) and we'll discuss it. I'm tired of listening to people who don't know what they're talking about complain about "fairness" of using a STANDARDIZED test to select applicants, come on grow up and grow a pair this isn't hug and tell everyone they can do anything time.


Edit: .....is this guy a troll, howell?

 

[Man In White]

I m just saying that there is a problem with the system and that there r many better applicants whose applications r not even looked at due to ERAS filters.

Define "better." Let's say a program has 1000 applicants, filters out 500 with Step 1, and then filters on other criteria for 100 interviews to fill 10 spots. How many "better" applicants do you think were lost in that process that is significant. Those 100 interviewees have excellent grades, LORs, CVs, AND they managed to pull a high Step 1 - they are more than overqualified for those 10 spots. The system seems to work pretty well.

Now, perhaps, a few stellar candidates in every other category had a bad day and did poorly on Step 1 and were screened out. Do you really think it's worth the program's time to sift through the extra 500 applications to find these few when they already have so many excellent candidates?

And let's be honest here - only the MOST competitive programs out there will set the bar high enough to make any difference in the whole process. If you think you're getting into UCSF or MGH with a 220 you better be ready for disappointment. There is nothing you can offer that their applicants don't already have - PLUS they have great board scores. I'm sure there are many, many more programs that have no such cutoff - less competitive programs that receive far fewer applications and thus have the time to review more of their applicants.

I can sympathize - I've been screened out in every way my whole life - didn't even get into med school on the first try, but I realize that it is a gigantic game and we are not entitled to anything in it.

 

[ResidentMD]

I have been closely watching this thread.
Tetris is absolutely right.
Why r not then retakes allowed at the USMLE steps like they r allowed at the MCAT?
If that would have been the case then the purpose of the exam would surely have been to rank the applicants.But,it is not so.
Good Luck, Tetris!

Dude - you have been arguing about this since nearly a month now. Seriously, dont you have better things to do? Even if you were right, there is no one here agreeing with you. So who are you out to convince? Or are you just enjoying occupying a little more of cyberspace everyday? No one here seems to be listening to you, so if you really want to devote your time to this, why not take it up with the NBME/ERAS/association of program directors of whichever specialty you are applying to?

This thread has gone over a 100 posts, and the only thing you seem to be doing is making a fool of yourself. And you didnt even start out like that. You just made a comment, people told you to stop, you didnt, and look where you are.

So just stop, and stop occupying more space.

Mods - it seems this thread has run its course, and the only thing that seems to be happening is bashing up this guy, who clearly does not seem to know when to stop. So lets just close it, unless someone has something else to add.

 

[JeffLebowski]

Dude - you have been arguing about this since nearly a month now. Seriously, dont you have better things to do? Even if you were right, there is no one here agreeing with you. So who are you out to convince? Or are you just enjoying occupying a little more of cyberspace everyday? No one here seems to be listening to you, so if you really want to devote your time to this, why not take it up with the NBME/ERAS/association of program directors of whichever specialty you are applying to?

This thread has gone over a 100 posts, and the only thing you seem to be doing is making a fool of yourself. And you didnt even start out like that. You just made a comment, people told you to stop, you didnt, and look where you are.

So just stop, and stop occupying more space.

Mods - it seems this thread has run its course, and the only thing that seems to be happening is bashing up this guy, who clearly does not seem to know when to stop. So lets just close it, unless someone has something else to add.

Yeah, I'm inclined to agree.

 

[howelljolly]

Edit: .....is this guy a troll, howell?

yes, look at his other posts. He is an IMG, but a fairly eloquent writer. He's having fun at the expense of our cortisol levels.

He has even told us his USMLE scores on the SDN, and his Step1 is fairly admirable, Step2, not so much.

If you're bored, you can look at his other posts and see the difficulties he's been having in landing a residency...

Said difficulty may be explained by the 25-30 point decrease from Step1 to Step2. Not because of being an IMG, or language barriers, or anything. A significant decrease from Step1 to Step2 is looked on poorly.

 

[Man In White]

I don't know .. I've gotten a few chuckles out of this thread in the last week or so.

 

[winner123]

I don't know .. I've gotten a few chuckles out of this thread in the last week or so.

I got the same as well!!

 

[Winged Scapula]

The thread seems to have run its course. If it continues in the vein of trolling/insulting each other, then I'll close it. Otherwise let's let it die a natural death.

 

[Man In White]

I got the same as well!!

Heh, likely for different reasons.

 

[JeffLebowski]

The thread seems to have run its course. If it continues in the vein of trolling/insulting each other, then I'll close it. Otherwise let's let it die a natural death.

You don't support thread euthanasia? You took an oath to alleviate suffering, you know.

 

[Winged Scapula]

You don't support thread euthanasia? You took an oath to alleviate suffering, you know.

Only if the thread wants to die, not just family and friends.

 

[winner123]

Dude - you have been arguing about this since nearly a month now. Seriously, dont you have better things to do? Even if you were right, there is no one here agreeing with you. So who are you out to convince? Or are you just enjoying occupying a little more of cyberspace everyday? No one here seems to be listening to you, so if you really want to devote your time to this, why not take it up with the NBME/ERAS/association of program directors of whichever specialty you are applying to?

This thread has gone over a 100 posts, and the only thing you seem to be doing is making a fool of yourself. And you didnt even start out like that. You just made a comment, people told you to stop, you didnt, and look where you are.

So just stop, and stop occupying more space.

Mods - it seems this thread has run its course, and the only thing that seems to be happening is bashing up this guy, who clearly does not seem to know when to stop. So lets just close it, unless someone has something else to add.

Seems like u have a habit of giving sermons to people.
But, who is here to listen to all yur crap?

 

[Rogue Synapse]

[agonal breathing]

 

[howelljolly]

And with that, readers, I think it's time to bring a close to this thread. It's not going to get back on track or get any better from here, I don't think.

Closing.

Um, its not closed

 

[smq123]

Um, its not closed

I closed it, but per a reader's request, reopened it, at least for the moment.

 

[howelljolly]

I closed it, but per a reader's request, reopened it, at least for the moment.

Bah humbug.

 

[tetris]

As to why this is unlikely to change:

1. The USMLE doesn't want the exam used for residency decisions. Hence, they are unlikely to change their policy in this direction.

2. The exam is used to assess adequacy for licensure. What happens if someone passes the first time, then fails the second? The problem with this is that each state has it's own laws regarding USMLE passage for licensure, and each state would need to address the legal problem. Even if states left it alone, if you were ever sued for medmal in the future it could (and would) be argued that you were incompetent based upon this failed exam.

3. You are assuming that PD's would believe the most recent, or highest, score. That is an assumption. There is some chance that PD's would simply look at your lowest score, or your first score. In that case, retakes would only be harmful.

Thanks for finally explaining why retakes aren't allowed. But these reasons don't explain why numerical scoring is used, rather than making it pass/fail.

smq, thanks for reopening; you closed it just as I was typing my response.

 

[howelljolly]

Thanks for finally explaining why retakes aren't allowed. But these reasons don't explain why numerical scoring is used, rather than making it pass/fail.

smq, thanks for reopening; you closed it just as I was typing my response.

The 2 digit score (which incidentally is NOT a percentile) is there because individual states can set a minimum acceptable score to be eligible for a state license. It can be whatever they want, not just passing.

 

[tetris]

These arguments are all beside the point. It doesn't matter whether residency programs use USMLE scores or PSes or LORs or clinical rotation grades or a crystal ball to choose which applicants they want to interview: *someone* is going to get shafted. Any time you are trying to winnow hundreds of reasonably competitive apps down to a manageable number, you run the risk of losing some perfectly good applicants no matter how you go about it.

This is now my third year serving on the adcom at my med school, and I can unequivocally tell you that choosing which applicants to interview or accept is not an exact science. There is a great deal of subjectivity at every step in the process. There is also no perfect system for going about it. Some med schools decide whom to interview according to set minimum GPAs and MCAT scores, and they get criticized for being "stats ******." My school chooses to not set minimum GPA and MCAT scores, but then we have people complaining about how we're not objective enough.

Ultimately, not everyone is going to love you in this world. That's why you don't apply to one single residency program (or med school either, unless you're applying ED). That's why you don't only attend one interview. That's why you don't only rank one hospital. Instead of complaining about how this or that system of choosing applicants isn't "fair," we'd all be better off by educating ourselves about the realities of the system, and adjusting our app strategies accordingly in order to maximize the chance of success.

Sure it's not a perfect system and it's overcrowded, but my complaint is that programs are at first going by this one criterion - board scores - without looking at anything else. This is inappropriate as the exams aren't meant for this purpose.

It also makes life much easier for programs as it effortlessly skims off a considerable number of applications. Aside from the money those candidates paid for applying ($25 per program after a certain # of programs), they are not even given a chance; their work experience, personal statement, LORs, etc, are not even looked at.

 

[winner123]

Sure it's not a perfect system and it's overcrowded, but my complaint is that programs are at first going by this one criterion - board scores - without looking at anything else. This is inappropriate as the exams aren't meant for this purpose.

It also makes life much easier for programs as it effortlessly skims off a considerable number of applications. Aside from the money those candidates paid for applying ($25 per program after a certain # of programs), they are not even given a chance; their work experience, personal statement, LORs, etc, are not even looked at.

When I said the same thing earlier on,I was attacked from my left and right and almost from everywhere.
Thanks, Tetris, for bringing the real issue up again!
Good Luck!

 

[howelljolly]

Sure it's not a perfect system and it's overcrowded, but my complaint is that programs are at first going by this one criterion - board scores - without looking at anything else. This is inappropriate as the exams aren't meant for this purpose.

It also makes life much easier for programs as it effortlessly skims off a considerable number of applications. Aside from the money those candidates paid for applying ($25 per program after a certain # of programs), they are not even given a chance; their work experience, personal statement, LORs, etc, are not even looked at.

Yes, I agree. but what can one do? Some criteria has to be first when PDs are culling the applicant list to give themselves a manageable stack of papers.

So which criterion should be first? USMLE scores? AMG/IMG? Prestige of med school? Which of these are a fair first step to rule out applicants? Which of these factors is the most modifiable? Looks like USMLE score to me.

Nobody has come up with a better alternative. If you can, please do.

Before this thread degenerates again, if youre going to post such comments, please come up with a logical alternative. Otherwise, you're really just whining.

 

[winner123]

Sure it's not a perfect system and it's overcrowded, but my complaint is that programs are at first going by this one criterion - board scores - without looking at anything else. This is inappropriate as the exams aren't meant for this purpose.

It also makes life much easier for programs as it effortlessly skims off a considerable number of applications. Aside from the money those candidates paid for applying ($25 per program after a certain # of programs), they are not even given a chance; their work experience, personal statement, LORs, etc, are not even looked at.

When I put forward the same thing earlier on,I was attacked by everyone here.
Thanks,Tetris,for bringing the real issue up again!

 

[howelljolly]

When I said the same thing earlier on,I was attacked from my left and right and almost from everywhere.
Thanks, Tetris, for bringing the real issue up again!
Good Luck!

Fine, bring up the real issue. But come up with a reasonable alternative. All you two have done is griped and moaned, and not come up with ONE better way to filter candidates.

As I said, there are other possible filters - AMG/IMG, Visa status, AOA status, maybe even graduate degree, and publications...

And there are other possible factors that the PD/PC can look at first - school prestige, even how beautiful you are on your photgraph.

Looking at the Personal Statement or the LORs first is unreasonable because its time consuming, and is related to writing skill (and we are not literature majors)

So, if you can not come up with a more fair First criteria than USMLE scores, leave it at that.

 

[tetris]

So which criterion should be first?

None. They should give every paper in the stack a fair chance, and ideally there shouldn't be numerical scores. There are programs that do look at every application. They assign enough faculty members and split up the work among them.

 

[howelljolly]

None. They should give every paper in the stack a fair chance, and ideally there shouldn't be numerical scores. There are programs that do look at every application.

THAT is complete utter nonsense. One program I interviewed at had received 4500 applications. The smaller programs I interviewed at recieved 2500 applications each. I cant imagine how many applications the larger or prestigious programs have recieved this year.

Programs that claim to look at every applications likely only mean to say that they don't filter, and download every application. Then the Program Coordinator, or perhaps the PD looks at each application for a few seconds. From that point they rule out applications themselves. Sure they LOOKED at every application. And the placed every application with a red flag (like low scores) in the trash.

Whether they LOOK at it or not, every program uses some arbitrary criteria to thin out the stack of applications

 

[winner123]

Fine, bring up the real issue. But come up with a reasonable alternative. All you two have done is griped and moaned, and not come up with ONE better way to filter candidates.

As I said, there are other possible filters - AMG/IMG, Visa status, AOA status, maybe even graduate degree, and publications...

And there are other possible factors that the PD/PC can look at first - school prestige, even how beautiful you are on your photgraph.

Looking at the Personal Statement or the LORs first is unreasonable because its time consuming, and is related to writing skill (and we are not literature majors)

So, if you can not come up with a more fair First criteria than USMLE scores, leave it at that.

Then,wat is the use of a personal statement?
For example,I have overcome my stuttering affliction and I have mentioned it in my PS.But,I don't think there has been any significant change in the number of interviews I have recieved.This because no PD wud have got a chance to go thro' my PS due to ERAS filters.
So, ERAS filters can prevent the application of some applicants with genuine issues from reaching the PDs.
We r humans and not machines.Only a human can understand another human's struggle.
So,wat do u think about it?

 

[howelljolly]

Then,wat is the use of a personal statement?
For example,I have overcome my stuttering affliction and I have mentioned it in my PS.But,I don't think there has been any significant change in the number of interviews I have recieved.This because no PD wud have got a chance to go thro' my PS due to ERAS filters.
So, ERAS filters can prevent the application of some applicants with genuine issues from reaching the PDs.
We r humans and not machines.Only a human can understand another human's struggle.
So,wat do u think about it?

First, there probably is no filter on the CS/CK, because most AMGs havent taken them yet. You probably aren't getting filtered out at all.

Your PS mentions overcoming a speech problem, and how it makes you a more compassionate physician. Thats good and all, but can you guess how many people personal statement mentions how they overcame a personal struggle? Probably most of them. And why assume that a PD should believe that overcoming a personal struggle will make you a better resident? Im not saying that it hasn't, but why should a PD choose you over someone else for that reason?

In other words, why should a PD choose someone who has overcome a personal struggle, that may have affected their CS/CK, when they can take a person who had no struggle, and did great on all the USMLE parts? (I don't remember how you did on the CS). And especially, why should a PD believe that overcoming a personal struggle does indeed build a character trait which makes for a stronger resident? That assumption is less "evidence based" than the correlation between USMLE scores, and inservice and Board exams.

What's equally (or more) likely than what you're assuming is the case, is: The PD is looking at your complete application and seeing an IMG, with a distant graduation date, who had a significant drop between Step1 and Step2. If that isn't enough to reject the application, the PS talks about some personal issue rather than, say, the unique features of your chosen specialty and why they fit you. Is that really what a PD wants to read? An abstract personal struggle, rather than a concrete breakdown of why you want to be an internist?

We aren't machines. We are all humans and we all struggle. While a PD may sympathize with you, you don't want sympathy. You want a job.

 

[winner123]

First, there probably is no filter on the CS/CK, because most AMGs havent taken them yet. You probably aren't getting filtered out at all.

Your PS mentions overcoming a speech problem, and how it makes you a more compassionate physician. Thats good and all, but can you guess how many people personal statement mentions how they overcame a personal struggle? Probably most of them. And why assume that a PD should believe that overcoming a personal struggle will make you a better resident? Im not saying that it hasn't, but why should a PD choose you over someone else for that reason?

In other words, why should a PD choose someone who has overcome a personal struggle, that may have affected their CS/CK, when they can take a person who had no struggle, and did great on all the USMLE parts? (I don't remember how you did on the CS). And especially, why should a PD believe that overcoming a personal struggle does indeed build a character trait which makes for a stronger resident? That assumption is less "evidence based" than the correlation between USMLE scores, and inservice and Board exams.

What's equally (or more) likely than what you're assuming is the case, is: The PD is looking at your complete application and seeing an IMG, with a distant graduation date, who had a significant drop between Step1 and Step2. If that isn't enough to reject the application, the PS talks about some personal issue rather than, say, the unique features of your chosen specialty and why they fit you. Is that really what a PD wants to read? An abstract personal struggle, rather than a concrete breakdown of why you want to be an internist?

We aren't machines. We are all humans and we all struggle. While a PD may sympathize with you, you don't want sympathy. You want a job.

U r wrong. There r filters on Step-2CK and CS as well.This statement shows yur lack of knowledge.Go and do yur homework first before posting anything here.
I have not written only about my personal struggle,but I have presented it in a way which shows how it has affected my choices in medicine and helped me become a better doctor.
Is the personal satement about overcoming a speech problem like any other struggle?It is not so easy as u r putting it.Seems like u r a machine without any human touch.It is yur struggle which make u wat u r.

So, according to u this PS thing is all useless,and there is nothing beyond scores.For u personal struggle carries no weight.If this is so then why do programs even interview applicants if scores r the only criterion for getting into a residency program.

 

[howelljolly]

U r wrong. There r filters on Step-2CK and CS as well.This statement shows yur lack of knowledge.Go and do yur homework first before posting anything here.
I have not written only about my personal struggle,but I have presented it in a way which shows how it has affected my choices in medicine and helped me become a better doctor.
Is the personal satement about overcoming a speech problem like any other struggle?It is not so easy as u r putting it.Seems like u r a machine without any human touch.It is yur struggle which make u wat u r.

So, according to u this PS thing is all useless,and there is nothing beyond scores.For u personal struggle carries no weight.If this is so then why do programs even interview applicants if scores r the only criterion for getting into a residency program.

Dont tell me Im wrong. Dont tell me what I understand, Dont tell me to do homework. Do not tell me what to do before I post here.

I am politely presenting a possible explanation for why you're having trouble landing a residency.

I don't discount personal struggle, what makes you think I do? Don't "so according to you..." me. I am presenting a possible explanation.The mark of an educated person is to be able to entertain an idea without necessarily accepting it - something you apparently cant do.

You know what? I put a great deal of stock in "finding oneself" and "personal struggle" and all that. But guess what, personal struggle is PERSONAL. Maybe if you struggle with residency applications some more, you'll see that in this world, nobody cares. Nobody thinks you're a special little snowflake who has more to offer than the next guy because of some deep personal insight that you might have. A PD would take a scutmonkey over Siddhartha any day. You're there to work, and pass the Boards, not be Mother Theresa

Your "personal struggle" does not make up for the fact that you graduated medical school quite some time ago, and that your Step scores dropped significantly. It simply does not make up for it.

You'll make more sense of why you can't get a residency once you get over yourself.

And the fact is, despite a good Step1 score, you still aren't getting offered interviews. I attempted to offer a logical explanation for why youre having trouble. You can choose not to accept it, and accept the "why don't they love me" attitude that you're taking. But in my personal struggle, Ive come to realize that I find it more useful to accept a logical explanation for my condition than a "they're big bad mean people, and I'm a poor victim" mentality.

I was trying to help. I really dont care about you or your struggle.

 

[Man In White]

I was trying to help. I really dont care about you or your struggle.

Hahah, nice, don't hold back now, tell him what you really think.

Ya, people seem to think they're entitled to something in this world when we are not entitled to anything. Med students are at the bottom of the totem pole. It's why we have to kiss gluteus, say yessir, smile when we want to punch someone and do scutwork.

The programs hold all the cards and they can do whatever they want regardless of whether we think it's fair/right/appropriate/acceptable/<enter synonym here>. We are not in a position to tell them what they should or should not do to choose their residents. All we can do is complain about it which is why this thread has reached the hundreds of posts.

Maybe when you guys become the finest docs in the world you can bring light to this injustice and read the thousands of apps for your residency programs (and then figure out how to rank them all without using cutoffs).

 

[Hassler]

Maybe when you guys become the finest docs in the world you can bring light to this injustice and read the thousands of apps for your residency programs.

LOL. Nice!

 

[Hassler]

So, according to u this PS thing is all useless

To be honest, I think the PS is pretty useless. Everyone writes similar things anyway. The only way it would get noticed is if it's really really outstanding or really bad.

 

[tetris]

Programs that claim to look at every applications likely only mean to say that they don't filter, and download every application. Then the Program Coordinator, or perhaps the PD looks at each application for a few seconds. From that point they rule out applications themselves. Sure they LOOKED at every application. And the placed every application with a red flag (like low scores) in the trash.

Whether they LOOK at it or not, every program uses some arbitrary criteria to thin out the stack of applications

That's much better than clicking an ERAS option to automatically throw away apps with "low" scores (low according to an arbitrary # they decide on, and low based on their incorrect use of the exams' intended purpose).

Large hospitals in large cities need to create large committees to review the large # of applications. Yes, applicants should feel a sense of entitlement to have their applications reviewed after they've invested much time and effort to prepare them, and paid the fee to submit them.

 

[QofQuimica]

Sure it's not a perfect system and it's overcrowded, but my complaint is that programs are at first going by this one criterion - board scores - without looking at anything else. This is inappropriate as the exams aren't meant for this purpose.

So you acknowledge that the system is not perfect and that it's overcrowded, but you want to deny PDs the ability to use a relatively objective method of trying to cope with the overload? What other method of screening do you think is more objective than board scores?

It also makes life much easier for programs as it effortlessly skims off a considerable number of applications. Aside from the money those candidates paid for applying ($25 per program after a certain # of programs), they are not even given a chance; their work experience, personal statement, LORs, etc, are not even looked at.

Well, making life easier for the programs by "effortlessly skimming off a considerable number of applications" is kind of the idea. If you applied to 30+ programs (as evidenced by your paying $25 a program), then you must have known that some programs would screen you out, whether due to your board scores or for some other reason. If you are fair about it, you will also acknowledge that stats, while important, aren't the end-all and be-all of residency apps. Even people with high board scores still get rejected by some programs for other reasons. Conversely, there must be some programs that do not screen people by Step 1 scores, because many people with barely passing board scores still match. Presumably, those programs screen candidates by some other method.

The thing is, you don't know ahead of time which PDs will filter your app out for whatever reason, and you also don't know which ones might invite you in spite of your Step 1 score being lower than their average (if in fact it is). The element of subjectivity in selecting applicants is one reason why it's important to apply to multiple programs no matter how high your boards are. Haven't you gotten some invites that surprised you but then not gotten others that you expected? I think most people would answer yes to this question.

Yes, I agree. but what can one do? Some criteria has to be first when PDs are culling the applicant list to give themselves a manageable stack of papers.

So which criterion should be first? USMLE scores? AMG/IMG? Prestige of med school? Which of these are a fair first step to rule out applicants? Which of these factors is the most modifiable? Looks like USMLE score to me.

Nobody has come up with a better alternative. If you can, please do.

Before this thread degenerates again, if youre going to post such comments, please come up with a logical alternative. Otherwise, you're really just whining.

Agree completely.

None. They should give every paper in the stack a fair chance, and ideally there shouldn't be numerical scores. There are programs that do look at every application. They assign enough faculty members and split up the work among them.

True, in a perfect world, this would be the ideal. But as things currently stand, with many programs receiving dozens or even hundreds of apps for each slot, it's simply not realistic for their PDs and faculty to read through each one.

Then,wat is the use of a personal statement?
For example,I have overcome my stuttering affliction and I have mentioned it in my PS.But,I don't think there has been any significant change in the number of interviews I have recieved.This because no PD wud have got a chance to go thro' my PS due to ERAS filters.
So, ERAS filters can prevent the application of some applicants with genuine issues from reaching the PDs.
We r humans and not machines.Only a human can understand another human's struggle.
So,wat do u think about it?

USMLE scores are a screening tool for some programs, not a decision-making tool. Once you get past the first screen, *then* people will start combing through other aspects of your file, such as PS, LORs, etc. So it's not that these things don't matter at all. They just don't matter the most to some programs that choose to screen by board scores.

We aren't machines. We are all humans and we all struggle. While a PD may sympathize with you, you don't want sympathy. You want a job.

Pretty hard to argue with this.

I would add that what some of you really seem to be arguing or upset about is the fact that life isn't always fair. Well, we're all adults here; it's time to put away the fairy tale books. Everyone gets the short end of the stick sometimes; that's just the way it is. As I said before, use what knowledge you have of the system and the resources available to you so that you can maximize your chances of success. These arguments about "what should be" are wasting your time and distracting you from focusing on "what is."

Best of luck to all of you.

 

[thesauce]

Tetris and Winner: how do you think the exam would need to be changed to be suitable for ranking applicants?

 

[Man In White]

Yes, applicants should feel a sense of entitlement to have their applications reviewed after they've invested much time and effort to prepare them, and paid the fee to submit them.

Hah, you're simply deluding yourselves then. Sorry, bud, you may have invested a lot, but no one owes you anything .. least of all the selection committees.

 

[Man In White]

Tetris and Winner: how do you think the exam would need to be changed to be suitable for ranking applicants?

Basically, all that would need to be changed is the little statement by the NBME from "We do not recommend using the USMLE for ranking" to "We do recommend using the USMLE for ranking."

Just like the MCAT. No rhyme or reason .. simply an arbitrary endorsement.

 

[NotAProgDirector]

None. They should give every paper in the stack a fair chance, and ideally there shouldn't be numerical scores. There are programs that do look at every application. They assign enough faculty members and split up the work among them.

I applaud your idealism. However, be careful what you wish for. Here's the scoop -- programs often receive 10x more apps than interview slots they have. They will have to find some way to choose whom to interview. If there are no USMLE scores, programs will find something to use.

What would we use?

LOR's: USELESS. All LOR's tell me that the person is in the top 5% of everyone the LOR writer has ever worked with.

Transcripts/MSPE: Useful for USMG's, useless for IMG's.

PS: Useless. How do I know you even wrote it? if you knew that I used it as a major determinant of whom was given an interview, how likely would you be to pay someone to do it for you?

This experiement has been tried before, both in medicine and other fields. And what becomes most important once some sort of objective measurement is removed is .... whom you know. An LOR from someone I know is much more valuable than one from someone I don't know. Going to a famous school becomes paramount. In the current system if you go to the "worst" medical school and then get a 260 on step 1, I would believe the Step score and not your "pedigree".

As you mention, we are all humans and not machines. A machine would review your entire application, score everything, weight everything, and decide whether to interview you or not. A human will look for a shortcut.

Thanks for finally explaining why retakes aren't allowed. But these reasons don't explain why numerical scoring is used, rather than making it pass/fail.

There are several other threads on this subject. Summary is this: The USMLE did want to switch to P/F with their next "reboot". Med school deans wanted it P/F also. PD's were strongly against it, as were most IMG's (since a stellar USMLE score opens doors). I think the bottom line is this: if the USMLE was changed to P/F something else (run by the NBME) would replace it. You'd then get the pleasure of spending $1200 on each step of the USMLE and then spend a similar amount on some sort of "high stakes shelf exam". There would be one for each field of medicine, so if you're applying for rads you'd probably need to take the IM exam (for your prelim) and the rads exam.

So, no matter what, exams and #'s will be part of the application process.

 

[exPCM]

I applaud your idealism. However, be careful what you wish for. Here's the scoop -- programs often receive 10x more apps than interview slots they have. They will have to find some way to choose whom to interview. If there are no USMLE scores, programs will find something to use.

What would we use?

LOR's: USELESS. All LOR's tell me that the person is in the top 5% of everyone the LOR writer has ever worked with.

Transcripts/MSPE: Useful for USMG's, useless for IMG's.

PS: Useless. How do I know you even wrote it? if you knew that I used it as a major determinant of whom was given an interview, how likely would you be to pay someone to do it for you?

This experiement has been tried before, both in medicine and other fields. And what becomes most important once some sort of objective measurement is removed is .... whom you know. An LOR from someone I know is much more valuable than one from someone I don't know. Going to a famous school becomes paramount. In the current system if you go to the "worst" medical school and then get a 260 on step 1, I would believe the Step score and not your "pedigree".

As you mention, we are all humans and not machines. A machine would review your entire application, score everything, weight everything, and decide whether to interview you or not. A human will look for a shortcut.



There are several other threads on this subject. Summary is this: The USMLE did want to switch to P/F with their next "reboot". Med school deans wanted it P/F also. PD's were strongly against it, as were most IMG's (since a stellar USMLE score opens doors). I think the bottom line is this: if the USMLE was changed to P/F something else (run by the NBME) would replace it. You'd then get the pleasure of spending $1200 on each step of the USMLE and then spend a similar amount on some sort of "high stakes shelf exam". There would be one for each field of medicine, so if you're applying for rads you'd probably need to take the IM exam (for your prelim) and the rads exam.

So, no matter what, exams and #'s will be part of the application process.

This reply sums things up nicely.

 

[Ariee]

Dude - you have been arguing about this since nearly a month now. Seriously, dont you have better things to do? Even if you were right, there is no one here agreeing with you. So who are you out to convince? Or are you just enjoying occupying a little more of cyberspace everyday? No one here seems to be listening to you, so if you really want to devote your time to this, why not take it up with the NBME/ERAS/association of program directors of whichever specialty you are applying to?

This thread has gone over a 100 posts, and the only thing you seem to be doing is making a fool of yourself. And you didnt even start out like that. You just made a comment, people told you to stop, you didnt, and look where you are.

So just stop, and stop occupying more space.

Mods - it seems this thread has run its course, and the only thing that seems to be happening is bashing up this guy, who clearly does not seem to know when to stop. So lets just close it, unless someone has something else to add.

Agree

I don't know .. I've gotten a few chuckles out of this thread in the last week or so.

Agree

Heh, likely for different reasons.

Agree

[agonal breathing]

Agree

I applaud your idealism. However, be careful what you wish for. Here's the scoop -- programs often receive 10x more apps than interview slots they have. They will have to find some way to choose whom to interview. If there are no USMLE scores, programs will find something to use.

What would we use?

LOR's: USELESS. All LOR's tell me that the person is in the top 5% of everyone the LOR writer has ever worked with.

Transcripts/MSPE: Useful for USMG's, useless for IMG's.

PS: Useless. How do I know you even wrote it? if you knew that I used it as a major determinant of whom was given an interview, how likely would you be to pay someone to do it for you?

This experiement has been tried before, both in medicine and other fields. And what becomes most important once some sort of objective measurement is removed is .... whom you know. An LOR from someone I know is much more valuable than one from someone I don't know. Going to a famous school becomes paramount. In the current system if you go to the "worst" medical school and then get a 260 on step 1, I would believe the Step score and not your "pedigree".

As you mention, we are all humans and not machines. A machine would review your entire application, score everything, weight everything, and decide whether to interview you or not. A human will look for a shortcut.



There are several other threads on this subject. Summary is this: The USMLE did want to switch to P/F with their next "reboot". Med school deans wanted it P/F also. PD's were strongly against it, as were most IMG's (since a stellar USMLE score opens doors). I think the bottom line is this: if the USMLE was changed to P/F something else (run by the NBME) would replace it. You'd then get the pleasure of spending $1200 on each step of the USMLE and then spend a similar amount on some sort of "high stakes shelf exam". There would be one for each field of medicine, so if you're applying for rads you'd probably need to take the IM exam (for your prelim) and the rads exam.

So, no matter what, exams and #'s will be part of the application process.

Thank you, this made me feel all warm and snuggly inside...

 

[AnesCoord]

To be honest, I think the PS is pretty useless. Everyone writes similar things anyway. The only way it would get noticed is if it's really really outstanding or really bad.

Mostly the PS isn't worth much, but it is good to check spelling, grammar, etc. It's amazing how many people will submit them without using the spell-check function! That, I think, is evidence of your attention to detail. (Or maybe OCD!)

 

[howelljolly]

Mostly the PS isn't worth much, but it is good to check spelling, grammar, etc. It's amazing how many people will submit them without using the spell-check function! That, I think, is evidence of your attention to detail. (Or maybe OCD!)

I feel like thats another disconnect between intended purpose and ultimate utilization. The applicant writes it with some idea that they want to get across - some skill, ability, interest, or experience they have which doesn't appear elsewhere on their application. Rather than use it for that purpose, the programs use it to check the applicant's proofreading skill. While, a majority of the residents writing takes the form of:

HEENT - NCAT PERRLA EOMI MMM
CVS - RRR (-)M/R/G LCTAB
ABD - SFNT (+)BS
EXT - FROM DTR 2+x4
CNS - (-)FND CN2-12 WNL AOx3

Ambien 5mg PO QHS

The residency selection process is flawed and meaningless, and everyone tries to find meaning and usefulness in each part of it even when there is none. The alternative is to admit that it's meaningless, and have a freeforall.

 

[AnesCoord]

The residency selection process is flawed and meaningless, and everyone tries to find meaning and usefulness in each part of it even when there is none. The alternative is to admit that it's meaningless, and have a freeforall.

But for now it's what we've got to work with so until there's something better, we have to figure out a way to make it work best. We can argue all day about how USMLE scores should be used, if there should be retakes, should it be just P/F...someone's always going to disagree. I, for example, disagree with retakes. It's a test you knew you had to take, nobody waited till yesterday to tell you the test would be today, and I'm sorry if your tummy hurts, but you know it or you don't. Yes, your personal statement is intended to provide some special detail about you, but if you don't bother to spell-check that tells me you might be sloppy in your work habits too.

Someone is always going to complain about a system that relies on individual opinions (is "outstanding" better than "stellar" in an LOR? Is a "B" at this school as good as an "A" at that one?) If it were a point system and 1000 points meant you're in, the person who scored 999 would compain it's not fair. As long as somebody doesn't win / match / pass / or whatever, that somebody will find fault with the system.

 

[tetris]

Tetris and Winner: how do you think the exam would need to be changed to be suitable for ranking applicants?

Tough question. I'm not a test writer and I don't know if there's a difference between admissions and licensing test questions. But think about this: should there be an admissions process for residency training? Haven't we already gotten admitted to med school, finished our course of study, passed our classes and licensure exams, and graduated? Why do we have to go through a second admissions process?

Of course, the answer is that there are so many applicants and not everyone can get a PGY-1 spot. I understand that. But the fact remains that it's not really an admissions process, and the test isn't an admissions test. Just something for you all to think about.

 

[howelljolly]

Tough question. I'm not a test writer and I don't know if there's a difference between admissions and licensing test questions. But think about this: should there be an admissions process for residency training? Haven't we already gotten admitted to med school, finished our course of study, passed our classes and licensure exams, and graduated? Why do we have to go through a second admissions process?

Of course, the answer is that there are so many applicants and not everyone can get a PGY-1 spot. I understand that. But the fact remains that it's not really an admissions process, and the test isn't an admissions test. Just something for you all to think about.

Of course thats not the answer. That fact does not remain.

Maybe its because programs are different? Some are in General Surgery, some are in Dermatology, some are in Family Practice, some are in Pediatrics....etc? Some are clinically oriented, some are academic, some are research focused. Some want book-smarts and high inservice scores, some dont care for that.

How will the program know if you fit their institution without having and admissions process like this? How will you know if you would like to work there, and if your learning style fits with their teaching style without this process?

 

[ResidentMD]

Tough question. I'm not a test writer and I don't know if there's a difference between admissions and licensing test questions. But think about this: should there be an admissions process for residency training? Haven't we already gotten admitted to med school, finished our course of study, passed our classes and licensure exams, and graduated? Why do we have to go through a second admissions process?

Of course, the answer is that there are so many applicants and not everyone can get a PGY-1 spot. I understand that. But the fact remains that it's not really an admissions process, and the test isn't an admissions test. Just something for you all to think about.

That is not the answer, at least not for Internal Medicine.

The answer is because -
1. A ton of people want to live in NYC/Boston/SFO but there are an X number of spots in those places
2. A ton of people want to train at "prestigious" programs, and there are only an x number of seats.

I can assure you, if you demonstrate the competence that you demonstrated in order to get into med school, you would get a PGY1 spot somewhere (possibly other than "ROAD"). Its when "how high you want to go" when the selection process comes into the picture. Then why shouldnt such programs also want to go high as well? If you want to go to a "premier institute", why shouldnt that program use its own defined criteria to pick the cream of the crop? And so what is wrong if "these programs" use a cutoff of 240 and above on step 1 for screening candidates?